title: Service developments for managing people with long-term conditions using case management approaches, an example from the UK.
abstract: BACKGROUND
  This research has considered current developments in the provision of services for people with long-term conditions within the NHS of England. Community Matrons are being employed and by adopting a case management approach they are aiming to improve patient care and reduce their demands for acute hospital care.
  
  
  METHODS
  Qualitative research was undertaken to explore experiences of community matrons and service leads on the development, implementation and provision of services for people with long-term conditions.
  
  
  CONCLUSIONS
  This research provides evidence of what is being done to meet the challenge of long-term conditions and provides lessons for similar challenges and service development for different areas of care and in other countries. Continual system and role change has had effects on service delivery and on the whole care. These effects relate to; defining the role of community matron and structure of service, training staff, identifying patients, providing infrastructure, demonstrating benefits, identifying gaps in services, ability to reduce avoidable admissions and identifying the advantages and difficulties of the role.
  
  
  CONCLUSIONS
  All of these aspects should be used to inform future development.
authors.affiliation: Research Institute for Public Policy and Management, Keele University, Keele, Staffordshire, ST5 5BG, UK.
authors.forename: Michelle
authors.initials: M
authors.lastname: Russell
authors.forename: Brenda
authors.initials: B
authors.lastname: Roe
authors.forename: Roger
authors.initials: R
authors.lastname: Beech
authors.forename: Wanda
authors.initials: W
authors.lastname: Russell