Over the last two, possibly three, decades there was a gradual and perhaps insidious move for psychiatric care from primary to secondary or tertiary care.

There is now a conscious and deliberate effort to move psychiatric care to primary care (where possible) which has several advantages. In one London Borough (Newham) we have discharged 500 patients from secondary to primary care and preliminary findings show satisfaction with this. However, future Commissioning Management may be based upon the changes.

We hope to describe the reasons behind such changes, the advantages and disadvantages of this change and a study showing more.