New health authorities (HAs) (post-April 1996) face the challenge of delivering highquality health care for their residents. This creates management challenges in both primary and secondary care settings. This paper describes an innovative initiative in primary care and, in particular, explores the management challenges facing HA managers working with GPs as selfemployed contractors in the development and successful implementation of the initiative. Since the 1990 reforms (the purchase/provider split) district health authorities (DHAs) had to achieve quality in secondary care through contracting. The Patient's Charter served as a guide to expectations. The focus of much quality activity since has been on waiting times and clinical effectiveness. The main management challenges for HAs have been: encouraging ownership of quality, developing monitoring and information systems, and involving consumers. Management tools have been straightforward: selecting contract types, using 'carrots and sticks', identifying preferred providers, disinvestment, publishing league tables, etc. The relationship between HAs and general practice as providers is different and certainly more complex than with secondary providers. New HAs have inherited GP contract administration from family health service authorities (FHSAs). The core GP contract requires minimal quality commitments, and the Patient's Charter sets minimal expectations. Main management challenges will be: encouraging self-employed contractors to improve service quality without formal contracting leverage and with minimal monitoring, improving both clinical and service quality, resourcing environmental and infrastructure improvements, achieving more equitable resource distribution and addressing specific human resource issues in general practice, e.g. overwork, low morale, recruitment, support for single-handed practices. Management tools will be more participative working, locality management, sharing protocols and guidelines, a focus on accountability, supporting education and audit, identifying agreed performance indicators, management through comparison, tackling variation and creating new incentives. Since 1992, Essex FHSA and then South Essex HA have worked alongside general practice to improve quality using the 'goals' process. Goals is a standards-based quality improvement programme. In 1992, Essex FHSA launched 'Goals for Practice 1995', a set of 38 standards for all general practices in Essex. Mainly, the standards focused on practice administration and service quality issues. The process was driven by three inspection visits (end 1993, 1994 and 1995), delivering significant improvements (mean score for practices improved from 69 to 90% achievement of standards; at the end of 1995 80% of practices had achieved 90% of goals, 29% had achieved 100%). Early in 1995, South Essex HA began developing 'Goals for Practice 2000'. From lessons learned and to meet additional requirements, partly pre-empting recent health White Papers, it differed in some substantial ways. First, it was expanded to include clinical and prescribing standards, standards were made more discriminating and were more widely negotiated at the outset. To encourage ownership the programme also became voluntary, but with rewards for practice achievement. Following its launch in November 1995 the Goals 2000 programme is bedding down with gradual uptake across South Essex practices. The paper outlines early feedback on the launch and progress to date.