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Are there really new clothes in the NHS wardrobe?

School of Health Care Sciences, The Medical School, University of Newcastle upon Tyne, Newcastle upon Tyne NE2 4HH

Much of psychiatric practice involves understanding a patient's perception of reality and the influences that may affect this perception, including those of the environment. In organisations, such as the National Health Service, the need for consensus and approval within the organisational culture and environment may influence the publicly expressed views of employees, a process encouraged by short-term contracts and performance related pay. This article briefly describes some diverse experiences relevant to interpreting the real and the apparent.