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The NHS is currently an ambiguous organisation without a clear purpose, and without a clear architecture. It is difficult to equate it with a federated organisation or franchise. Therefore, the idea that leadership development is a national activity is likely to create the attitude of abdication at the local organisational level, with local organisations developing their own ideas, based on their own perceived needs. This runs into difficulties as well, because the NHS culture has massive incentives for self interest now, and is generally managed at level 2 rather than levels 1 and 3, making the whole approach to leadership short term and devoid of future scanning, and effective person management. There are several ways to deal with this. One is to bring back the old idea of regional staff officers (calling them something else) who scanned the workforce and responded to its development needs by promoting the necessary development activities. This, combined with a Centre for Wellbeing and Performance that implements The Manager's Code - Putting People First - will give impetus to developing skills at levels 1 and 3 and provide consistency over a longer period of time. These two ideas combined with a perspective that embraces the whole of the healthcare industry (public, private, charitable, overseas, educational sectors) as a learning and development mosaic will provide the practice experiences necessary to develop all levels of skill, knowledge and experience, so long as triple loop learning is applied in practice. So, to summarise - local organisations have to look after their own development; region wide staff officers scan for their region and promote region wide development within the framework promoted and delivered by a Centre for Wellbeing and Performance, which will use the whole of the healthcare industry as a learning and development organisation. Finally, role models are essential. Local organisations need to be able to negotiate secondments for all eligible staff to work with role models. Such models will need to meet the criteria of level 1 and 3 working as set out by the Centre for Wellbeing and Performance. Level 2 skills are currently being taught all over the place, and nothing further needs to be done to make these more widely available.