ABSTRACT
This chapter argues that although the new structural arrangements are in line with current organisational thinking about decentralised decision-making, the implementation process has been problematic. It examines the opportunities and challenges facing these fledgling organisations as they set about four key tasks. These are developing the multi-disciplinary Board of 18 members into a cohesive team, setting priorities for the Local Health Group (LHG), creating a corporate identity and developing working relationships with stakeholder agencies. The chapter describes the policy and organisational contexts within which Local Health Groups have been established. The relationship between these new organisations (LHGs) and existing holders of the territory, for example Local Medical Committees, is also potentially difficult. The chapter concludes with recommendations for further organisational development activity to help LHGs perform their new roles effectively to begin to meet the challenge of improving the health of their local populations.
