It is good to read of the work of Dr de Silva and his colleagues in South Tyneside. ^{Reference De Silva1} They are seeing people at an impressive hit rate and providing a service which people like. As in Gnosall, the model being used takes advantage of primary care settings. I think the difference is that we provide expertise within primary care, with a view to a potential three tiers (primary, secondary, tertiary), ^{Reference Jolley, Greaves, Greaves and Greening2} whereas de Silva is describing a secondary tier outreach. The advantage of Gnosall, which has been demonstrated now over nearly 9 years, is that continuity of support and integration of care are facilitated and sustained. ^{Reference Greaves, Greaves, Walker, Greening, Benbow and Jolley3,Reference Clark, Moreland, Greaves, Greaves and Jolley4} Great stuff though: people are catching on!