Teacher Support Teams (TSTs) are a way of supporting individual teachers who request support over a teaching concern relating broadly to special educational needs. This paper reports on the development of these teams and the evaluation of their workings and impact in four secondary schools. The training and setting up process were monitored over four terms and the impact assessed at the end of this period using a case study evaluation strategy. This paper provides details from two schools, one that managed to build the TST into the school system, and another that had difficulties in doing so. It then summarizes several key general lessons that emerge from the four schools. The paper concludes with a discussion of the policy context of this teacher support initiative and its relationship to staff development and support as a school priority. The project is also evaluated in the context of findings from a national survey of SEN teacher support. Recommendations are then made for governors and senior managers about implementing support systems in the current school system.