This study will evaluate the needs and provision of care for patients in the late stages of Parkinsonism and their carers in several European countries. This will done through an in-depth assessment of patients and carers, interrogation of national and regional databases, and assessment and outcome of management strategies in six European countries. We will compare the effectiveness and cost of different health and social care systems, and carry out a trial comparing assessment by a specialist with management suggestions, guidance and access to telephone advice to that of usual care. A systematic literature review of the evidence for effective management strategies, analysis of the study data, and evaluation of change in outcomes following specialist review will provide the basis for recommendations in the management of late stage Parkinsonism. In addition, the project will produce a platform for the assessment of patients with late stage Parkinsonism, their current treatment and care provision, as well as guidelines on the management of this late disease phase. The results may also provide a model for the research on better management of other chronic neurological disorders and age-related disorders in various health-care systems.