Purpose -To increase understanding of both the process of new service development (NSD) and the nature of services as delivered to customers. Design/methodology/approach -Four qualitative, exploratory case studies encompassing public (health) and private (financial) sector service organisations. Findings -Managers select stakeholder groups for involvement in NSD attributing stakeholder salience, centrality to the process and power to influence the final service design. Customers are "dormant" stakeholders, thought to lack the knowledge/experience to contribute meaningfully to NSD. Their interests and needs are channelled through other stakeholders.Research limitations/implications -The research is confined to two service industries based on a key informant approach; thus generalisability to other industries may be limited. Practical implications -Multiple stakeholder involvement places a growing emphasis on the need for NSD managers to be skilled in managing complex, multi-layered and multi-faceted processes, often without legitimate power. This is likely to be a particular challenge for the public sector. Originality/value -This paper examines the relatively underdeveloped area of NSD and from an unusual perspective, i.e. that of services as outcomes of an amalgam of stakeholder interactions and relationships. Furthermore, it represents one of only a few in-depth studies of NSD within a health service context.

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To control the cost of drugs prescribed by general practitioners (GPs), the Netherlands Ministry of Health decided to implement an electronic prescription system. This paper uses an interpretive perspective to analyse the reasons for limited acceptance of the system. While the promotion campaign focused on the system, GPs based their decision on wider contextual factors.This article examines the limited success of an attempt by a national healthcare agency to implement an electronic prescription system (EPS). The promoters wanted to reduce the cost of drugs prescribed by general practitioners (GPs), and invested heavily in developing the system and promoting it to the intended users. GPs are autonomous, self-employed professionals and they reacted to the system in different ways-some used it in full, some partially and some not at all.The analysis relates these reactions to theories about the acceptance and use of information systems. Trying to understand why an information system is used (or not) becomes interesting especially when the users have a high degree of autonomy. Promoters cannot then rely on hierarchical authority to ensure acceptance, instead they need a better understanding of the users' attitudes to the system. If these attitudes relate to features of the system, then designing a system that will, for example, be easy to use will encourage acceptance. However, if they reflect a wider set of beliefs, such as personal views on the tension between evidence-based medicine and the exercise New Technology, Work and Employment 19:2