Purpose The purpose of this paper is to examine the case that health service leadership is more than the sum total of all the health service management activity observed; and to advocate for improved leadership in health services through an examination of topdown management structures and processes which “crowd out” leadership behaviours. Design/methodology/approach Application of historical and contemporary contexts to health service management and health service leadership approaches. Findings The neglect of leadership is discussed and the case is put for a tightlycrafted position on how leadership should be emphasised and raised to greater prominence. Formulae for conceptualising leadership are presented in order to show the constituent elements underpinning clear descriptions of leadership. Research limitations/implications Further research on leadership, and more targeted education for leaders, is needed. Practical implications One way to build leadership capacity is to create a sustainable partnership between health service academics and leaders in the field. Originality/value Developing formulae for framing leadership is not reductionist per se but specifies with precision the essential elements needed to express health services leadership success.
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