This paper examines the potential for managed care techniques to develop in the UK National Health Service. It begins with a review of managed care approaches but no attempt is made here to review the wealth of material on managed care in the USA. The reasons for attempting tighter management of care and the main tools used are examined. Existing elements of the managed care approach in the NHS are then examined and the need and scope for further use of managed care tools in the NHS are explored. Finally, the potential contribution of the private sector to care management is discussed.