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In February, IMPOWER and CIPFA brought together senior leaders from local government, finance and the NHS to explore a pressing question: what does it really take to deliver transformation in increasingly complex public sector systems? The discussion’s write-up, which can be found here, reinforced a theme that many leaders will recognise – successful transformation is rarely about finding a perfect plan. It’s about building the confidence and capability to navigate complexity.

“We have reform everywhere all at once,” said Adrian Smith, Chief Executive of Nottinghamshire County Council, opening our recent Shared Learning Event. The scale and pace of change facing councils present significant challenges, but it also creates a rare opportunity to embed prevention at scale. Realising that opportunity will require councils to think differently about service design, workforce models, local intelligence, and leadership.

As discussed in my last article, across health and care, we are not short of evidence-based models for improving discharge and flow. Frailty models, Home First, Discharge to Assess, virtual wards, transfer of care hubs and neighbourhoods all point in broadly the same direction: support people in the least restrictive setting, avoid unnecessary hospital stays, and focus on recovery and independence. The recent NHS England Model Discharge Pathway reinforces these principles.

“What if rather than trying to organise an optimal response to current operating conditions, what we did was to optimise our capacity to respond to the changing nature of the world?” This is a question posed by a participant of IMPOWER’s Complex Transformation Academy, capturing one of the biggest challenges facing local government today. It struck a chord; leaders learn how to work in complicated environments focused on improving performance against KPIs within established service structures.

Michael Wyatt recently returned to IMPOWER after a spell as Associate Director of Clinical Pathways and Deputy Divisional Director for Medicines at Surrey and Sussex Healthcare NHS Trust. Closing the gap between knowing and doing Most systems already know what needs to change. What they lack is the time, capacity, and delivery support to make it happen.

Working from December 2025 – May 2026 Nottingham University Hospital Trust (NUH) delivered a length of stay reduction of two days across six geriatric wards, with the support of IMPOWER. IMPOWER were initially commissioned by NUH in July 2025 for a brief proof of concept project, to test the impact of a strengths-based approach to discharge. This work identified opportunities that could be directly taken forward by the Trust, together with wider possibilities across the place partnership.

Written by Rob Walsh, Associate Director for IMPOWER Consulting When I spoke at the first session of the Complex Transformation Academy, I started with a simple thought: complex transformation isn’t really about programmes, plans or structures. At its core, it is about people, culture and how we choose to lead, and how we translate ambition into something that delivers real change.

Last week, at my first UKREiiF conference, I joined a roundtable on fiscal devolution hosted by The MJ and IMPOWER, alongside Core Cities Chief Executives and Mayoral Combined Authority Chief Executives. It was a conversation that stayed with me on the train home. There is a real moment to seize. Not in the abstract debate about devolving tax powers, but in the opportunity to design a settlement that aligns economic growth with the outcomes that matter to people in our cities.

IMPOWER and Pixel Financial Management co-hosted a shared learning event, on financial sustainability in SEND and inclusion, that brought together more than 160 leaders from across local government. The event was chaired by Rob Powell (Executive Director, Warwickshire County Council) with contributors, including Adrian Jenkins from Pixel Financial Management, Ebony Hughes and Rob Hart from IMPOWER and Rachel Adler, Director of Strategy & Performance, Hertfordshire County Council.

Health systems across the UK are facing a shared dilemma: how to move towards prevention and care in the community while managing unprecedented demand, stretched budgets and operational pressure. From my perspective, the challenge for many finance leaders is not a lack of ambition, but the difficulty of creating space for long‑term change in the face of immediate risk.