Innovation and personalisation are driving the policy debate on primary care services. Realising patient choice, out-of-hours access, new delivery models such as walk-in centres and successfully implementing practice-based commissioning are the new challenges facing clinicians and managers in the NHS. Taking into consideration the recommendations of the Darzi Report and the CBI report - Just what the patient ordered - the government’s plans to make the NHS more responsive and accessible to patients through better commissioning were discussed. The issue of how competition will operate in encouraging new models of care provision into the system and raising standards was also considered. This conference was an opportunity for representatives from across the public, private and voluntary sectors to discuss how to make the new commissioning environment work effectively in the interests of equitable access, patient outcomes and value for money for the taxpayer.