The aims for this research were (1) to profile leadership styles within one health service organisation, according to Bass and Avolio's (1995) taxonomy of leadership; (2) to identify leaders' characteristic 'forms of leading and communicating and (3) to explore followers' perceptions of leadership engagement. A three-phase programme of research was utilised within a single case study starting with a pre-study, followed by 360-degree questionnaires (Multifactor Leadership Questionnaire) distributed to leaders and followers within this health organisation and finally, a series of qualitative semi-structured interviews with selected leaders and followers. By approaching the issue of communication practices inherent within specific leadership styles, this study represents a uniquely comprehensive and in-depth analysis that contributes to research and theory in the leadership field. In particular, the focus on followers' perceptions provides this study with one particular point of differentiation from previous research activity in the area of leadership and communication. Although three leadership styles were identified within this particular case study as a combination of transformational and transactional, transformational and transactional, the majority of leaders were identified as demonstrating mostly transformational behaviours. Consequently, semi-structured interviews were conducted to depict the interplay of various communication practices inherent within these specified styles. These results indicated that 'feedback', 'time management', 'face-to-face' and 'daily' communication are practices rated highly by followers and increase satisfaction levels during interaction. These results are significant in terms of understanding, identifying and addressing communication practices that are demonstrated by leaders within specific styles of leadership. Thus the current study proposes that it is the identification and analysis of followers' perceptions within the leader/follower interface that will move this area forward.