Refractory angina affects approximately 5-10% of patients with angina. Sufferers are significantly disabled by their symptoms, which are made worse by fears about what is happening to them. They are frequent attenders in GP surgeries, hospital outpatient departments and emergency admissions units. Patients who take part in an Angina Management Programme (AMP) that provides education, stress management and relaxation feel better, live longer and are able to avoid unnecessary invasive tests and palliative revascularisation procedures. AMPs can be effectively commissioned and delivered in primary care.