Introduction. Where are we now? The NHS in the mid-1990s. An introduction to priority setting in the NHS. What is NHS purchasing, and where is it going? Marketing and the NHS. Casemix, coding and contracting: a beginner's guide. Shared care or integrated care? Managing clinical services for chronic disease across the interfaces. Managing quality through outcome measurement and audit. Towards evidence-based practice: the role of research and development, training and education. Continuing medical education: a fundamental balancing act. Management arrangements in NHS Trusts. The medical director: corporate player, not representative role. The clinical director: poacher turned gamekeeper? The Future.