title: Improving the quality of primary care.
abstract: BACKGROUND
  This paper considers the role of teaching primary care trusts (tPCTs) at the turn of the century. A retrospective evaluation of a complex intervention is used. The evaluation has three perspectives. These are (1) a commentary on tPCTs in health policy in England, (2) the authors' reflections as senior members of a tPCT in Northern England and (3) a look-back exercise with tPCT members.
  
  
  RESULTS
  It outlines the achievements and reflects on the experience of the tPCT and its relationship with its stakeholders. The resultant themes and challenges experienced by the tPCT members working at their organisational boundaries with their stakeholder both provide organisational developmental insight for the emergent primary care commissioning groups (Health and Social Care Bill 2011) and highlight the continuing need for organisational cultural change within general practice.
  
  
  CONCLUSIONS
  Quality criteria for acceptability, accessibility, appropriateness, equity, clinical effectiveness and cost-effectiveness can only be truly addressed by a learning organisation approach. This was one of the original remits for tPCTs.
authors.affiliation: University of Central Lancashire, Preston PR1 2HE, UK. PMilne@uclan.ac.uk
authors.forename: Paul
authors.initials: P
authors.lastname: Milne
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Coyne
authors.forename: David
authors.initials: D
authors.lastname: Pilgrim
mesh_terms: D003362:Cost-Benefit Analysis; D004739:England; D006291:Health Policy; D006297:Health Services Accessibility / Q000458:organization & administration; D006801:Humans; D011320:Primary Health Care / Q000191:economics / Q000458:organization & administration* / Q000592:standards; D058996:Quality Improvement / Q000458:organization & administration*; D012189:Retrospective Studies; D013222:State Medicine / Q000458:organization & administration* / Q000592:standards