Review

A vision not very clearly shared

SHARED CARE: a model for clinical management
Peter Edwards, Stephen Jones, Dennis Shale, Mark Thursz
Radcliffe Press, 1996, £18.50

Shared care seems to be much talked about but practised with difficulty. It causes confusion and misunderstanding and is an area of enormous differences of opinion. I was hoping this book might bring some clarity. Unfortunately I feel more confused than before I read it. I began to wonder if it was directed at policy makers rather than coal face workers but it clearly states that it is ‘an important vision of future health to GPs’, such as myself.

The book says its purpose is to examine current developments in shared care, describe and promote a model for shared care, and offer a vision of how shared care could be developed in future. It starts relatively well with a description of current aspects of shared care. There were some useful insights and suggestions, but the later sections on modelling and different approaches are complicated and inaccessible. There is no highlighting or summarising of important points. Occasional insights are there, but buried in turgid pages of complicated concepts.

It seems strange that ante-natal care, one area where shared care has worked, is only given a glancing mention towards the end of the book, and drug dependency, where shared care has been mentioned as a way forward in several government and medical documents, does not even get off the starting block. Likewise HIV infection and chronic mental health problems — other domains which are looking at shared care — remain unexplored.

The book ends with a section called ‘Implementing shared care schemes’. I am engaged in doing just that at present, but sadly the book offered very little help to me.