This chapter considers the principles of community development (CD) and its relation with primary care more closely, and offers examples of this in practice. CD is fundamentally about ways of bringing about change through the empowerment of local people and communities. There is no shortage of opportunities for Primary Care Trusts and primary care professionals to get involved in strategic and practical initiatives for health improvement, for example in Local Strategic Partnerships. Organisational development is recognised by the Department of Health as an important dimension of community development. The Community Health Project in Waltham Forest developed out of a partnership between the local Housing Action Trust, the health authority and local residents in 1994. Balancing out community development, service delivery and strategic partnership work has been a major challenge as the project has grown, and been buffeted by the external changes in the NHS.