Voices of transformative leadership

Make sense of the world

The complex and interrelated challenges that organizations face demand that leaders pay close attention to the external environment, engage with a wide range of stakeholders, and articulate a clear and compelling worldview that creates shared understanding and a sense of urgency.

S+B: We often hear from leaders that we are in a unique moment, with the external environment becoming increasingly challenging. Does this ring true? And what does it mean for your role as a leader?

JOSEPH KAMARA: Anyone who works in East Africa will tell you that climate change is a huge driver of humanitarian needs. Disasters are becoming more frequent and more intense. Historically, we faced a drought maybe every ten years. Now it is every three years. Just before the declaration of the covid-19 pandemic, we had massive floods, followed by desert locusts that destroyed about 5 million hectares of cropland across the region. And then, just as the communities were starting to recover, a drought started. And with covid-19 impacting supply chains, transportation, and productivity, it was clear we were going to have a significant food crisis. So, we have no respite. It is one thing after another.

Then, of course, we face armed conflicts—4 to 5 million refugees and 12 million internally displaced people across the region. And that was before the Sudan crisis broke out in 2023. The number of people displaced is huge. Usually, it is the poor people who are hit the worst. Once agriculturalists lose their livelihoods, their ability to produce is gone, and some will be forcibly displaced. Conflicts at the global level also hurt us. The conflict in Ukraine caused the global oil price to skyrocket, which translated into higher cost of living: higher prices for transportation; for commodities; for fertilizers; for imported wheat, rice, cooking oil. In Somalia and Sudan, people depend on wheat, and the price of bread became impossible.

The reality is that these issues are interconnected, and they reinforce one another. To be effective at creating resilience, it’s not enough to respond to a crisis, you also need to take a long-term perspective. My role is to remind my colleagues: “Wait a moment. Yes, we are going to respond here, but what were the causes? What are the forces at work we should be thinking about?” We may not have the resources to address every cause, but we can understand more clearly the potential impact of what we are doing. I encourage my coworkers to think broadly, to think beyond what they see today, beyond the immediate crisis we are responding to, and look at the long term.

S+B: Does this resonate with your experience in the healthcare sector, Manoj?

MANOJ PATEL: I remember a moment when we were coming out of the pandemic. A lot of people were leaving the healthcare sector because of covid-19. We had extreme weather events across the country—unprecedented flooding in Auckland, and storms in Christchurch that damaged our hospital. We had a shooting event close to our head office in downtown Auckland. We were already on high alert because of cyberattacks on health organizations in New Zealand. And in the middle of all this, we were trying to gear up as an organization for a bright future.

At a certain point, I started to realize that these were not one-off events. This was the pattern of today. We are going to be constantly facing crunchy issues, and, quite frankly, we need to set ourselves up to expect them. We were doing a great job of marshaling resources to deal with each situation, and the opportunity for the longer term was to adopt a mindset and capabilities to deal with this constant cycle of events—as well as maturing our ambition as an organization.

S+B: Andy, how do you approach making decisions in the face of so much uncertainty?

ANDY MITCHELL: We need to make decisions based on where we think the world is heading. In the underwater battle-space, we have a requirement to act out to 2110 with our current nuclear submarine fleet, let alone any new craft we bring in. I think Jeff Bezos had it right when he said that you should ask yourself what won’t change, and build a strategy around that. In our case, we know that data is going to become more prevalent, along with computer processing and networking. We know that climate change is an issue we are going to need to deal with. So, it’s about making logical decisions based on what you know will be true, what you can infer, and what you are prepared to bet against.

Set radical ambition

After creating a shared understanding of the issues, transformative leaders set a radical ambition. They focus on a major problem that their organization is uniquely positioned to solve. They encourage the organization to stretch to the limits of what is feasible, and give people confidence that the objective can be achieved.

S+B: A radical ambition stretches people in new ways, so it’s important to focus on something deeply rooted in the purpose and values of the organization. Given that challenging environment you have described, Manoj, what was the radical ambition that Southern Cross Healthcare set out to pursue?

MANOJ PATEL: Our ambition starts with our obligation as a for-purpose health organization that doesn’t have corporate ownership, which is unique in private healthcare in New Zealand. We can take long-term decisions that would be more difficult for a conventional, privately owned player. Our transformation journey really began when our board challenged us to step up to this opportunity.

We decided we needed to be ambitious around how we support the patient as a whole—transforming clinical pathways and the experiences that patients and their families go through. Healthcare is often transactional. If a patient is unwell, they see a general practitioner. If they need imaging, they get an X-ray or MRI. If they need a specialist consultation, they get a 20-minute appointment with a specialist. But what if a medication or a procedure isn’t funded? If the patient can’t pay for it themselves, they won’t get it. What if the patient needs to take six months off work after surgery? Nobody is paying for that, so it’s a burden on the patient. What if a patient can’t look after their children because they are going through oncology treatment? The social and psychological impact on the family isn’t funded or supported.

So, the opportunity is to look through the patient’s eyes at what’s important to them. It is about taking a bio-psycho-social approach: What’s the main biological issue? What’s the psychological impact on mental health? What are the social, family, and work aspects of the situation? Stepping back, a lot of things need to change to realize this ambition. We need to work with funders, work with the clinicians who are part of today’s journey, work with clinicians with different specialties who aren’t part of today’s journey, and work with commercial interests. We need to understand the challenges faced by different segments of the patient population. And we need to enable our own organization and our core beliefs along this journey.

S+B: Joseph, how do you articulate the need for radical ambition within World Vision?

JOSEPH KAMARA: The problems we are confronting are enormous, and they are not going to end. The needs are going to grow. So, what can we do differently? Because if we don’t do things differently, we will become irrelevant. This is my drive: What are the alternative ways of doing business, of helping people, of easing pain? Sometimes I say to colleagues: “Imagine you are standing on a cliff. There’s no bridge to the other side, and you can’t go back. You need to leap. Is this what you are going to do? What is going to drive you? How are you going to overcome your fears, overcome the obstacles, and get across?”

Achieve promised outcomes

Having set a radical ambition, transformative leaders channel their organization’s energy toward delivering on it. They translate ambition into specific, measurable outcomes and create the structures and systems that enable the organization to go beyond business as usual. Transformative leaders also remain personally engaged as execution moves forward, fighting the organization’s natural tendency to settle for functional excellence as opposed to transformative change.

S+B: Organizations can be resistant to change—especially organizations that have been successful for a long time. Is this something you experienced during E.ON Sweden’s transformation journey, Susanne? And what changes did your leadership team make to help the organization reinvent itself?

SUSANNE GELLNER: When I came into the business, we were organized by function—asset management, operations, and customer care. In the first phase of our transformation, even before energy transition was high on the agenda, we changed this. We moved to a structure with three business areas, each with full P&L responsibility. This was partly about breaking down silos and partly about introducing more business-mindedness into the culture. Our engineering culture remained critically important, of course, but the new structure enabled us to think end-to-end about customer journeys, for example. Although we didn’t know it at the time, it also put us in a position to pick up the pace for the phase we are now in.

Today, there’s real urgency to move fast and do things differently. The energy crisis arising from the war in Ukraine was a wake-up call, especially in our part of the world. The energy transition and electrification are accelerating. There’s a completely new flow, physically, in the grid, with solar and wind coming in and big, stable sources such as nuclear being phased out. So, we are learning to run the system differently, with better methods and new technology. That’s the physical part of it. In relation to customers, contracts are changing. We need to be able to accommodate more flexibility and have different business models for different customers. Again, the challenge for us as an organization is moving fast enough. It’s a major shift.

Here’s a very hands-on example: historically, if we needed a transformer, we would calculate precisely what we needed and then source it. Today, we might need to source 25 transformers in advance. We don’t know exactly where and when we are going to use them. But if we don’t order them now, we may not get them for years. So, in finance and procurement we need to convince ourselves to take that risk. And the engineers need to accept that they may not get exactly what they want, but it will be good enough. We need to think in different ways.

S+B: Beyond systems and processes, what works in terms of getting an organization aligned and committed to achieving the promised outcomes? Manoj, Andy, what’s your experience and advice?

MANOJ PATEL: We are innovating to show what’s possible if we raise our ambitions. For example, we are working across different cancer streams to identify where things can be done better. We looked internationally at different models, and different technology options that enable pathways to diagnosis that are better designed around the patient experience. We are looking to develop pathways that empower people to better manage their health. The early results from the pilot are promising. We've been able to detect early-stage cancerous changes and therefore prevent cancer from developing in a group of people with an average age of 50. These are real people and their families whose lives changed based on the program we are developing.

This is a program and a story that transcends the business case. It’s not about ROI. It speaks to mission and purpose, which is especially important in the early stages of transformation. It gives people hope and belief that not only can you dream of a better future, but you can also achieve it.

ANDY MITCHELL: You need to have a clear vision, a sense of the journey, a North Star you’re moving towards. Reinforcement is the key thing. People sometimes make fun of me because I mention the same few things over again—and it can be exhausting to keep doing it. But, over time, reinforcement works.

The other thing is learning to communicate in new ways. I grew up professionally in an industry where the people tended to have similar technical, commercial, or project leadership backgrounds. I was trained to discuss everything very logically. Now I’m interacting with people who have commanded warships, or battalions of soldiers or marines. They don’t necessarily communicate in the same way. Basically, I’ve come to realize that I’m quite good at communicating with a small percentage of the population. It’s something I’m working on.

Act as a catalyst

For a company to deliver outcomes that matter and address the challenges that today’s organizations face, a wide spectrum of skills must come together—not just from within the organization, but also from the wider ecosystem. Transformative leaders act as catalysts for coalitions, building trust and combining resources across teams and from other organizations. They are magnets for talent, defining the capabilities they need, finding and attracting diverse talent, and creating an environment in which people can thrive.

S+B: Susanne, electricity generation and distribution are in the spotlight due to the forces you mentioned earlier—energy transition, electrification, concern about energy security. What does this mean for how you engage some of your major stakeholders? 

SUSANNE GELLNER: Remember that for a long time, this was a very stable industry. Dialogue with the regulator was about striking a balance between reasonable prices for customers and a sufficient return for us. There was hardly a conversation about energy security—or how to finance growth. Today, all this has changed. It’s a more complex set of relationships. It is more political.

Working with a regulator is not fast paced—that’s just the nature of the relationship. It’s not like a customer negotiation where one side or the other can walk away. We talk about long-term goals: What do we want to achieve within the energy industry? What do we need to do? And then the hard part: What is needed to make it happen? Also trying to find solutions together—solutions that are acceptable to us as a company and are also acceptable to the regulator. As a leader, to be honest, I’ve been forced to step out of my box. I’ve learned that one can do much more than one initially thinks, although it takes guts to step up and try to push.

S+B: Andy, how will the Royal Navy’s ecosystem change? Who do you need to work with as the Navy evolves, and how will you need to engage them differently?

ANDY MITCHELL: Some things probably will remain the same. Our allies and the people we work with across government will be broadly similar. The ecosystem of industry partners may not change all that much. But how we will work together and the capabilities we will need will be very different.

We’re moving from thinking of the Navy as a collection of ships to thinking of ourselves as a network of maybe 10,000 nodes: ships, boats, planes, uncrewed systems, vehicles from the commando force, the Royal Marines, sailors. This is not a once-in-a-generation transition, it’s probably once in 100 years. The battleship-to–aircraft carrier transition was the last time we went through something this big in terms of changing the capabilities you need, the types of people you need, the range of disciplines, the processes, and so on.

So, if you squint, the future Royal Navy might look broadly the same. But the fabric underpinning it will be completely different. We’ve got missiles, we might have lasers. We might have different sensors. These things will have different supply chains. We’ll have trusted industry partners accessing live data from our ships. So, the ecosystem of how you work, what competencies you need, what competencies you need from your partners, what conversations you need to have, is all changing dramatically.

Power the engines

Reinventing your organization requires asking people to constantly step outside their comfort zone, which increases the risk of burnout. Transformative leaders consciously power their own engines so they can power the engines of others. They understand and act on what they need to do personally to remain energized and help make sure others don’t burn out by paying attention both to their own behaviors and to the organizational practices that structure how work gets done. They strive to maintain a growth mindset and understand that everyone involved in a reinvention—starting with themselves—needs to transform at least as much as the organization.

S+B: Leaders have a responsibility to look after their teams, yet if they do not look after themselves, they don’t have anything left in the tank to look after others. So how do you stack the odds in your favor? How do you remain energized?

MANOJ PATEL: The tools that work best for me are self-reflection and writing. The challenge is finding sufficient regular time to do it, and I haven’t really done enough of late, if I’m honest. But taking regular time to think and to write helps me manage myself and the way I show up in different contexts. It allows me to contextualize what’s going on, reinforce what’s important to me and where I want to go, and strategize around the tools that will help me get there.

When it comes to the team, I’ve really tried to empower them to be the owners and champions of the patient experience, whether that’s in cancer care, orthopedics, or women’s health. Transformation in healthcare requires leaders who have a breadth of knowledge, experience, empathy, and networks across clinical streams. These leaders then need to drive change and equally support the entire organization to develop understanding, buy-in, and ownership. I see my team as champions of this journey.

JOSEPH KAMARA: People have various sources of strengths. For me, spirituality is important. My spirituality helps me to reflect, to think, to calm myself down, and to remember that I have limitations. Then there is the radical ambition we spoke about. Like for most people in my organization, this is a vocation. I have a very strong connection to the work that I do. Then there is going into the field and seeing the results. This gives me joy. About a year and a half ago, I went to Northern Kenya and visited a family that had lost nearly all their livestock to drought. They used to have about 45 animals. They were left with six or so—very few. We could see the carcasses, the bones all around. And, before we left, our host slaughtered a goat for us. It was one of the toughest moments for me to accept his generosity. The man had lost everything, but he said, “If you visit my house, you cannot leave hungry.” My goodness. How can I go back and do more?

The authors thank Nadia Kubis for her contributions to this article.