This paper provides evidence of the inability of UK NHS trusts to stimulate attendance at their AGMs and that attendance is statistically unrelated to published measures of trusts' financial results or perfomance ratings. Evidence is presented of attendance and procedures at trust AGMs and comparisons are made with the private sector. Concepts of power and ritual are applied to the discussion of the results. The findings suggest that the AGM is disconnected from other NHS governance mechanisms. This has implications for both the general concept of empowering stakeholders in the NHS and for specific local empowerment proposals such as the creation of NHS Foundation Tusts.