Practice development activity occupies an ambiguous position in relation to both clinical practice and research. In practice, it is seen at times as an added extra to normal work despite arguably being an inherent part of professional practice. In research, it fails to demonstrate the rigour of being generalisable because of its explicit location in a specific care environment. The study reported in this paper explored the implications of this ambiguity for practitioners who seek to develop health care practice. Ten focus groups were held with health care researchers and practitioners concerning the processes of developing practice in the North East of England. The results demonstrate how people manage themselves and the uncertainty that surrounds the use of research in clinical practice. The paper argues for an appreciation of reflexive forms of research, such as action and practitioner research, which do not disassociate research and practice and in which practitioners have a role in knowledge creation as well as knowledge implementation.