In episode 42 of the National Health Executive podcast we were joined by Steve Gulati who is an associate professor at the University of Birmingham as well as director of healthcare leadership at the university’s Health Services Management Centre. During the podcast, we discussed the difference between leadership when he first joined the NHS in the 90s and to now, plus the main levers for these changes. Steve also highlighted the ‘well-known truths’ about NHS leadership which are seldom voiced as well as what changes he would like to see in the future. “Leadership in those days was almost synonymous with management – it certainly wasn’t [like] the nuanced distinctions that you get today,” said Steve. “Allied to that, there was a concept that was more prominent of what I would call ‘stewardship’ rather than leadership.”