The contribution of clinical leadership to service redesign: a naturalistic inquiry

Numerous policy papers and academic contributions across a range of countries emphasize the importance of clinical leadership in health services. This is seen as especially vital at a time of simultaneous resource constraints and rising demand. Most of the literature in this topic area concerns itself with conceptual clarification of types of leadership and with delineation of requisite competences. But other work on leadership has emphasized the importance of attending to practice in concrete situations in order to identify the dynamics at play and the nature of the challenges. The purpose of this article is to contribute to this latter task by drawing upon a set of data which reveals crucial aspects of the problems facing potential clinical leaders of service redesign. This paper reports on the nature and extent of the challenges as identified by clinicians of different types as well as managers and commissioners.