In 1990 and 1991, 67 practice nurses with a total of 12,725 consultations took part in a before and after study of health board attached and practice-employed nurse workload. The intervention of the New General Practitioner Contract (DoH 1989) and other primary care changes in April 1990 provided an opportunity to examine the process of care, and identify and changes in workload or differences in working patterns of attached and practice-employed nurses, as a result of these modifications. Practice-employed nurses initiated more of their own appointments following implementation of the New Contract and saw fewer GP referrals. Routing treatment room work had decreased for both groups of nurses in the second year. Both groups of nurses had also increased their level of therapeutic listening in the second year, but practice-employed nurses reported higher levels of therapeutic listening than their attached colleagues during both recording periods.