Managers' leaders, health unions and GPs this week welcomed new guidance from the government on the future shape of primary care commissioning.

The NHS Executive guidance on primary care groups states they will operate legally as committees or sub-committees of health authorities.

HAs will have ultimate responsibility for establishing PCGs, which will cover populations of around 100,000. But proposals for PCG configurations should emerge from discussions between HAs, GPs, nurses, other health professionals, community and acute trusts, and social services.

PCG leaders must meet a 12-point set of criteria, including wider public health needs, local consultation and working relationships between primary care and social care professionals.

HAs must notify the NHS Executive of local PCG configurations by July.

Shadow PCGs should be set up to prepare for going live in April 1999.

Their functions will include staff appointments, governing arrangements, and smooth transition from fundholding or local commissioning.

Appointments must be subject to fair and open competition, but priority should go to fundholding and health service staff with relevant skills or qualifications.

HAs and GPs are urged to engage community nurses in configuration decisions.

Royal College of Nursing community health adviser Lynn Young said she was 'utterly thrilled, ecstatic and happy' with the 'very strong message from the NHS Executive'.

NHS Confederation chief executive Stephen Thornton described it as 'an example of how the Department of Health can provide very useful advice, particularly when it listens to the service'. He was glad to see the 'very clear and firm reference to the role of community nursing'.

Manufacturing Science and Finance union health secretary Roger Kline said he was pleased that staff appointments must be subject to equal opportunities and that GPs alone could not decide what PCGs would do.

Unison national officer Roy Paterson welcomed the specific references to the involvement of community nurses and other groups. But he was concerned about jobs for the fundholding staff who would be displaced.

A spokesperson for the National Association of Comissioning GPs, said it would support the guidance, which was 'in line' with its own policies.

The New NHS: modern and dependable - establishing primary care groups. HSC 1998/065.