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It was Anthony Robinson who said ‘If you always do what you have always done you always get what you always got’. So, I don’t think it is a bad idea to have turnover of leaders in our NHS. NHS needs new vision, new ideas, new thinking, new culture and for that to happen we need new leaders. Sadly, many NHS leaders stay in leadership positions for many years and it is like ‘Old wine in a new bottle’. Same old names come in different leadership positions in different parts of the NHS! Of course, that doesn’t mean we get rid of all ‘old leaders’. The leaders who perform well should be encouraged to stay but there must be evidence that these leaders are performing well and this is why it is important for all leaders to have proper performance management system and this must be published. One of the most important thing of leadership is 360 feedback from those who are affected by these so called leaders leadership. This is a must. This must include behaviour, attitudes, values and other important qualities of a good leader. Only those who score consistently high feedback sores should be continued in the position of leadership.