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The concern of this paper lies with empowerment of middle managers in a community health trust. It considers the impact of traditional structures and cultures upon the level of decision which middle managers are empowered to make. The conclusion reached is one which suggests that the level of discretion available to middle managers was one of making task‐orientated decisions rather than decisions about strategic change. However, even this was compromised by financial constraints and by “best practices” imposed by the personnel function.

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