In recent issues, the Postgraduate Medical Journal has explored the concept of specialty care in the community. With the present drive towards providing local, specialised care for patients with chronic diseases the need for a new type of specialist is self-evident. Such specialists will need to be based in the community and, in addition to delivering treatment, they will be expected to promote healthier lifestyles. Clearly, an organised approach to health improvement is critically important in an age when obesity, sexually transmitted diseases and cardiovascular diseases are major sources of morbidity. Education of patients is a core element of successful treatment, but educating people so as to prevent the development of illness is a much more effective approach.

During the 21st century, clinicians with a specialist interest will need to take proactive steps to help ensure a healthy population. For the vast majority this will be a new aspect of their work, but one that is ideally suited to a professional practice based in the community.

This issue of the Journal brings together comments from leading politicians and the Chief Medical Officer. Their combined views confirm the need for a new approach to specialist care and treatment—one that will be flexible and based in the community.