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The UK National Health Service is undergoing a radical period of change. The changes represent a massive challenge and opportunity for those who manage healthcare in the UK. South East Thames Regional Health Authority′s programme for developing their top managers for future roles in the National Health Service is outlined. A competencebased approach is described, using development centres to identify individual needs. The focus of the programme is on helping individuals to recognise and effectively use the development opportunities that already exist in their organisation. The author has managed this programme since its inception in September 1990 and summarises the research process used to identify competence models for executive roles, and the aim and structure for the development centre. Some issues and learning evolving from this ongoing management development programme are introduced. South East Thames are encouraging hospitals to develop the learning organisation concept with the intention that learning opportunities are created for individuals while the organisation is transformed as a whole.

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