This site is intended for health professionals only

What makes an exemplary system leader?

What makes an exemplary system leader?
Credit: marchmeena29/iStock/Getty Images Plus via Getty Images
By Mike Mullins
20 June 2025



Psychologist and leadership development coach, Mike Mullins, shares the findings of research that explored the traits of exemplary system leaders. This is the first in a series of five articles on the subject.  

As a psychologist and leadership development coach, I’ve been fascinated by the experiences and mindset that make great leaders.

In 2020, I collaborated with Practive Ltd, which NHS England had commissioned to interview 40 leaders across the health and care system, all of whom had been identified as exemplars of systems leadership. The aim of the research was to uncover the mindset, skillset and experiences that develop great system leaders.

Following the interviews, I wrote a paper, The Undefended System Leader. This drew on the themes that emerged, as well as systems and complexity theory, to distil what makes an effective system leader. In this series of five articles, I’ll share our main findings and explore what it looks like in practice to develop exemplary systems leadership.

System leadership

Let’s start with what we might mean by the term system leadership:

  • It’s a mindset: a way of seeing the world of organisations
  • It’s the ability to see how systems impact behaviour: to understand the strengths and limitations of their particular stage of leadership consciousness and their default approach to problems.
  • It’s the ability to enable others to be their best selves: to help them imagine and be inspired to co-create a different positive future.
  • It’s about collaboration: coalition-building and systems insight to mobilise innovation and action across a large, decentralised network.
  • It’s having a different relationship to time: systems leaders can see and live the long-term vision and avoid getting caught up in the current paradigm that might be inhibiting change. As a result, they’re able to focus on strategic priorities like population health and reducing health inequalities.
  • It’s about bringing a range of skills, attributes and qualities to energise, catalyse, enable and support the process of systems-level change: system leaders are intelligent, ambitious visionaries with systems thinking and relating, as well as strong skills in management and delivery. They have presence and humility. They are good listeners and skilled facilitators and coaches who can effectively engage stakeholders with highly divergent priorities and perspectives. Systems leaders don’t occupy the spotlight themselves; they operate as catalysts, enabling and supporting interdisciplinary, cross-system action.

All the research says that the best health outcomes are consistently delivered by high-performing multi-professional teams working together in a spirit of genuine collaboration with the focus on improving population health. Such high-performing teams are most likely to be built by skilled system leaders.

‘Inside out’ leadership development

So, how can the health and care system meet the challenges of integrated care and enable its leaders to transcend context and embody a genuine system leadership mindset and behaviour?

Our thinking to date indicates that an ‘inside out’ approach is critical for the development of system leaders, based on four key leadership development steps:

  • Being aware of and managing your tendency to system blindness and how the pressures of the system in the NHS and care system can adversely affect your relationship with others.
  • Recognising your current way of ‘meaning making’ as a leader and developing it. Identify your strengths and areas for development.
  • Understanding your default approach to different types of problems faced by the NHS and care system – the obvious, complicated and complex. Learning to adapt your approach to them. 
  • Finally, and most importantly, being willing to embark on a personal journey. Becoming more aware of your whole self: values, purpose, strengths and, crucially, your shadow side. Understanding how your drives and defence mechanisms might trip you up as a systems leader. Learning the humility and ability to share power, which is so characteristic of an undefended system leader. In my experience, a leader’s defended ego can be the biggest block to being an effective system leader.

The leaders we interviewed back in 2020 had these qualities – that’s what made them exemplars of system leadership. They had the capacity to bring vulnerability, compassion, empathy and curiosity into dialogue with system partners. There was a willingness to see the truth of multiple perspectives. They were willing to be wrong, to make mistakes, and even fail, in the interests of experimentation and learning.

The next article will look at the first of these steps: how to be aware of system blindness and how pressures can affect your relationships.

If this resonates with you as a leader within the health or care system, or as an organisational development professional responsible for the development of future leaders, then please share your thoughts and reflections. Email address: [email protected]

Mike Mullins is founder of Mike Mullins Consulting Ltd

Want news like this straight to your inbox?

Related articles