"Feel the fear and do it anyway": the hard business of developing Shared Governance

The article provides an overview of recent lessons from the Shared Governance literature, a description of a 4-year evaluation study and a highlighting of important issues which emerge from this. Early UK Shared Governance implementation relied heavily on North American experience, but there is now a growing body of UK experience. The literature review draws upon evaluation research to date, provides a contextual description of the Shared Governance site and the approach adopted, together with a description of the quantitative and qualitative evaluation design used. The findings indicate that early problems had the most profound impact, that there were continuing chronic difficulties and that a number of important issues have subsequently emerged. The article concludes that there are some significant successes, but that Shared Governance implies cultural change, is subject to "fashion swings" and that there are practical limits to what can be achieved. Implementation means hard work but can produce worthwhile results.