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Reports a study of fundholding in general practice in the Northern Region and notes that although fundholding may have changed the role of practice managers and some general practitioners, the structure of authority remains unaltered. It appears that decision making remains the prerogative of the clinical partners and reliant on the establishment of consensus as the decision‐making approach. Notes that a key feature of fundholding was to enable general practices to develop as small businesses, formulating business plans and setting up management systems supported by computer technology. However, the practices explored within this particular study appear to be working well within the new system despite the continuation of traditional approaches. The outcome in the long term remains to be seen.

This story of the 108‐year‐old Birmingham Newton Company, manufacturers of industrial and automotive lubricants and chemical products, might well have come to an abrupt end twenty years ago — on 20 March 1968 in fact — when a disastrous fire gutted the company's Holt Street works, blending plant and laboratory, leaving a pile of smoking rubble where Ernest Newton founded his family business in 1880.

It is well established that women face multiple barriers accessing treatment for problematic and unhealthy alcohol use, but less is known about how their interconnected problems affect how they seek help from, and access, alcohol-treatment services. This study aims to explore the dynamic nature of women’s help-seeking for problematic and unhealthy alcohol use and how this can be compounded by unsuitable treatment services, especially when women present with complex needs.

Thirteen semi-structured interviews with women who had accessed alcohol-support services were conducted, audio-recorded, transcribed and analysed thematically using the complexity theory.

For women with complex needs, the process of seeking help may trigger unpredictable behaviours, health or social problems and intermittent serial access to treatment. Current services do not always address women’s holistic needs. Unless services focus on addressing interconnected problems – including historic trauma – they may compound the complexity of women’s problems. Complexity theory offers novel insights into this process, a concept not applied to problematic and unhealthy alcohol use treatment previously.

Services should adopt the complexity-focused perspective featured in this study. While the authors acknowledge the increase in gender-responsive provision, the limitations of this study include a small sample size, the self-selecting nature of the sample and retrospective reporting. Participants were recruited and selected by service staff resulting in gatekeeping and possible sampling bias.

Services should adopt non-linear approaches to treatment. Implementing complexity approaches to treating women’s problematic and unhealthy alcohol use should capture the dynamics, complexity and non-linear nature of women’s help-seeking journeys as well as their internal and external responses that may result in relapse. The authors recommend complexity-focused, multiple-component and integrated collaborative strategies to address not only addiction but also all components of women’s needs, including past trauma.

Applying complexity-thinking to help-seeking experiences for alcohol treatment and recovery services is novel and proved useful in understanding the variety of women’s experiences and how these interact with their help-seeking behaviours, including treatment environments.

OPTIONS OPEN TO SMALL FIRMS Small firms constitute 90 per cent. of those engaged in manufacturing and distribution. Pressures of competition and the necessary reliance upon one or two key men cause many small firms to disappear without trace—others amalgamate or become absorbed into larger units as their very success draws attention to themselves and to their needs for the specialist knowledge available in the bigger unit. But as rapidly as small organisations disappear, others appear to take their place. New industries or new expressions of personal service frequently favour this. It may also be expected that the effects of Selective Employment Tax and the Training Board Levy, with their encouragement to existing organisations to divest themselves of labour, will create opportunities for small industrial units not hitherto directly favoured in this way. The major long‐term problem of the small organisation is most likely to be management or executive succession. Where, as is often the case, the driving force, the business skill, behind the company is one man, the problem of his replacement is likely to loom large to himself, his family, his colleagues (who recognise their own incapacity for this role), and those employees who depend upon the continuance of the firm for their livelihood.

This case serves as an introduction to field sales management. A manager must address three sales representatives' ingrained behaviors in order to implement a major shift in marketing strategy. Students should recognize the nature of the "man-in-the-middle" squeeze: the manager caught between the pressure of implementing a new strategy from the top and the resistance to change from the bottom.

John Newton, Texaco Ltd, gives Chemrecon delegates an A‐to‐Z insight into lube‐oil blending, application and environmentally safe usage

Fear of technology is a common problem, even today when computers are found in most business environments. Illustrates how a department can be affected when one employee seems incapable of coping with computerized systems. Indeed, in this case, severe interpersonal and personal stress‐related problems severely curtail the implementation of an important new system. Students are asked to evaluate the situation and to recommend an appropriate intervention.

Why is it that when you present a report to some managers, they read it through in great detail whilst others scarcely read it at all?

Describes the views of practice managers in 30 fundholding practices in the Northern Region concerning their role in the scheme. A self‐completion questionnaire was mailed to practice managers and general practitioners containing questions designed to elicit their views about changes in relationships inside and outside the practice; their level of involve‐ment in various aspects of fundholding; and the costs and benefits of the scheme. A total of 30 first‐, second‐, and third‐wave fundholding practices in the Northern Region, June 1993 were involved. Replies were received from 22 practice managers (73 per cent) and 83 general practitioners (49 per cent). Concludes that although fundholding has increased the nature and volume of the workload of practice managers, these changes do not appear to be causing any tensions between managers and clinicians. At the moment fundholding extends the support role of practice managers and does not alter existing authority relations in practices.