Abstract
Most health systems in developed countries have been designed to ‘cure’ acute episodes rather than to ‘manage’ chronic conditions. New models of chronic care provision have been developed to respond to the changing burden of disease and there is already considerable practical experience in terms of policies and pilot studies focused on testing their feasibility. Applying a framework that identifies and analyses ten key prerequisites to achieving high performing chronic care-based health care systems, we find that the design of the Spanish NHS already meets some of these pre-requisites. However, other features are still in their early stages of development or are being applied only in limited geographical and clinical contexts.