This report shows that managers in NHS and social care organisations struggle to prevent discrimination on the grounds of age. Based on a telephone survey of 75 senior managers in hospitals, primary care groups, community trusts and social services departments, it shows that while the majority support moves to combat age discrimination, they lack practical tools for the job. They feel unsure about how to identify age discrimination in practice, and whether age-related policies and practices are ever justifiable. The report concludes that the government's stated objective of eradicating ageist practices from the NHS will not be achieved unless local managers are given more help to implement the policy, and suggests ways to do this.