Values, rather than structures and frameworks, should guide the overall activities of PCTs.

The PCT must both support innovative practice and feel supported in being an innovative care provider.

Individual and organisational incentives must be aligned with the PCT's objectives.

Local participants must drive innovation and use available flexibilities, including the Primary Care Act.

Time will be needed to develop complex new webs of local relationships.

Expect PCTs to develop at differing paces; this is natural and should be expected.

There may be lessons to learn from the private sector, particularly in relation to the development of quality management processes and the application of clinical governance.

Local people have a right to be informed and engage in shaping PCTs and the services they deliver or commission.