Since 2010, there has been growing interest in understanding how reforms to public financial management (PFM) systems can support improvements in spending on basic services. This paper takes stock of the emerging agenda on PFM and service delivery by asking what’s new, what’s missing and what (should be) next? It looks mainly at the way the agenda has played out in relation to health services, where there has been more sustained attention and research than for other social sectors such as education or social protection, before considering the prospects for a broader public finance agenda on service delivery in the final chapter.