ABSTRACT
This chapter outlines the way in which doctors have been involved in management, leadership and transformation of services over the past 60 years since the inception of the National Health Service (NHS) in 1948. The current focus on medical leadership as particularly espoused by High Quality Care for All: Next Stage Review is perhaps a further step in the journey of the changing role of doctor in the NHS since its inception in 1948. As the NHS and many other systems internationally seek to get more doctors involved in management, it is worth reflecting that the creation of the NHS in 1948 had created a framework within which medical professionals could become salaried employees whilst retaining clinical freedom. Following the start of the NHS in July 1948, many hospitals were led by a medical superintendent supported by a matron and hospital administrator. Most NHS hospitals began to introduce a medical management system based around clinical directorates.
