The PCG tool kit Second edition By Roy Lilley Radcliffe Medical Press 144 pages £30

Quick! Must get this review written and published before Roy Lilley gets a third edition out.

The pace of change in the NHS, as well as the production speed of the publishing industry, are well reflected in this update. The first edition sold 10,000 copies, crows Lilley, who battles valiantly to keep abreast of the tide of Whitehall paper. The foreword, by Michael Dixon, was written in January and elements of the book focus on 'go live' day, 1 April 1999.

So, is it past its sell-by date already? Not really, although some primary care groups will be further forward, depending on their origins.

The formula is simple: lots of blank spaces (it's a workbook), checklists lifted wholesale from NHS Executive guidance and an irreverent running commentary from the cheeky chappie himself.

Flip through the pages, he invites - and with only a contents page and no index it's the only possible approach.

It is nicely done on 144 A4 pages with nice little icons, boxes and a clean and inviting layout. It really is difficult not to start scribbling in it.

The power of the book, and the skill and craft of the writing, lie first in setting up the light-hearted atmosphere and the relaxed chatty style and then the solid punch of those exercises. It's the old one-two. Jab with the left and hook with the right.

Rate on a scale of one to 10 the level of enthusiasm shown by your GPs for PCGs.

Consider how to consult with service users and providers and draw up an action plan.

Devise a mechanism for reporting clinical governance objectives and results to the PCG board.

Like all good consultants, the author has the knack of asking focused but open questions. Tackling these really will help your PCG.

Sometimes the flood of creativity and vision is overwhelming - and some of the ideas are stunningly simplistic. Do you want to really understand social services? Try putting yourself in their shoes and plan to hit some of their targets. Five are listed on page 52.

Working in partnership really is about consciously and openly tackling issues of power. Under lead commissioners, the author reminds us, there are some ego issues here - you know, the little things, like who's the boss.

The subsequent exercise helps us to think through the different perspectives, and examine our own conscience.

Make a list of primary care services that could be better led by social services. What are you prepared to let go?

Finally, while there is a lot of simple, practical, do-it-yourself stuff here, the author is at his best when reminding us of the strategic.

The strongest part of the book is the powerful message about the shift from level two to level three: that is, from a PCG - a subcommittee of a health authority - to a primary care trust - a body with statutory responsibilities.

Arrangements for accountability will be the key, as will a clear understanding of the roles of the board, the chair and the chief executive.

The author is pretty sure that not all chief executives will be able to make the transition. But I'm pretty sure that those who do will have worked their way through a lot of this book.

Tim Scott

Fellow, British Association of Medical Managers.