A structured programme of care for patients with established coronary heart disease was established in 2003 and delivered in the primary care setting. Known as Heartwatch, it involved twenty percent of the country’s General Practitioners, and aimed to reduce morbidity and mortality among the cohort of patients enrolled in the programme. It adopted a multidisciplinary approach with GPs, practice nurses, and health promotion staff working in partnership with the patient to achieve the optimum outcome. Favourable results were shown for certain risk factors such as control of blood pressure and cholesterol with little change in areas such as weight and exercise levels.  This programme in 20% of practices continues. Decisions about expanding secondary prevention programmes await legal and contractual discussions.