ABSTRACT
This chapter explores the reasons and ways in which doctors are becoming involved in increasing numbers and in ever more sophisticated roles in management within the National Health Service (NHS), despite a long period of reluctance to do so. Doctors remained free from any significant involvement in management for the first 40 years of the NHS, almost enjoying self-employed status. Clinical needs of individual patients have thus historically provided the focus for doctors' decision-making, and by making decisions for patient care management doctors have always contributed in some way to the 'management process'. Clinical needs of individual patients have thus historically provided the focus for doctors' decision-making, and by making decisions for patient care management doctors have always contributed in some way to the 'management process'. The emphasis on doctors acquiring clinical leadership and management skills is evidenced by the introduction of the Medical Leadership Competency Framework.
