Most Read Article – The NHS and Community Care Act, 1990: Recent government policy and legislation

The NHS and Community Care Act, 1990: Recent government policy and legislation, The Psychiatrist (1994) 18: 13-17

Graham Thornicroft, Sentor Lecturer

PRiSM, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, Consultant Community Psychiatrist, Maudsley Hospital, Denmark Hill, London SE5 8AZ


The National Health Service and Community Care Act, 1990, enacts some provisions contained in the Working for Patients and Caring for People White Papers. The former measures were introduced immediately in 1990 and contain, for example, the legal basis for NHS trusts and fund-holding GPs. Most of the community care sections of the Act were delayed in their implementation until April 1993. The key element is allocating the main coordinating responsibility as ‘lead agency’ to local social service authorities; they are charged with conducting ‘needs assessments’ on clients presenting with problems. Whether, however, there is a legal obligation upon social services departments to provide care for people with unmet needs is not yet clear.

Lancashire Care staff can request the full-text of this paper, email:

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