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Abstract
The new white papers on primary care present opportunities for general practices to extend and develop their services to patients. These could enhance professional roles within practices and lead to new partnerships with secondary care, community health services, and social services. Two examples of new services are outlined: a practice led proposal to develop an integrated service for people with learning disability across a whole district, and a community health trust's contribution to extended primary care in an inner city area. For patients, the potential advantages of the reforms include more comprehensive and more integrated care in the community. The possible pitfalls of changing contractual arrangements include threats to the gatekeeping function of the referral system and, more fundamentally, to the central role general practice currently has in primary care in the United Kingdom.
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