The paper revisits the theme of clinical leadership in UK countries, following an earlier (2009) review. It examines the competency‐based approach; considers the emerging voices of clinical leaders; explores the results of evaluation research studies; identifies learning from intra‐UK and international comparisons and considers the issue of leader development versus leadership development. It concludes that there is little conceptual clarity; that there continues to be a major disconnect between clinicians and managers; that different approaches to developing clinical leaders are emerging in different parts of the UK and that the major challenge remains to develop leadership, rather than leaders. Copyright © 2014 John Wiley & Sons, Ltd.