Applying the evidence: guidelines in primary care.

General practice has faced a tremendous workload challenge in meeting the National Service Framework targets. For the first time, the new General Medical Services (GMS) contract links practice remuneration to diagnosis and management of chronic diseases; in particular, it offers practices a significant financial incentive to undertake management of cardiovascular disease. However, in order to undertake the work and meet the targets, particularly those relating to management of blood pressure, serum lipids, and glucose, primary care teams will have to approach cardiovascular disease in a highly systematic manner. Much of the work is likely to fall upon practice nurses. While many in primary care have been reluctant in the past to invest in future health gain, the new GMS contract offers a good opportunity to change that way of thinking.