Sustainable leadership in healthcare: moving from good intent to system impact

01 Dec 2025

Australian healthcare leaders carry heavy loads and navigate significant complexity. Many move from clinical or operational roles into leadership with only a fraction of the preparation that made them expert clinicians, yet they are expected to perform as expert leaders. They balance relentless operational pressures with the mandate to deliver long-term improvement.  A national study of 276 managers and executives confirms what people already know on the ground: most leaders value ethics, continuous improvement, staff wellbeing and accountability, yet too often lack protected time, tailored development and consistent measures of leadership effectiveness beyond financial KPIs. The majority believe investing in leadership development directly and significantly lifts recruitment and retention, strengthens culture, improves clinical safety and boosts organisational efficiency.

These findings align with a wider economic signal. Recent CEDA analysis of the IMD 2025 rankings shows Australia slipping on the very capabilities that underpin adaptability and innovation, including a fall to 60th on employee training and weak scores for international experience. In short, we are under-investing in the skills that help people and organisations adapt at pace. For health services navigating AI, new models of care and cost pressure, that is not a theoretical risk, it is a performance constraint.

HardyGroup’s experience echoes this evidence. Across systems in Australia and New Zealand, sustained, peer-to-peer learning with real work, real accountability and expert facilitation continues to build confidence, judgement and networks that endure beyond a workshop. The refresh of HG’s Executive Learning Sets after independent review underscores the value sponsors and participants are seeing in structured peer learning that fits the cadence of executive life.

A shift in emphasis is now required. Rather than episodic courses, leaders and managers need longitudinal development at every level, integrated with the work. Professional mentoring and coaching rated highly helpful in the study, as did on-the-job, manager-led training, yet access and time are uneven. Leaders also called for practical help with hard problems: managing performance, building culture, leading change and maintaining personal wellbeing amid operational pressures. This is where boards and executive teams can act decisively.

A useful frame is risk intelligence. Traditional debates swing between risk appetite and risk aversion. Risk-intelligent leadership equips people to sense, interpret and respond to uncertainty, to learn quickly from signals and to rebalance resources without eroding trust or safety. In health, that looks like leaders who can weigh patient-time and workforce-time, who de-escalate low-value activity, who connect data with lived experience, and who create psychological safety so issues surface early.

Four actions for Boards and Executive Teams

  1. Make leadership development unavoidable. Fund and mandate protected time and a choice of development opportunities, with clear participation expectations for managers, senior clinicians and executives. Prioritise mentoring, coaching and peer learning sets tied to live strategic work.
  2. Measure what matters. Balance financial metrics with culture, trust, staff wellbeing, recruitment and retention, safety and improvement capability. Report them with the same cadence and seriousness as budget results.
  3. Build risk intelligence. Develop decision frameworks with depth and breadth of understanding current and future risks, along with the cost and opportunity costs involved. Normalise prudent experimentation, timely course-correction and transparent accountability.
  4. Clear capacity for leadership. Remove low-value work, simplify approvals and give leaders protected time for strategic planning and people leadership, not just operational firefighting.

The cost of inaction is familiar: burnout, churn, inconsistent care, expensive mistakes and failed change initiatives. The dividend for action is compelling and measurable: safer care, stronger culture, better flow and financial performance. Now is the moment to invest in the leaders who hold the system together.

Read the full article in the journal of healthcare leadership or watch the 3-minute video abstract.

References

  1. Gunter S, Nogueira RC, Hudson C, Morton R, Jones CJ. Perceptions of Sustainable Leadership in Australian Healthcare. Journal of Healthcare Leadership, 2025.
  1. Committee for Economic Development of Australia (CEDA). IMD World Digital Competitiveness Ranking 2025: Australia results and commentary. 2025. CEDA
  2. HardyGroup. Newsletter, October 2025: Executive Learning Set program update and leadership development highlights. 2025.