A PCT requested myself and a colleague to run a programme to redesign the process of booking patients in for community services eg long-term conditions management (it covered all services delivered in PCT buildings). Involving staff, stakeholders and service users revealed that the overall community service could be run more cost-effectively, and more appropriately for service users at the same time supporting healthcare staff, by devolving administration to the community buildings rather than centralising. The PCT was extremely pleased with the result.