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Whither the elephant?: the continuing development of clinical leadership in the UK National Health Services


  • John Duncan Edmonstone

    Corresponding author
    1. University of Keele – Centre for Health Planning & Management, Newcastle-under-Lyme, Staffordshire, UK
    2. MTDS Consultancy, Ripon, North Yorkshire, UK
    • Correspondence to: J. D. Edmonstone, University of Keele – Centre for Health Planning & Management, Darwin Building, University of Keele, Newcastle-under-Lyme, Staffordshire ST5 5BG, UK. E-mail:

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The paper revisits the theme of clinical leadership in UK countries, following an earlier (2009) review. It examines the competency-based approach; considers the emerging voices of clinical leaders; explores the results of evaluation research studies; identifies learning from intra-UK and international comparisons and considers the issue of leader development versus leadership development. It concludes that there is little conceptual clarity; that there continues to be a major disconnect between clinicians and managers; that different approaches to developing clinical leaders are emerging in different parts of the UK and that the major challenge remains to develop leadership, rather than leaders. Copyright © 2014 John Wiley & Sons, Ltd.