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Introduction The paper is concerned with the contribution of management development to the culture change in the health service which the Griffiths Report (DHSS, 1983) and subsequent reforms (DHSS, 1986; [...]

The importance of internal, cognitive or covert support mechanisms to ensure successful application of managerial skills is highlighted. This durability factor has often been left out of the managerial success equation. But consistent application of managerial qualities demands a supportive network to ensure durability. Thus, the introduction of cognitive behavior modification-based management consultations is seen to alter maladaptive thoughts, behaviors and affect which hinder job performance. A skillbuilding managerial framework is laid out for the effective implementation of such cognitive behavioral techniques, even in hard business environments.

Successful managers develop practical theories or frameworks to guide them in problem solving and decision making. A practical theory can be a key element in focusing and handling change and in managerial development. A managerial framework is most useful when it conceptualizes and outlines a vision for people based on the assumptions and values of managers and employees. The development of a managerial framework in a long-term care hospital is described, with focus on performance appraisal, training and career development.