The presence and/or absence of effective leaders in healthcare can have a stark consequence on the quality and outcomes of care. The delivery of safe, quality, compassionate healthcare care is dependent on having effective clinical leaders at the frontline. In light of the Kirkup and Francis Reports the article explores some ways of translating clinical leadership into healthcare quality improvement. This is achieved by exploring: What is clinical leadership and why and how this is important to healthcare quality improvement, clinical leadership and a duty of candour along with the importance clinical leadership plays in the provision of quality care improvement and outcomes. Clinical leaders are not pre-defined roles but emerge from the complex clinical setting by gaining an acquired expertise and how they then internalize this to develop and facilitate sound relationships within a team. Clinical leaders are effective in facilitating innovation and change through improvement. This is achieved by recognising, influencing and empowering individuals through effective communication in order to share and learn from and with each other in practice. The challenge for healthcare organizations in regard to creating organizational cultures where a duty of candour exists is not to reinvent the wheel. By turning something that is simple into something complex which can become confusing to both healthcare workers, patients and public. By focusing on the clinical leader’s role and responsibilities we would argue they play a crucial and pivotal role in influencing, facilitating, supporting and monitoring that this happens in practice. This may be possible by highlighting where and how the duty of candor can be aligned within existing clinical governance frameworks.