Considerable documentation is available to explain the theory of fund-holding, and this should be consulted for more detailed guidance on fundholding issues. This chapter outlines some of the practical issues relevant to fundholding. It explores the responsibilities of a fundholding practice. Assessment of health needs is vital for the effective deployment of health service resources. A preparatory year fee is available to practices who wish to become fundholders. Once a practice has been approved as a fundholder, it is entitled to an annual management allowance, subject to a maximum reimbursement, to permit the practice to manage its fund effectively. In order to gain fundholding status, practices have to demonstrate that they have the capability to operate the fundholding software. Data collection is the essential first step in calculating the hospital services element of the fund. Negotiation is an important element in the establishment of relationships, particularly those of the practice with its providers.