TY - JOUR AB - Purpose– The purpose of this paper is to explore the early experiences of those involved with the development of Clinical Commissioning Groups (CCGs), examining how the aspiration towards a “clinically-led” system is being realised. The authors investigate emerging leadership approaches within CCGs in light of the criterion for authorisation that calls for “great leaders”. Design/methodology/approach– Qualitative research was carried out in eight case studies (CCGs) across England over a nine-month period (September 2011 to May 2012) when CCGs were in their early development. The authors conducted a mix of interviews (with GPs and managers), observations (at CCG meetings) and examined associated documentation. Data were thematically analysed. Findings– The authors found evidence of two identified approaches to leadership – positive deviancy and responsible guardianship – being undertaken by GPs and managers in the developing CCGs. Historical experiences and past ways of working appeared to be influencing current developments and a commonly emerging theme was a desire for the CCG to “do things differently” to the previous commissioning bodies. The authors discuss how the current reorganisation threatens the guardianship approach to leadership and question if the new systems being implemented to monitor CCGs’ performance may make it difficult for CCGs to retain creativity and innovation, and thus the ability to foster the positive deviant approach to leadership. Originality/value– This is a large scale piece of qualitative research carried out as CCGs were beginning to develop. It provides insight into how leadership is developing in CCGs highlighting the complexity involved in these roles. VL - 29 IS - 1 SN - 1477-7266 DO - 10.1108/JHOM-04-2013-0075 UR - https://doi.org/10.1108/JHOM-04-2013-0075 AU - Coleman Anna AU - Segar Julia AU - Checkland Kath AU - McDermott Imelda AU - Harrison Stephen AU - Peckham Stephen PY - 2015 Y1 - 2015/01/01 TI - Leadership for health commissioning in the new NHS : Exploring the early development of clinical commissioning groups in England T2 - Journal of Health Organization and Management PB - Emerald Group Publishing Limited SP - 75 EP - 91 Y2 - 2024/04/20 ER -