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The “Peckham” initiative is introducing a coherent framework for research and development (R&D) in the UK National Health Service (NHS). This entails close collaboration between the universities and the health service. However, there are inherent weaknesses in the current ethos of research and academic which suggest that there may be little understanding of the needs of NHS decision makers. There is a danger if health service managers do not take control of the agenda for R&D that it will be subverted to serve narrow academic interests. Explores means by which this can be averted. Suggests that managers should control the strategy of R&D and through the use of checklists determine broadly the content of study protocols.