The role of the doctor in the NHS has evolved over the past 40 years. Initially doctors were expected to do their clinical work, and the administrator or manager's role was to help doctors by providing the necessary resources. Since the 1980s some doctors have been taking a larger role in management predominantly as clinical directors responsible for their service line.
However, many frontline doctors are still not involved in leadership, and there can be a separation between doctors in formal leadership roles and those who continue to treat patients and undertake their teaching and research. This separation has contributed to a growing sense of disaffection from frontline doctors who felt uninvolved in resource allocation decisions that affected the way they provided care.