Chronic disease management is a key component of all nursing care whether directly working within a 'chronic disease speciality' or providing emergency or acute care. This book is practical, clinically orientated and provides a step-wise approach to developing a service based upon the needs of the patient. It uses the example of rheumatology to highlight common clinical issues for nurses who wish to develop a chronic disease nursing service. The first chapter of the book provides a brief overview of how nursing has developed, the changing workforce and how government bodies and policies should be considered when planning the development of a service. The second section provides a framework for the development of extended roles within nursing and guides the nurse through the process of preparing a business proposal, setting up a telephone helpline service, nurse led clinics and how to select appropriate assessment tools. The final section discusses more advanced and innovative developments for nurses. These include the role of leadership and clinical governance in service provision and team working, nurse led joint injection clinics, the value of blood monitoring clinics, the nurses' role in understanding immunology in relation to chronic disease and the use of new cytokine therapies.