Improving disease management in the United Kingdom: what can be learned from U.S. experience?

Chronic diseases are a large and growing burden for health services. The British National Health Service is set up in a way that has many advantages in the management of chronic diseases, but lessons from U.S. managed care plans show that several changes could be implemented to improve the efficiency and effectiveness of care for patients with chronic conditions. These include the introduction of limited market competition; financial incentives, particularly across primary and secondary care; increased patient self-help; and improved clinician-manager relationships.