Considerable management challenges must be faced in order to ensure the successful operation of primary care groups (PCGs). The insights to be gained from those involved in total purchasing pilots (TPPs) are likely to prove valuable in informing the development of PCGs, and workshops were held to capture some of these. The TPP evaluation revealed that organisational arrangements were key to the success of the pilots. PCGs are to be larger and more complex than TPPs and face additional challenges in developing corporate identity and common vision. It was generally felt that problems with managing an organisation covering populations of 100,000 or more would be resolved by developing a hierarchical model involving sub-groups within the PCG. The workshop participants' key messages are: it will take time to succeed; it will take resources to manage successfully; and, first class information technology is essential.