In 1986 the King's Fund, with the financial support of the DHSS, established three experimental projects in inner London to explore the possibilities for improving primary health care by developing small scale management and planning of services. One of these projects was located in Riverside HA. This report describes how the Riverside project was set up and documents in detail one particular initiative - the Pimlico Patch Committee - an experiment in which statutory and voluntary providers and service users were brought together and given a say in planning for their locality, The report is divided into chapters, following the development of the patch committee chronologically; describes how the experiment was reviewed after 6 months and how it has progressed since.