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This paper describes the first year of a national programme supporting implementation of one of the key policy initiatives forming part of the programme of health reform in England, practice‐based commissioning (PBC). The paper presents an audit of service redesign initiatives based on the first six months' work of 27 sites in the first wave of the programme, and discusses the early practical learning about the implementation of PBC by both participants and stakeholders. The role of the programme in facilitating two‐way links between policy development and practical implementation is highlighted, and the development of the programme, and other parallel learning routes, to meet the emerging needs of particular groups in relation to practice‐based commissioning is described.

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