This chapter focuses on the study of three hospitals in the process of a Trust merger. Fieldwork concentrated primarily on seeing the merger through the eyes of a developing directorate, the Critical Care Directorate. The directorate incorporated intensive care, accident and emergency, theatre and chronic pain services. The researcher’s main access to this process was the observation of directorate meetings, initially between all head nurses and directorate management, and later involving clinicians. This was supplemented by interviews, particularly with those associated directly with intensive care. Whilst the prime focus of this research is the intensive care service, this chapter aims to analyse the success of the merger process by tracing its effects across the directorate.