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In 2002/3 the Health Foundation launched an ambitious five‐year Programme of investment in leadership development. This investment included resource for simultaneous evaluation (Lucas 2006). Against a background of unprecedented upheaval in healthcare systems in the UK, the Leadership Programme has evolved, encompassing initiatives aimed both at individuals and teams. The Programme has been refined to provide a more explicit focus on leadership for quality improvement. This article reviews what has been learnt from this investment to date, focusing on lessons both for practitioners and for academics.The focus of this paper is what has been learnt from running the Foundation's three individual leadership schemes over the past three years. The authors argue that to be effective talent spotting needs to develop rigorous mechanisms for identification of potential; that there needs to be a sustained focus on quality improvement outcomes if leadership programmes are to deliver more than personal development; that the most effective development is work rather than classroom‐based; and that organisational commitment for leadership development is critical if the full impact is to be realised. The authors draw on an extensive evidence base from the Programme evaluation, including some case studies.

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