In June 2003, GPs (family doctors) in the UK overwhelmingly (80%) supported a new contract which has been hailed by some as the biggest change in their employment terms since the NHS was founded in 1948. As well as being paid for ‘essential’ services which are the ‘core’ activity of a GP’s daily work, GPs would be paid for quality of care in relation to chronic disease and the organisation of care. In addition, it has been recognised that this new contract could enable GPs to provide and be paid for ‘enhanced services’ traditionally confined to hospitals and so formalise the concept of GPs with Special Interests (GPswSIs).