Many changes in community care in the UK are currently under way, prompted by the 1990 National Health Service and Community Care Act. Final implementation was in 1993, but the full impacts are still working their way through. The 1990 Act aimed to alter four balances: between institutional and community-based care;between supply-led, provider-dominated services and needs-led, purchaser-dominated services;between NHS and local government responsibilities for decision-making and funding; andbetween public and independent (voluntary and private) sector provision.
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