This article examines the changing nature of the central organization of the NHS and its relations with the field. It is based on a two-year tracer study of regional health authorities (RHAs) as they were reorganized into regional offices (ROs) and became part of the civil service. The research evidence suggests that the centre of the NHS cannot be treated as one organization; the wider Department of Health, NHS Executive HQ and regional offices have distinct identities within it. The analy...