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The purpose of this paper is to explore leadership in the context of the hub and spoke network in oral and maxillofacial surgery (OMFS) in the English National Health Service (NHS).

This paper is a conceptual paper using literature relating to the antecedents of shared leadership and relevant policy documents pertaining to both NHS policy and the development of OMFS. The paper is informed, theoretically by the conceptual lens of shared leadership.

The paper identifies the challenges that may be faced by policymakers and those involved in the hub and spoke network in developing shared leadership. It also reveals the implications for policymakers in developing shared leadership.

The paper is conceptual. It is acknowledged that this is a preliminary study and further work will be required to test the conceptual framework empirically. The paper discusses the policy implications of developing leadership in the hub and spoke network. As networks are of interest internationally this has wider relevance to other countries.

There is limited research on the antecedents of shared leadership. In addition, the conceptual framework is applied to a new policy context.

There is a certain type of British trader who, with pharisaic unction, lifts up his voice and deplores the unhappy condition of “the heathen in his blindness,” including all persons of other nationalities and any of his own who may happen to differ in opinion from himself. On these collectively it is his habit to bestow his contemptuous regard when from his elevated position he condescends to thank Providence that as far as the methods and conduct of business are concerned he is “not as other men.” Of course, most people recognise that the attitude assumed by this type of person is one for which it is difficult altogether to blame him. Born as he was in an atmosphere reeking with traditions of insular supremacy, and nurtured from his youth up on notions of commercial arrogance, it is no miracle that he arrives at maturity with singularly inflated ideas of the greatness of his powers and person. If there is one thing more than another in which he feels particular pride it is the possession of a superabundant stock of what he is pleased to call “business acumen,” and to hear him, it might be imagined that no one could approach him in enterprise and general commercial ability.