Wales is a small country with a strong political focus on social justice. The national strategy promotes service integration and community-focussed care but there has been limited progress. Costs are rising and there is a reliance on a medical model that increases dependence on services.A community orientated model defines 60 local areas for the development of primary and community care services. Local clinical leadership and community engagement has delivered a variety of local solutions (expanding the roles of primary care nurses, community pharmacists, physiotherapists, mental health teams and allied health professionals).  Fraternity is a key enabler – bringing professionals together to share experience and develop common goals. The national policy places a high value on equality, but the system is slow to change. GPs have a growing desire for 'liberty' – to allow more rapid local problem solving and decision making.The Wellbeing off Future Generates Act requires public bodies in Wales to improve social, economic, environmental and cultural wellbeing but also to think long-term, ensuring that future generations benefit from actions taken now. This requires cultural change, prioritising informed choice and measuring value for the individualLarge healthcare organisations tend to centralise decision making, to gain a sense of 'control', particularly when there are workload and financial pressures. We are working to increase confidence in a more localised approach, negotiating the freedom for primary care teams to fully utilise their unique expertise.A Primary Care Model for Wales has demonstrated the potential of local partnerships, to achieve greater equity and deliver a sustainable approach. With small local budgets teams can explore new approaches that are specifically tailored to their context; however, the full potential of this approach will not be achieved without greater freedom to act locallyPrimary care clinicians in Wales have structures that support fraternity, providing time and resources to develop solutions to improve equity. However, without more freedom to act they will be unable to deliver the ambition of our national commitment to future generations.