The discourse of leaderism in health care has been a subject of much academic and practical debate. Recently, distributed leadership (DL) has been adopted as a key strand of policy in the UK National Health Service (NHS). However, there is some confusion over the meaning of DL and uncertainty over its application to clinical and non‐clinical staff. This article examines the potential for DL in the NHS by drawing on qualitative data from three co‐located health‐care organisations that embraced DL as part of their organisational strategy. Recent theorising positions DL as a hybrid model combining focused and dispersed leadership; however, our data raise important challenges for policymakers and senior managers who are implementing such a leadership policy. We show that there are three distinct forms of disconnect and that these pose a significant problem for DL. However, we argue that instead of these disconnects posing a significant problem for the discourse of leaderism, they enable a fantasy of leadership that draws on and supports the discourse.

Recent literature on hybridity has provided useful insights into how professionals have responded to changing institutional logics. Our focus is on how shifting logics have shaped senior medical professionals’ identity motives and identity work in a qualitative study of hospital consultants in the United Kingdom’s National Health Service. We found a binary divide between a large category of traditionalist doctors who reject shifting logics, and a much smaller category of incorporated consultants who broadly accept shifting logics and advocate change, with little evidence of significant ambivalence or temporary identity ‘fixes’ associated with liminality. By developing a new inductively generated framework, we show how the identity motives and identity work of these two categories of doctors differ significantly. We explore the underlying causes of these differences, and the implications they hold for theory and practice in medical professionalism, medical professional leadership and healthcare reform.

This article addresses the question-can a deterioration in organizational spaces erode a profession's status? It draws on organizational spaces literature to analyse the relationship between design of the physical work setting and senior doctors' experiences of deprofessionalization. Analysis of qualitative data from a study of senior hospital doctors identifies two main themes that link the experience of spaces with perceptions of the erosion of professional status and reduced knowledge sharing. These two themes are: emplacement, which is the application of coercive power both in and through spatial arrangements, and isolation, which refers to physical alienation in the workplace leading to disconnection and a perceived loss of power. Observing the changes in the physical environment over time and mapping them against these processes of deprofessionalization may offer interesting new insights into the sociology of professions.

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In this paper we explain how and why elite doctors in public service