The research data demonstrated that political ideology and the policy process shape the profile and processes of nursing leadership, whether that leadership is primarily political, clinical, academic or managerial. Effective nursing leadership within each domain is therefore currently limited by nursing's political reactivity. Health policy to date has largely been formed and imposed with limited input from nursing, although there are notable exceptions to this. The work of the Royal College of Nursing (RCN) is of note, having developed a voice on the value of nursing which has credibility within political arenas