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The article examines and comments on the development of clinical management at an NHS hospital Trust. It utilises a qualitative case study methodology to collect data from key stakeholders at this Trust. The data suggest some of the reasons why doctors may be receptive or non‐receptive to the notion of clinical management. It recommends that attention is focused on the specialty context as a key factor in influencing the development of clinical management. It also suggests there may be other important factors, for example: training; the role of change agents; structure of clinical directorates; and individual factors such as cognition, attitudes and motivation.

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