- This paper aims to support primary care groups (PCGs) planning to develop local services for older people and carers. It provides a comprehensive overview of current policy developments and draws on the wider literature to discuss the likely issues and challenges that PCGs will face in reshaping services for their older population. The report concludes that services for older people and carers are still in need of improvement. Fragmentation, lack of alternatives to hospital care and negative attitudes towards older people are just some of the issues highlighted in the paper. But it is also clear, given the current policy climate and earlier experiments with primary care commissioning, that PCGs may now have the opportunity to make a real difference to the health and well-being of older people and carers if they can generate the enthusiasm, ambition and local influence to drive strategic change. The paper is published as part of the King's Fund's PCGs and older people project.