Published: 13/05/2004, Volume II4, No. 5905 Page 20 21

The Department of Health has mapped out a five-year plan for the NHS. It includes new public service agreements on chronic disease management and a 2.5 per cent efficiency saving target. What do you think of the new measures?

Chronic disease management is an NHS priority whose time has come. In Shropshire and Staffordshire, we have launched an initiative called Extending Choice in Diabetes.

It is part of our strategy to offer a range of educational and clinical support services to promote self care and management in pursuit of the fully engaged scenario seen in the original Wanless report.

It will be interesting to see whether there is shared learning between mental health models of care/recovery for people with enduring mental health problems, and the primary care model of the 'three Rs' (registration, review and recall) for people with conditions such as asthma, diabetes, heart disease or arthritis.

It is difficult to tell what sort of public service agreement target will demonstrate effective CDM.

It is far from clear what impact payment by results will have on CDM. It seems likely performance-based reimbursement will still see resources sucked into hospitals, especially foundation trusts.

Vanessa Barrett, head of strategy, Shropshire and Staffordshire strategic health authority

It is good to see CDM moving to the centre of government health policy. In relation to 'improving the patient experience', though, I can see the usual problems of how to measure success.

Overall, there is a danger that NHS staff are going to become disillusioned with yet another plan - one comment I've already heard is: 'What about the 10-year NHS plan?

It is only four years old.'

Steve Gulati, director of HR and organisational development, Leicester City West PCT