Explored primary care-led commissioning (PCLC) in the National Health Service in England and in Wales, and aimed to set these in the context of NHS changes since 1991. PCLC is understood here to mean the process of arranging the whole range of health care services (acute, community, primary), either by providing services directly or by commissioning them from other providers. Topics include: commissioning; changes in the NHS and performance targets; administrative structures of Primary Care Trusts and Local Health Boards; effects of commissioning on the roles of general practitioners and other health care professionals; the role of Patient and Public Involvement in health care commissioning. To obtain a free account please register with the UKDA.