There are seven key principles in the care of patients with chronic illnesses which are fundamental in offering an appropriate service and adequate care for these patients. These are the principles that should underlie the setting up and management of any primary health care service endeavouring to treat patients with chronic illness. They determine how one understands the care of such patients and how to organise a service or practice. These principles are discussed in this article and will provide both the right mindset and the right organisational approach for effective chronic illness care.