Health services in the fictional county of Borsetshire are every manager's nightmare. An escalating health authority deficit, a recently merged acute trust with deep-rooted tensions, a prying MP, ever-more demanding patients, a naughty non-executive, a wayward single-handed GP and serious worries about year 2000 compliance. All this and an implacable regional office wanting strategies, demanding progress and insisting on improved performance.

Such was the scenario which greeted the players in HSJ's first Management Challenge, staged last week in the hothouse atmosphere of Birmingham's botanical gardens. Teams were confronted with sudden, looming problems, had to distinguish on the hoof between the urgent and the merely transient, and were forced to the inescapable conclusion: collaborate or perish.

Management simulation games have a long history in the NHS. Remember the Rubber Windmill from 10 years ago, designed to test how the service would respond to the internal market (it collapsed). On this occasion, however, it was the teams - 36 of them, drawn from throughout the NHS - which were being tested rather than the system. They rose valiantly to the challenge, with the best displaying creative and innovative approaches to intractable health service problems. On this showing, ministers can be confident that the service has the management capacity to cope with whatever they throw at it well into the next century.