The health care sector is characterised by constant reforms aimed at the efficient delivery of safe effective and high quality care effective leadership is required to lead and drive changes at all levels of the health system to actualise the goals of the ongoing reforms in health care organisations leadership in the health care sector is spread across management and clinical workforces creating peculiar challenges the chapter examines the concept of leadership in the health care . Effective healthcare leadership requires applying a variety of skills including being able to manage conflicts between team members respond to changes across the industry adhere to patient safety guidelines and optimize a health organizations financial performance in leadership roles such as hospital administrator and medical practice manager todays healthcare leaders are expected to excel in all of these capacities and many others so whats the best way to develop these abilities. The fourth edition of leadership in healthcare responds to the ever growing importance of leadership to a healthcare professionals role today and includes updated content to reflect the new guidelines set out in the 2018 nursing and midwifery council standards. Leadership is the most influential factor in shaping organisational culture so ensuring the necessary leadership behaviours strategies and qualities are developed is fundamental there is clear evidence of the link between leadership and a range of important outcomes within health services. This occurs where the leader possessing clear authority motivates by reward or punishment transactional leadership is still practised widely in healthcare settings this is in part due to the ingrained hierarchical nature of professional relationships in healthcare settings transactional leadership may be useful in helping healthcare organizations meet operational and financial targets but its role in service improvement is limited