Purpose – This paper aims to explore if and how employees in a healthcare organisation perceive changes in their managers’ leadership behaviour over time. Design/methodology/approach – An interview study was conducted with employees whose managers had participated in a two-year leadership development programme offered by their employer, Healthcare Provision Stockholm County. Qualitative content analysis was applied, and the interview discussions focused on areas in which the majority of the informants perceived that a change had occurred over time and their answers were relatively consistent. Findings – The majority of employees did discern changes in their managers’ leadership over time, and, with very few exceptions, these changes were described as improvements. Practical implications – The knowledge that employees perceived changes in their managers’ leadership supports investments in leadership development through courses, programmes or other initiatives. Originality/value – The present findings contribute to a deeper empirical understanding of leadership as it is practised over time in everyday contexts among employees in healthcare organisations.