The Primary Care Reference Design Project aimed to provide value for money lessons and performance measures for health and social care. The project involved developing designs for new service agendas through dialogue and engagement with stakeholder groups. The designs were developed to meet quality expectations established by the government while also being delivered within affordability constraints. The proposals were not intended to be used as strict templates, as the diversity in scale and nature of projects being commissioned would make this impractical. The publication includes replicable ideas and elements from the designs to support learning and establish clear expectations for the quality and affordability of the resultant proposals.