Leadership is an essential feature of the life of a paramedic. During incidents, while working with multi-agency colleagues, and within organisations, leadership is an expected quality for paramedics to have. Across health and social care organisations, leadership is said to be of pivotal importance to future success. This has led to a large investment in leadership development programmes that organisations are now seeking to justify. Leadership, as a concept however, is complex and multifaceted. The nature of leadership has been debated over millennia and disagreement remains as to how to define it. The current article uses Critical Interpretive Synthesis to consider how approaches to leadership have developed over time. It concludes with a synthesising argument that leadership is a social construct; as such, no single definition will ever be appropriate. However, the four elements that comprise the leadership equation should be considered if the paramedic leader is to be effective.

David Johnson - Academic Delivery Manager, Sheffield Hallam University

Peter Bainbridge - Locality Quality Manager, East Midlands Ambulance Service

Wendy Hazard - Paramedic and Ambulance Operations Manager, East Midlands Ambulance Service