Planning and implementing change across the health system is complex. Targeting individual sectors for change (e.g. public health departments, hospitals or general practices) without securing reciprocal changes and strengthening inter-relationships across the health system, is unlikely to succeed [10, 18] . Planners must consider how connectivity across the health system might be strengthened to enable optimal use of general practice resources for planning [68] . While this may be challenging, particularly in countries with weak governance structures for primary health care, omitting general practice input into the planning process may be considered unethical [69] and counterproductive.