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In this essay, I explore the rise of the concept of ‘leadership’ in the English NHS, highlighting the similarity with a previous shift from (bad, old) ‘administration’ to (good, new) ‘management’. I take a critical look at this discursive shift and highlight some of the overblown claims made for the value of ‘clinical leadership’. I argue that, rather than turning all NHS staff into leaders, we should perhaps tone down the level of our rhetoric and instead emphasize the need for a service full of good followers who will maintain a relentless focus on care, quality and efficiency. [ABSTRACT FROM PUBLISHER]