- In recent years, new health care delivery initiatives have emerged that promise to overcome some of the long-standing difficulties that hinder the various parts of the NHS from working efficiently and effectively together. These include national service frameworks, care pathways and NHS Direct. However, their full implications have yet to be thought through, and while some may remove the barriers between health organisations and professionals, new barriers may take their place. This publication takes a fresh look at the structure of health care delivery in the UK. It provides an overview of the historical development of the NHS to date, and in so doing raises the question of what an ideal health service should look like. It also covers new ground in proposing an innovative conceptual framework that describes health care delivery systems in a new way, and draws out the implications this framework has for service users, health professionals and policy makers.