The DHSS funded three development workers to work in three differing health authorities to explore the possibilities for improving primary health care in the inner city by developing patch or locality management and planning of services work more closely together; and to establish three local experiments with different approaches to patch working and to document these. Three districts were Islington, Riverside and Lewisham, and North Southwark. This report is the result of the brief to research and document the progress towards decentralisation in Lewisham and North Southwark.