Unseen architecture: Leadership’s role in creating space for service transformation

A dark blue background with light blue text that says "By Jane Maber and Marianne Brierley, Unseen Architecture: Leadership's role in creating space for service transformation"

Great leadership isn’t about having all the answers and dictating the work. It’s about defining the parameters within which the work can happen. 

This is the final piece in our series on the “Space around the Thing“—the critical, often-invisible work that underpins successful transformation in public services. We’ve previously explored how transformation demands designing for whole problems, the importance of trust and relationship-building, and how to treat existing infrastructure and governance as material to work with. Here, we focus on the most vital element for making it all happen: the role of leadership.

Over the past year, we’ve been working with NHS England to transform the national breast screening service. Developing a new digital system to replace legacy technology, while also improving the overall experience for staff users and screening participants, is complex. We’ve noticed that the difference between delivering meaningful change and re-hashing what’s already there isn’t usually due to tools or methods—it’s whether leaders make enough space for teams to do the work properly.

Without this, teams can end up building things that don’t meet user or policy needs. Or building great things that fail during implementation due to lack of buy-in. Either way, this is wasting public resources.

So how exactly can leadership make space for transformation? Here are some of our key observations.

1. Steer the ship

Great leadership isn’t about having all the answers and dictating the work. It’s about defining the parameters within which the work can happen. 

A few weeks ago, we flocked to our quarterly in-person, all hands meeting.  The content of the day focused around a clear proposal for how we might approach decommissioning the legacy breast screening system (NBSS).  There were some initial milestones to aim for and the opportunity to give genuine feedback to enrich the plan.  And there, after months of collectively grappling with the numerous ways to achieve our goal, we had the direction we desperately needed – and the means to use our knowledge and experience to influence it. While the plan wasn’t perfect (what plan is?) it’s given clear signals to enable teams to prioritise and move forward confidently. 

The difference this has made highlights the power of having a clear direction for delivery teams set by leadership. In our newest team in particular, there’s a stronger sense of positivity and focus on improving how participants are booked into breast screening. We’re no longer stuck on decisions outside our control—progress is being made.

Autonomous teams work best when they have a clear purpose or outcome. In this case, it’s replacing a legacy system by a set date. But other examples include delivering cost savings to ensure stakeholder buy-in or significantly improving the user experience in some way.

We have had numerous conversations about whether we should lead with replacing NBSS in the first instance. This approach is pragmatic, but there are trade-offs to be made. Our users will have to wait longer for more significant service transformation and the communications narrative is more complicated to navigate.

We will realise user benefits from replacing NBSS, like less manual work and improved service resilience through more intuitive workflows. However, the leadership has ultimately had to prioritise the organisation’s needs over significantly transforming the user experience at first. Necessary? Yes. Comfortable? No.

Leaders have the benefit of seeing the bigger picture and the responsibility to use that understanding to guide their teams. That often means being comfortable with making uncomfortable decisions. 

2. Create the conditions

As Marianne highlighted in the first post in this series, the NHS environment is especially complex. The processes and systems that make it function are difficult to understand and individual patient journeys have numerous touchpoints that are often siloed. 

It takes resilience and persistence to see genuine transformation through to the end and teams can easily burn out. It’s all too common for ideas not to land, or to feel like most of the doors you’re knocking on are closed.

Leaders have a much broader understanding of an organisation’s work, its goals and its weaknesses. Making space for teams to deliver value is about using this knowledge to influence the space around the thing. Connecting teams to the right places so that great ideas can gain momentum, and spotting outside opportunities that will support service rollout. 

In breast screening, for example, leadership encouraged teams to explore introducing more consistent use of DICOM headings (describing the information that is stored about a mammogram). This work was identified as something that would improve long term data sharing and interoperability with the new service, including supporting AI image reading in the future. This sort of work exists in the space around product teams and requires collaboration with NHSE data standards teams; the Integrating the Healthcare Enterprise (IHE) initiative; and Mammogram machine and PACS manufacturers. 

Space and connection outside of the immediate work is important. But it’s nothing without the culture in place to make the most of it. Working in the open goes hand in hand with permission to look outwards, and permission to fail. Openly talking about what we’re doing, learning, and need help with benefits whole organisations and can speed up decision-making. Several of the senior leadership team for the breast pathway regularly blog about their work and are visible across our Slack channels. And this ‘role modelling’ is crucial to creating that culture. It’s silent permission that says: ‘this is how we do things here’. 

Finally, creating the right conditions is also about making the hard decisions. Recently in breast screening, it became clear that one of our goals – to move to digital first comms – needed to be sequenced differently to allow teams to lay some foundational functionality in our new service first. This was a difficult decision. Trade-offs had to be made around the impact on the delivery team, timing of potential cost savings and perceptions within breast screening offices. Ultimately, with a clearer pathway towards replacing NBSS now in place, leadership made the strategic decision to shift teams’ focus towards doing just that. This will create space for better service development, including digital comms, later.

While in theory this all fits neatly into two boxes – head down in delivery vs head up in leadership – nothing is ever that simple. The challenge, as ever, is balance. We don’t always get this right. It’s often clearer in hindsight which conditions or decisions would have been the right ones. It’s a constant learning process, and leadership and delivery teams alike have to show some grace and humility to keep up the momentum.

3. Knowing when to let go

One of the less visible parts of creating the space for transformation is knowing when to step back.

In the work we’ve seen, this is often where things feel most uncomfortable. Many leaders have deep expertise in delivery, product, or operations. They’re used to being the person who can spot problems early or unblock decisions quickly. That instinct doesn’t disappear when they move into leadership roles.

But creating space for teams sometimes means not stepping in, even when you could.

We’ve seen teams make better progress when leaders stay close enough to understand what’s happening, but resist the pull to direct the detail. That doesn’t mean being hands-off. It means being deliberate about how they’re involved—asking questions that help teams think things through, rather than providing answers that close things down too early.

In practice, this can look like small moments:

None of these are risk-free. Sometimes teams will take a path that doesn’t work out. But when leaders consistently step in to avoid those moments, teams can become dependent on that direction. Over time, that limits their ability to navigate complexity themselves. Leaders are also inherently further away from the action. Even with the most impressive knowledge and experience, stepping in and dictating decisions sometimes risks actually moving in the wrong direction.

So there’s a mindset shift around what “being useful” looks like. Instead of adding value through answers or decisions, it comes from:

We don’t always see this done cleanly. In some cases, leaders hold on longer than they intend to, especially under pressure. In others, they step back too quickly and teams lose a sense of direction. The balance tends to emerge over time, through trust on both sides.

What’s consistent is that letting go isn’t a one-off decision. It’s something leaders have to keep recalibrating as teams grow in confidence, as risks change, and as the work evolves.

Closing the gap

What this work has highlighted for us is that the space around the thing doesn’t manage itself. It sits between disciplines, between delivery and strategy, between intention and reality.

And that space can easily be missed.

In practice, we’ve seen the value of having someone explicitly focused on it. Our Change Leads have been navigating the space around the thing to connect the dots and help make sense of how decisions, constraints, and opportunities play out across the whole service. They’re advising both the leadership and delivery teams accordingly to close the gap and enable respective roles to focus on what’s needed to deliver successfully.

Going forward, it’s clear we need more explicit definition, ownership and support for the space around the thing if we want to see true transformation of the NHS and wider public sector services.