Transformational change in a hospital: How time and history constitute leadership agency

This paper addresses a research gap in showing how the complexity of change leadership in the hospital sector can be understood in the dialectics between local leadership and its near and wider context. Specifically, leadership is connected to the history and temporality of the field as core constituents of leaders’ change agency, and politics and policy are foregrounded as temporal elements in leadership. Presenting a longitudinal study of leaders’ struggles, the paper offers novel theoretical and practical insights that raise questions concerning healthcare manageability and the scope of what is possible in leadership at a given moment in time.