ABSTRACT
This chapter discusses the methods used by the case managers to achieve the substitution. It explains their work with informal carers and their direct recruitment, deployment, supervision and support of care helpers. Most of the cases with a high level of social care received it from members of their family. Only a few of the cases without family support had substantial levels of informal care. The evidence of the community care project suggests the interdependence of the organisation of social care, the handling of specific and complex social and psychological difficulties, and the mobilisation of community resources. The substitution of low for high-cost inputs is a central feature of the logic of the community care approach; one of the main features which could make the investment in more efficient and equitable care self-financing. Differences in National Health Service costs were entirely due to the greater use of acute facilities by community care cases.
