This paper reports the results of primary research which was carried out in July 1995 with respect to business planning within first, second, third and fourth wave National Health Service (NHS) Trusts. The purpose of the research was to examine current practice in these Trusts in three areas--namely, the levels of responsibility for business planning in general, the business planning processes applied by these Trusts, and the tools and techniques used by business planning managers in the compilation of business plans. The research, based on a 37.5% response rate, concludes that, as a general rule, business planning in first, second, third and fourth wave NHS Trusts tends to be a board-level activity, where senior managers have a job title which reflects this function. Secondly, the research shows that by far the greatest challenge for Trusts lies in the external marketplace. In areas such as patient needs forecasting, competitive (Trust) intelligence, purchaser and general practice fundholder requirements, data are difficult to acquire. Finally, the evidence suggests that there is a significant gap between what is regarded as business planning practice in the NHS and what is actually applied as best practice. The report concludes that business planning in the NHS Trusts sampled appears to be an art rather than a science, and that many assumptions made by business planning managers are founded on qualitative information rather than on specific, measurable data derived from the external and internal market.