Current reasons for admission Rapid deterioration and need for ventilation.

Some admissions related to non-compliance with medication.

Some admissions related to another chronic illness.

Changes envisaged by 2008 Primary care to play a more active role in case management.

Increased availability of equipment in primary care and the community.

Increased patient empowerment - for example, antibiotics and equipment in the home.

Improved drug therapy - for example, steroids without side-effects.

Trends in incidence Difficult to forecast. Increased pollution could increase incidence, but will environmental controls have an impact?

Impact of health promotion - similarly difficult to estimate.

Scenario for 2008 Increased role in primary care.

Acute admissions to reduce by about 70 per cent.