Managing in Health in Social Care By Vivien Martin and Euan Henderson Routledge 350 pages£16. 99 Agreat deal is now expected of managers at all levels.

Although some will have been trained specifically in the art and science of management, others have to pick it up as they go along. But what is management? Are we talking aptitudes, skills, techniques, and if so how do these relate to values, vision and judgment?

This book, which is based on the learning materials prepared for The Management Education Scheme by Open Learning (MESOL), endeavours to cover the practicalities as well as paying some attention to the bigger issues such as the current environment in which healthcare is provided.

More than 20,000 people have taken part in MESOL. That alone ensures that the book is well grounded in experience. Case studies are provided, some of them anonymised but others attributable, which is to be preferred as it gives them credibility.

Appropriately, the book starts with managers in action from which a range of activities are summarised. What emerges is how fragmentary a lot of managerial work is and how there is a rich mix of the relatively trivial with the more important and long term.

Interestingly, top managers are not immune from the syndrome of the urgent driving out the important. One of the earliest challenges therefore is to sort the wheat from the chaff and try not to spend too much time on the less important issues.

More than ever before, managers are being judged on their effectiveness, and the authors wisely differentiate between effectiveness of individuals, of the team and of the organisation as a whole. This will depend on leadership, and traditional models are not always appropriate, although I feel that the concept of leading from the side or behind is conceptually a little confusing. The authors stress that effective managers have a repertoire of behaviours, which they can adapt to the situation, but are careful to note that the range is limited by the personality and, in any case, to become too chameleon-like tests a manager's credibility: he or she ceases to seem 'real'.

Quality management has hopefully now become embedded in the NHS but it is useful to be reminded of some of the difficulties in establishing how to define quality, how to set standards and how to evaluate results. I was sorry not to see any reference to the process of accreditation here, particularly as where direct management is not possible, it is a key component of regulation.

Managing in a political environment also gets little mention and the difficulties facing partnership management across health and social care are under-explored.

The bibliography is somewhat sparse although it is obvious from the text that the authors are fully aware of the relevant literature. My management bible was Koontz and O'Donnell's Principles of Management. But for today's health service managers this volume will be extremely helpful and worth every penny.

Andrew Wall Visiting senior fellow at Birmingham University's health services management centre .