ABSTRACT
This chapter briefly examines the ways in which healthcare is managed by the devolved governments of the United Kingdom. There is a commitment across the four nations to integrate primary and secondary care provision, aiming for a smoother transition for patients between the two, but more importantly trying to reduce hospitalisation by anticipating potential problems and providing support services to prevent admission. The 'Expert Patient' programmes were a catalyst for this shift of emphasis. These programmes were designed to enable people to become more confident in making educated decisions about their condition and their care. Community nursing services are central to the management of the health needs of an ageing population within primary care. Community nursing services generally were fragmented with no standard framework for calculating workload or caseload allocation. Community nurses must ensure that they are involved in the decisions about how services will be developed at the strategic level.
