A mutual health service in Scotland Do we understand fully the leadership implications?

Purpose - The purpose of this paper is to explore the leadership implications of a mutual health service in National Health Service (NHS) Scotland. Design/methodology/approach - Analysis of extant government policy and suggestions of leadership considerations for practice. Findings - Moving towards a mutual health system will require new ways of thinking about health care and existing leadership practices in NHS Scotland. The leadership implications at the strategic, operational and tactical levels of delivery in NHS Scotland will need to be thought through. At present, it is not clear how this will be done, either from the available health-related literature or from policy. "Mutuality" will require a complex and multi-layered effort to embed it within the culture of the organisation, which will require inspirational leadership and sustained management from the government, the NHS and the wider public to make the change happen. Research limitations/implications - This paper suggests that more leadership research is still required to understand fully - and implement - a mutual health service in Scotland. A theoretical framework and/or empirical reference points have yet to be developed. Practical implications - This paper highlights the practical implications in operationalising government policy. Originality/value - Little - if any - has been written about the leadership implications of a mutual and public health service.