There are three challenges for pandemic planning by general practice. First, there is no systematic framework for planning this sector's response. Preparing for health threats and emergencies is an essential function of public health, but is not core business for general practice. Second, the way in which ambulatory health services will interact with each other and with the broader health system response to a pandemic is unclear. General practitioners (GPs) in Canada [7] , Australia [8] and the UK [9] have expressed uncertainty about how to participate in such a response. Third, planning and implementing changes for pandemic influenza across the health system is complex. Although there is little evidence linking specific preparedness activities to effective system-wide responses to pandemic influenza [5, 6] , change management theories point to a need for dynamic partnerships between general practices and other ambulatory care services, hospitals and public health departments [10] . The strength and structure of these linkages vary around the world, depending on decentralisation processes, the regulatory and legal system, and financing within health systems [11, 12] . Although general practice, or family medicine, is organised differently in different countries, there is considerable potential for transferable learning at the meso-level of management planning [11] .