Quality improvement is a necessary exercise for any developing organisation. With the changes currently taking place in the NHS, particularly the relocation of services from secondary care to primary care, it is vital that general practice nurses (GPNs) are able to review and make improvements to their practice. This article reviews the policies that are changing the landscape of primary care, examines the benefits of quality improvement initiatives and provides an exemplar of an effective quality improvement training programme. The author argues that the NHS cannot meet the healthcare needs of the population without a sustained and comprehensive commitment to effective quality improvement as its principal strategy.