Purpose: The purpose of this case study is to describe the design and delivery of a leadership programme for a diverse group of clinicians and middle managers within a British mental health organisation. Design/methodology/approach: This paper shows how the course was co-designed between managers, clinicians and higher education, specifically to meet the needs of individuals, teams and the organisation. The authors' thoughts and impressions are presented based on their experience of developing and facilitating this program. Particular attention focuses on notions of leadership, adult learning and organisational change and how these influenced the design of the course. Furthermore, consideration is given to aligning the programme to the organisational culture and strategic plan. Findings: Drawing on Kolb's experiential learning cycle, a process map for the learning journey emerged which shows how the participants were able to critically blend theory with experience and practice. Using a three-dimensional model developed by Boydell and Leary (2000) of implementation, improvement and innovation, performance outcomes were identified and placed within a taxonomy of learning. This enabled a more specific and sophisticated approach to eliciting the learning that has taken place. Furthermore, this framework provides an approach to identifying future learning and development needs. Originality/value: This paper offers the theory and narrative for our approach to designing and delivering a leadership course, reflecting on the impact of the course and the achievements for course participants and the organisation. Given the criticisms that such courses do not make explicit their theories of management and leadership practice nor the educational processes that underpin their design and development, we seek to redress this. Not only do we combine emerging leadership theory with cultural and organisational development needs, relevant methods of adult education were also chosen in order to optimise learning and performance development. (Contains 1 figure.)