In summary therefore, I believe Community/Mental Health Trusts must: Work closely with purchasers/contracts in context. Focus local services in GP surgeries or own homes. Dispose of unnecessary estate. Concentrate on what they do best. Meet customer needs, improve customers' perceptions and market and publicise services. Cut out restrictive professional practices and increase staff flexibility, information systems etc. Develop customer relations, contracting, business planning. Identify ¿niche' (minority/specialist) markets (including social care). Develop active Quality Assurance, Clinical Audit, outcomes, research programmes. Create effective organisation and management style (Empowerment, delivery). Minimise costs (Value For Money, minimise internal expenditure, rationalise estate, streamline management). Maximise income. Build alliances. Develop user empowerment, advocacy etc. Finally, whatever the future holds we must keep our eye on the ball - the patient - and ensure their needs are paramount over professions and organisations.