Much of the care given by healthcare providers around the world on a day-to-day basis can be described as ‘reactive’: people who think that they are ill present to a healthcare provider for a diagnosis and treatment. However, growing numbers of people with an established chronic disease need a different form of care, care that is structured and proactive. On a regular basis and following an agreed plan, they need to participate in regular review of their underlying chronic condition and its complications. The concept of regular review for control and complications is explicit in a number of the existing national and international statements on chronic disease care. Roger Gadsby calls for the implementation of systems which offer ways to improve chronic disease care, and looks to the example of developments in the structure of diabetes care in the UK.
chronic disease, non-communicable diseases, UK National Service Framework for Diabetes, pay-for-performance schemes, guidelines