This review examines broad issues of concern regarding the primary/sec
ondary care interface. The main purpose was to identify areas of good
practice which could be adapted for more general use. One of the most
fundamental aspects identified was communication, which is discussed i
n some detail. Also covered are shared prescribing and disease managem
ent. The data suggest that the most effective system(s) of shared care
has yet to be established. Further qualitative and economic evaluatio
ns are required, taking into account patient preferences. Although the
literature does describe certain practice exemplars, it is clear that
inter- and intra-professional communication continues to be a problem
. Whilst information technology may provide some of the solutions, it
is concluded that a culture change, which compels health professionals
to make sharing of patient information a much higher priority, is req
uired.