From my limited pilots side of things.
For you to get a VMC climb/decent against, you have to tell the procedural controller that your visual with the traffic he is separating you against and give him some hint that its the right one. Normally they will have one coming in on an advisory route and one going out. Hence the "on the nose"
If you give it to him in one call, his next call will be to the other aircraft asking if they will accept a VMC climb/decent against you. Unless its another pilot used to operating in and out those types of fields they won't have a clue what the controller is on about. But usually accept it because the controller has offered it.
As you pass each other with a wave the procedural controller then transfers you over to a scottish area controller who is usually abit pissed off because all his separation alarms have gone off because 2 IFR aircraft with a scottish squawk have been within 1 mile of each other at the same altitude.
Does that sound about right Niknak?