BMJ  2004;328:220-222 (24 January), doi:10.1136/bmj.328.7433.220

Education and debate

Rethinking management of chronic diseases

¹ Health Policy, King's Fund, London W1G 0AN

Recent organisational changes to the NHS are bound to affect the care of patients with chronic diseases. But will they help or hinder?

The first 150 words of the full text of this article appear below.

Chronic disease represents a huge burden of ill health in the United Kingdom and a large cost to the NHS. Yet for many years government policy has focused on improving access to elective care. Recently, attempts have been made to improve the management of selected chronic conditions through the introduction of national service frameworks together with the associated activity of the NHS Modernisation Agency and the national clinical directors. But the NHS still has no agreed model for managing all chronic diseases. We aim to stimulate debate by suggesting some basic ingredients of good management of chronic diseases and examining how recent policies might influence their development and implementation in the NHS in England.

Workers in chronic care have tried to develop a consensus on the basic ingredients of a model of good management for chronic disease. One model that has gained widespread credibility in the United States is the . . . [Full text of this article]

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