The Grey Book

A group chaired by the then Permanent Secretary, Sir Phillip Rogers, produced the Management arrangements for the reorganised National Health Service report, which detailed management roles and responsibilities and introduced the idea of 'consensus management'. The report became known as 'The Grey Book'.

Senior management teams would be multi-disciplinary in nature and make decisions that had to be agreed by all members (consensus management). The report rejected the idea of introducing a chief executive role, given the complexity of the NHS.

The report prescribed in detail the role of managers of services including nursing, pharmacy, and speech therapy.

While there were supporters of the consensus management approach, disadvantages included confusion and a lack of visible leadership.


Edwards B.
The National Health Service - A manager's tale: 1946-1992.
Nuffield Provincial Hospitals Trust; 1993.

Rivett G.
The Development of the London Hospital System, 1823 - 2015.; nd.