Abstract
The recent profound changes in health care policy and the management and organization of the National Health Service have had a major impact upon nursing. Indeed, the development of the new management culture has challenged the organizational and management structure of nursing. This paper explores the role of nursing leadership in relation to the management of care delivery. The need for nursing leadership, its struggle for emergence and its effectiveness are discussed. The author concludes that for nursing to survive in the reformed health services strong leadership is essential. To achieve this the profession must move away from its traditional power base and refocus on clinical practice and the management of nursing rather than the management of nurses.

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