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This article presents the views of board members from two primary care groups in South West England on benefits and concerns relating to the imminent development of primary care trusts, and perceived implications for service delivery and management arrangements.

Considers the changes which are being implemented in primary care, and the patterns which are now beginning to emerge. Examines the changing context within which practices now function (both political and managerial), and considers the power which GPs are beginning to exert, as well as the impact which they may have on the interface between primary and secondary care. Examines the systems being developed for assuring quality in general practice. Predicts an explosion in the need for appropriate information for management and for medical audit in UK primary care, because the context within which general practitioners (GPs) deliver primary care in the NHS is changing rapidly. It is only now becoming evident that this turbulence may well offer major new opportunities to GPs, as well as permanently altering the balance of power in the NHS between primary and secondary care.

The paper attempts to examine the development of Primary Care Groups in the NHS, utilising a conceptual framework taken from relationship marketing. In particular, it looks at a framework representing the complex relationships between the Primary Care Group and a diverse range of internal and external stakeholders and the implications of these relationships. It reports the preliminary findings of an ongoing, in‐depth case study of two Primary Care Groups; with data collected from in‐depth interviews with a small number of key stakeholders. The results, so far, suggest the importance of developing and maintaining longer‐term relationships with a range of partners, both internal and external. It recommends that Primary Care Groups should develop strategies to work closely with these stakeholders, as an essential underpinning to developing continuous improvement in performance, quality and “user” retention.

This conceptually‐focused paper looks at particular changes implemented in the UK National Health Service. The specific context is the creation of a new organisational form: the primary care group, which brings together general practitioners and other primary care staff in a given locality. The paper attempts to examine the consequences, for the development of these groups, of the shift from competition (in the internal market) to relationships based on collaboration and partnership. The broad policy objectives envisage much greater emphasis on working in partnership, participating in strategy and planning (via new health improvement programmes), developing joint working, and promoting the integration of service delivery. A relationship marketing perspective is explored as one way of conceptualising the development of new relationships between primary care groups, health authorities, local authorities, trusts and other agencies and the paper suggests that relationship marketing offers a way of facilitating policy change.

Many patients referred by their GP for an assessment by secondary mental health services are unlikely to ever meet eligibility thresholds for specialist treatment and support. A new service was developed to support people in primary care. “the authors evaluate” whether the phased introduction of the Lambeth Living Well Network (LWN) Hub to a population in south London led to: a reduction in the overall volume of patients referred from primary care for a secondary mental health care assessment; and an increase in the proportion of patients referred who met specialist service eligibility criteria, as indicated by the likelihood of being accepted in secondary care.

The evaluation applied a quasi-experimental interrupted time series design using electronic patient records data for a National Health Service (NHS) provider of secondary mental health services in south London.

Scale-up of the Hub to the whole of the population of Lambeth led to an average of 98 fewer secondary care assessments per month (95% CI −118 to −78) compared to an average of 203 assessments per month estimated in the absence of the Hub; and an absolute incremental increase in the probability of acceptance for specialist intervention of 0.20 (95% CI; 0.14 to 0.27) above an average probability of acceptance of 0.57 in the absence of the Hub.

Mental health outcomes for people using the service and system wide-service impacts were not evaluated preventing a more holistic evaluation of the effectiveness and cost-effectiveness of the LWN Hub.

Providing general practitioners with access to service infrastructure designed to help people whose needs cannot be managed within specialist mental health services can prevent unnecessary referrals into secondary care assessment teams.

Reducing unnecessary referrals through provision of a primary-care linked mental health service will reduce delay in access to professional support that can address specific mental-health related needs that could not be offered within the secondary care services and could prevent the escalation of problems.

The authors use NHS data to facilitate the novel application of a quasi-experimental methodology to deliver new evidence on whether an innovative primary care linked mental health service was effective in delivering on one of its key aims.

The purpose of this paper is to explore the nature and value of the clinical management role undertaken by primary care doctors in Ireland. To date, a majority of research has focused on clinical management roles in the acute sector.

The paper presents a sub‐set of data from a mixed methods study. In total, 14 semi‐structured interviews are drawn upon to identify the nature and value of the clinical management role in primary care.

Comparison with acute sector research identifies considerable differences in the nature of the clinical management role across sectors – and in the associated value proposition. Structural and role‐related contingencies affecting the potential value of clinical management roles in Irish primary care are discussed. Structural influences include the private ownership structure, low complexity and limited requirement for cross‐professional coordination. Role‐related influences include the primacy of the clinical identity, time constraints and lack of managerial training.

The findings provide a limited basis for generalisation, premised on 14 interviews in one national context. However, given the international shift towards the provision of health services in primary care, they provide a research agenda for an important healthcare context.

The findings draw attention to the need for policy consideration of the value of the clinical manager role in primary care; how policy can support effective primary care management; and the need for specialised management training, which takes account of the small‐firm context.

The paper identifies that primary‐care clinical‐management roles focus on operational management and oversight and discusses the structural and role‐related factors which affect their efficacy.

There is evidence that the mental health needs of people with learning disabilities are not adequately met. Primary health care is seen as the way forward to ensure full consideration of psychosocial factors in the promotion of health care. The agenda for action includes improving mental health through general health promotion, surveillance and care. This paper explores how this evidence is being translated through professional and national policy initiatives into innovative mental health of learning disability services that build bridges between primary and specialist services and ensure a comprehensive strategy to meet the mental health needs of people with learning disabilities.

The issue of “out of hours” provision of primary care services by family doctors has excited particularly marked debate in the UK. This article considers the implications for this debate of results from a project designed to elicit the views of users of out of hours primary care provision. Focus groups were used to gauge definitions of “out of hours” services, factors governing the use of some services rather than others and influences on the evaluation of different options. The centrality accorded by patients to the social dimensions of a more “traditional” relationship with family doctors was central to the selection and evaluation of alternative provision. Any significant initiative in the reconfiguration of local health care services might thus be regarded as much a social enterprise as a technical challenge based on the most equitable and efficient application of resources.