ABSTRACT
As shown in the foregoing chapter, political leadership from the centre has been hugely influential throughout the history of the NHS in setting the broad agenda. But, as also noted, the realisation and implementation of the ideas has depended massively upon behaviours at the local level. Crucial here have been the roles of managerial and clinical leaders. The increased role of managers in the NHS during the past two or three decades could be seen as part of a wider movement, across public service organizations more generally, where a ‘New Public Management’ and a more strategic role for public sector managers has been noted (Hood 1991; Ferlie and Ongaro 2015). Likewise, during the same period, there have been periodic calls to bolster the leadership role of clinicians, or at least for some of them. Hence, both managerial and clinical leaders can be regarded as actual, or potential, significant players in the task of meeting the innovation challenges of healthcare.
