Nearly two decades ago, Smith (1999) recognised that little had been published on the implementation and usefulness of clinical supervision in the operating theatre. Accordingly, she conducted a small action research project and reported its findings. These were deemed to have been in a positive direction and a number of benefits were listed, essentially clustered around better communication between operating department practitioners (ODPs). Prophetically, however, she thought 'it would be interesting to observe if this enthusiasm and motivation continues after the project is completed' (p308). Two years later, Smith (2001) lamented that clinical supervision was no longer practised in theatres and that its introduction in other areas had 'met with little success' (p436). She believed the reasons to be the 'culture of the NHS, the negative attitudes by enough members of staff to have an impact and hidden agendas and micro-politics'.