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The paper attempts to examine the development of Primary Care Groups in the NHS, utilising a conceptual framework taken from relationship marketing. In particular, it looks at a framework representing the complex relationships between the Primary Care Group and a diverse range of internal and external stakeholders and the implications of these relationships. It reports the preliminary findings of an ongoing, in‐depth case study of two Primary Care Groups; with data collected from in‐depth interviews with a small number of key stakeholders. The results, so far, suggest the importance of developing and maintaining longer‐term relationships with a range of partners, both internal and external. It recommends that Primary Care Groups should develop strategies to work closely with these stakeholders, as an essential underpinning to developing continuous improvement in performance, quality and “user” retention.

The purpose of this paper is to explore the application of marketing in health care, and in particular to assess its relevance to clinical leadership in the UK NHS.

The paper discusses a marketing perspective using literature and policy material.

The paper suggests that a marketing perspective is relevant in the UK NHS. Health service reforms have created a market in which choice and competition are levers for improving performance. Central to this is the notion of patient choice. Marketing is a way of exploring these issues. The paper suggests that there may be resistance to ideas originating from the private sector, and this needs to be overcome.

Marketing offers a framework and a set of techniques with which to improve organisational performance and ensure a focus on quality in meeting the needs of the patient. The new payment‐by‐results funding system ensures that money follows patients. Providers will need to focus on quality to attract patients and track resulting funding streams.

The paper demonstrates that private sector methods and techniques are relevant in the public sector, although one must take into account differing contexts.

Examines managerial effectiveness in the NHS, in particular the effectiveness of the clinical director. Based on a qualitative study of an NHS Trust hospital case study, utilizes a social cognitive perspective to analyse the data and draw conclusions. Uses the data to suggest a possible framework for examining the effectiveness of individual directors. The framework may be relevant to other messages, particularly those in professional service organizations. It may also be used as a diagnostic tool to assess these managers. The framework is grounded in the perceptions of the interviewees at the Trust: both clinical directors and managers.

Suggests that there is a need to explore managerial public sector effectiveness given its complexity and subjective nature. Argues the case for a multi‐perspective approach to public sector effectiveness, based on specific, inter‐related perspectives. Chooses these perspectives based on their ability to contribute to an explanatory framework focused on the features of effectiveness. Concludes that managerial effectiveness is essentially about understanding, reinterpreting and making sense of differing role expectations, which the framework developed will hopefully help in developing.

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.

Reviews the role of the clinical director in the NHS, based on data collected in a qualitative research study. Utilizes role theory to invite insight into a relatively new but important managerial role. Suggests that effectiveness in the role may be measured by the extent to which managers are able to meet the expectations of their role set, and also that the overall effectiveness of the clinical direction may be the extent to which he or she is able to influence, adapt, modify or change these role expectations.

Evaluates a competence‐based management development programme for a public sector client. Utilizes qualitative methodology to gather data about the impact of the programme on participants′ behaviour and skills. The focus is a large city council, and the participants are from a varied occupational background, e.g. careers, environmental health, social work. Concludes that while behavioural changes are evident, there is also continued merit in the more traditional academic aspects of development.

Focuses on organizational change in a “first wave” NHS trust hospital. Examines the experiences of a group of clinical directors at this hospital as they respond to external pressures to change, instigated by recent Government policy. Analyses qualitative data, collected via in‐depth interviews with the clinical directors, using psychoanalytic concepts and theory.

Briefly examines the organizational context of the clinical director in the NHS. Utilizes theoretical contributions from cultural, symbolic, political and postmodernist perspectives and applies these to the experience of clinical directors. Discusses the importance of understanding individual subjective views of meaning as represented in purposive/cognitive maps. Concludes that the clinical director should be able to diagnose the subjective views of organizational participants as a basis for understanding individual/group behaviour.