An alternative model for case management in Flintshire.

This article presents and reviews the evidence from a local service that has been developed in order to meet the predicted rise in the level of chronic disease in Wales. Three nurse case managers have been proactively working with surgeries in Flintshire (North East Wales) for the past two years to introduce a case management approach for the patients from those practices. Using data for the 12 months before and after the case managers intervention for each patient, the service appears to reduce emergency admissions, by a median of 1 emergency admission per patient and reduces length of hospital stay by a median of 2 days.