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ion between nurses and physicians in truth disclosure. National standards are commonly used as an improvement strategy in healthcare, but organisations may respond in diverse and sometimes negative ways to external quality demands. This paper describes how a sample of NHS hospital trusts in England responded to the introduction of national standards for 7-day services (7DS), from an organisational behaviour perspective. We conducted 43 semi-structured interviews with executive/director level and clinical staff, in eight NHS trusts that varied in siz