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Griffiths in theory and practice: a research assessment.

This paper focuses upon one of the major recommendations of the Griffiths Report: the appointment of general managers at each level in the NHS. It is based on a study of a sample of 20 district general managers (DGMs) who had been followed for a year to 18 months at the time this paper was written. Their first major task was to restructure their districts; some of the variations in these structures are described, together with what happened to officers from different professional backgrounds, and the reactions of the doctors, nurses, and paramedics. The ways in which the DGMs sought to change the culture of the NHS are outline. A number of major ongoing dilemmas are identified. The study suggests what the learning needs are of present and future general managers.