RT Journal Article SR Electronic T1 Medical leadership – in the scrum or shouting from the sidelines? JF Future Hospital Journal JO Future Hosp J FD Royal College of Physicians SP 37 OP 38 DO 10.7861/futurehosp.4-1-37 VO 4 IS 1 A1 Simon Constable YR 2017 UL http://www.rcpjournals.org/content/4/1/37.abstract AB As has often been the case in its nearly 70-year history, the NHS finds itself in difficult times with very real clinical and financial sustainability challenges and a need to transform itself. The vision has been laid out in the Five Year Forward View, but if there was a ‘how-to’ manual for delivery it could be argued that it isn’t always completely clear and some chapters are incomplete. In the context of change in the modern NHS, medical leadership is often spoken about as being key and yet what this means varies between different people and at different times and on a whole spectrum of scale, from small projects to whole health-economy redesign. This article consists of some personal reflections on what it feels like to be in the midst of both.