The basis of the project paper reports a study of area management teams carried out in England by Rockwell Schulz between January and March 1981. Perceptions of consensus management are discussed with a study of the roles of individual team members and the influence of others such as local authorities, consultant medical staff and the DHSS. The perceptions of top managers about their relative roles are examined in the context of other relevant research and attempts to conclude why the role is what it is. The final chapter examines the prospect of changes in the top management role in the light of the 1982 reorganisation.