One of the disappointing features that emerges from the report is the slowness of movement out of institutions and the build-up of services in the community. We have arrived at a sea change in approach. Recent decades have seen a movement out of large psychiatric hospitals and into the community. Community services used to be seen as outreach services from the hospital. That was right and proper at the time. Now, however, we should reach the point where we see hospital services and consultants based in the community, and the acute hospitals, the in-patient facilities, as providing backup for the community services, rather than the other way around.