This new Council Report replaces the College's previous position on community care, Caring for a Community, published in 1994 (CR36). Its aim is to summarise the College's views on the core components of humane and effective community care for adults of working age with mental illness. It reflects the significant changes in the UK context over that time — both the increasingly critical stand taken by some politicians and interest groups, and the welcome emphasis on clinical governance and evidence-based practice enshrined in the recent National Service Framework (NSF). This report has evolved alongside the NSF, and covers much of the same ground. Some of the terminology will have changed but we have retained terms (such as keyworker — instead of care coordinator) that were in current use during our deliberations. It does not deal with issues of training or workforce planning because these are considered elsewhere.

We have tried to strike a balance between being comprehensive and being focused. Colleagues have told us that they would like some concrete figures and proposals to work around, both to aim at and to use in local discussions. This has inevitably involved judgement and selectivity about the content. Not all these judgements can be supported by research findings but we have consulted widely. Despite the prescriptive style of some of these suggestions they in no way deny the importance of local circumstances or the need for local sensitivities and adjustments.

This is a clinically-led document. We believe that psychiatry, working closely with our partners (members of the wider multi-professional mental health team, social services and the users of the service and carers), should take an active lead in the continuing development of community services. We should neither back off from them nor adopt a reactive stand to externally driven policy.