Nearly 25 000 general practitioners currently remain nonfundholders1 (Scottish Office and Northern Ireland Office, personal communication). They include those who find the prospect of fundholding unacceptable, impractical, or irrelevant but who remain committed to securing the highest quality care possible for their patients.2 Both the General Medical Services Committee3 and the Royal College of General Practitioners4 have encouraged general practitioners to use the internal market to the benefit of their patients, and participation on commissioning or advisory groups has provided opportunities for translating these ambitions into action.

The Nottingham Non-Fundholders Group was formed to make the best use of the opportunities provided by the purchaser-provider system to benefit patients; on p 930 members describe its formation and early achievements.5 It is not alone; the recently formed National Association of Commissioning General Practitioners identified 42 groups after a single letter to the BMJ.6 Those expressing …