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Sustainability of water quantity management is largely associated with the provision of environmental flows. However, the implementation of environmental flows has been problematic, particularly when water needed for the environment has already been allocated to other uses. The potential rebalancing of allocations brings other aspects of sustainability to the fore, namely distributional and procedural justice. This paper reviews the Catchment Abstraction Management Strategies (CAMS) programme established in England and Wales in 2001 with the aim of creating a 'sustainable' balance between water users and the environment. A review of CAMS outcomes from the first 4 years of implementation found that the 'sustainable' balance achieved broadly equates to maintenance of the status quo. This is in part because, without appreciation of the inequities in abstraction rights and the lack of tools for their management, constrictions on environmental improvement remain. Increased transparency of these inequities and constraints is proposed as a priority for procedural justice and as a basis for further decision making regarding allocations. The case study has shown that to move beyond the platitudes of sustainability to real changes for environment and society, the history and institutions of environmental management, distributive justice and procedural justice must be critically reviewed and challenged. [ABSTRACT FROM AUTHOR]