ABSTRACT
This chapter examines the organizational and governance arrangements put in place by primary care groups and trusts in England over the period 1999-2004, using this as the basis for distilling lessons for researchers and practitioners about the design, implementation and evaluation of effective governance arrangements for primary care organizations. Consideration is given of the growing sophistication of organizational forms adopted by primary care organizations, and the associated increase in bureaucracy and management costs associated with running PCG/Ts. This development of PCG/Ts as larger and more complex organizations is seen to be a consequence of their expanding remit, and the fact that they have evolved from local GP-run and – developed organizations into statutory NHS bodies largely operating in accordance with national agendas and priorities.
