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In operational terms, the characteristics associated with achievement were: the ability to hold and use budgets; the availability of adequate management resources; good relationships with external agencies, particularly the health authority; effective management systems; the presence of product champions both within the TPP but also in HAs and trusts; a strong dynamic executive management team; the inclusivity of stakeholders; the engendering of a collective responsibility and corporacy within the TPP; and a positive national and local context. In terms of service development, where there is vested local interest or enthusiasm, there tends to be more success than when the objectives are more strategic. 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