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This book describes some of the innovations in the care of theelderly which took place in and around Birmingham in the late1970s and early 1980s. The book focuses on one care group andone place; but despite this, or perhaps because of this, itclaims to have more than local or specialist interest. It de-scribes the fine detail of innovation, and the interaction ofone change on another. It is about innovation and how thisis perceived; and about change and how this is achieved. Itshould be helpful to would-be innovators in other fields andin other locations.

There were several reasons why this flurry of innovationin the care of the elderly took place in the West Midlands inthe late 1970s. These included: the social pressure of agrowing number of old people in need; the political desira-bility of being seen to be doing something about it; theeconomic need to make more effective use of limited resources;the opportunities provided by specially designated funds; andtwo major attitudinal shifts – from institutional to communitycare, and from service-orientated to client-orientated provi-sion. Against this background active people with good ideasseized the chance to do something.