Parkinson’s disease (PD) is a progressive neurological disorder affecting at least 120 000 persons in the UK today. Age is the most potent risk factor. With the rising numbers of elderly, PD will become an increasingly important cause of disability and mortality. This has significant implications for health planning.

In recent years, there has been growing emphasis on the key role of the specialist clinic, interdisciplinary team and the PD specialist nurse in the management of the condition, as well as recognition that quality of life for people with PD and their carers relates to more than motor disability and disease severity. Appropriate care planning requires skilled assessment, and a new paradigm, incorporating four progressive clinical management stages (diagnosis, stable maintenance stage, complex stage and palliative stage) may be useful. The importance of all these aspects to successful holistic management of PD should be emphasized but is beyond the scope of this review, as is diagnosis, which is the subject of a separate contribution.