ABSTRACT
In comparison to the stability of general practice over the previous 25 years, the years since 1989 have brought unremitting change not least in the terms of the General practitioners (GP) contract, the development of fundholding and the development of new styles of management by Family Health Service Authorities (FHSAs) and health commissions. In one county the FHSA and District Health Authorities (DHA) were coterminous and came together in one building under one Chief Executive; in the other county, three health commissions were created in three DHA areas and incorporated various aspects of the FHSA's functions. The new health authorities also need to do all they can to promote the development of effective practice management. This may not be achievable solely through the provision of education and development opportunities. The workshop discussions repeatedly revealed the paucity of empirical research evidence on the rapid changes occurring in the organization of practice-based primary care.
