Action on clinical effectiveness is showing that success in implementing evidence based practice is achieved only when there are real local partnerships between clinicians and managers. The challenge is not to turn clinicians into managers but to recognise that some aspects of the task are the direct responsibility of managers. The recent white paper on the NHS, with its emphasis on quality and concept of clinical governance,1 has given added impetus to the creation of these partnerships. The requirement for chief executives of trusts to make “appropriate local arrangements” may make little progress unless doctors and managers reach a shared understanding of their distinct contributions to the development of evidence based practice and generate enthusiasm for the approach in organisations. Progress may be contentious because some clinicians are sceptical about the interest of managers in clinical effectiveness and evidence based practice.2 Clinicians are usually interested—and excited—by discussions about research, but their interest wanes when those discussions progress to questions about the routine use of research findings. Interest in implementation is often viewed …