The education and support of leaders at the level of ward or team leader is essential to move the government’s plan for modernising the NHS forward. Development at this ‘grass roots’ level is paramount if leaders are to foster an environment where midwives work together to provide women centred care. There appears to be a deficit of appropriate development at this level and a definite need for a comprehensive development programme for clinicians facing the move into a leadership post. This study considered the experiences of midwifery team leaders; the transition from clinician to clinician/team leader and the challenges associated with the role.