ABSTRACT
Often people complain that the NHS is only good for acute care, but for chronic care, it tends to fall down. Which appears to be a gross generalisation. As a regular user of the service, it appears that the NHS is doing very well under extreme pressures. The current model of primary care does not work well and needs to change by creating community centres where specialists come regularly to carry out investigations or therapeutic interventions. Hospitals are essential for advanced surgical diagnostic medical care, but services for the long-term management of many conditions are needed too. Follow-up of patients can be in the community not necessarily in hospitals. A group of generalists who had special training in cardiovascular disease, or cancers, or respiratory disease, infectious diseases or mental health could be based in the community, and they can go on to create a network of specialist generalists, and based in the community, they will be better able to manage complex long-term co-morbid conditions. Often, there seems to be reluctance from the medical staff to change because of status which needs to be addressed.
