The challenges facing today’s leaders in health and care are complex. Now, more than ever, they need to be system leaders, capable of working across boundaries to find solutions to the increasing demands placed on services. They need to bring together expertise and use resources from primary care, secondary care, mental health services, public health, social care and the voluntary and community sector. The list is exhausting. They also need to engage with people who use health and care services, and their carers, on the one hand, and senior specialists and politicians on the other.