Strategies for improving chronic illness care: some issues for the NHS

Chronic illness is the predominant disease pattern today; however, healthcare systems have been slow to adapt. This paper describes a number of strategies to enhance chronic illness care, now often termed ‘care for long-term conditions’, including targeting, prior authorization, guidelines, profiling, financial incentives, gatekeeping, subcapitation, case management, information systems, interdisciplinary teams and end-of-life care. It compares how such programs have been implemented in the UK, under the NHS framework, and in the USA.