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This report is based on a retrospective evaluation of the Darzi Fellows in Clinical Leadership Programme, supporting multidisciplinary clinicians and allied healthcare professionals (AHPs) in project-based attachments to NHS organisations across London. The Darzi Alumni and London South Bank University collaborated to develop a longer-term review of the impact of the Darzi programme (currently in Cohort 9). This evaluation complements the in-programme evaluations of each cohort demonstrating the immediate success of eight previous cohorts of ‘Darzi’ Fellowships in London. The fellowship combines a work-based change project and a Leadership Development Programme incorporating a Post Graduate Certificate over the course of a year. This longitudinal study demonstrates that overall there is much evidence that the Darzi programme has practically and intuitively shown Fellows how to think first and then act differently for alternative outcomes. Fellows are much more proactive than reactive because of the programme. Many responses carried a central message of empowered, enlightened and highly skilled individuals who are actively and uniquely challenging the status quo. Thus, there is clear evidence that the Darzi programme has created a plethora of systems thinkers and doers, with a greater understanding of how to use data to bring about system change. A picture emerged of often bold individuals with a determination to actively instigate change across London and beyond. There is evidence that many Fellows are emerging as leaders, acting as catalysts for sustainable change in the healthcare environment. By any reasonable measurement, the Darzi programme continues to be successful with learning and behavioural change sustained after the Fellowship year.