ABSTRACT
This chapter examines some proposals to overcome gaps between promise and performance and outlines the essential features of a Year of Care (YoC) programme. It discusses how this might be applied in systematising the design, commissioning and delivery of services to people with long-term conditions as well as informing the 'time specified' care plan that they have negotiated with primary care-based service providers. The aim has been to devise structures and methods that meet the defining features of primary care (continuity, coordination, and comprehensiveness) and provide guidance on how services should be configured to the benefit of improved quality of care, improved quality of life, and increased cost-effectiveness. Individualised year (case, care and/or health) plans will be developed as an individual with a long-term condition as principal negotiates an agreed year plan (case, care and/or health) with service providers (the agents).
