Mike Gill is Director at At Scale Limited and author of “How to Survive Austerity: A Field Guide for Public Sector Managers”
Every generation thinks they’re living through the apocalypse. I’m currently reading an amusing book by Tom Phillips that reminds us humans have an impressive track record of believing the end is nigh – and being spectacularly wrong. Not an instant topic for humour but worth a read.
When you’re living through crisis, the fear is real. The pressure is real. The sleepless nights worrying about next quarter’s figures or transformation milestones – very real indeed.
If you’re leading in public services right now, it genuinely feels apocalyptic. Forty-three pioneer sites are implementing neighbourhood health models while managing impossible demand pressures. Budgets that were tight three years ago now feel laughable. Workforce challenges are genuinely frightening.
And yet. We’re still here. People are still receiving services. Not perfectly, not without strain, but it’s happening.
The question isn’t whether we’re facing significant challenges – we absolutely are. The question is whether catastrophising helps us navigate them. Spoiler: it doesn’t.
What I’ve learned from four decades in public sector delivery is that organisations that survive and thrive aren’t the ones with the shiniest strategies. They’re the ones who can hold two truths simultaneously: yes, this is genuinely hard, and no, it’s not the end of the world.
They can look at a funding gap without reaching for “managed decline” narratives. They acknowledge workforce pressures whilst still investing in development. They maintain focus on what matters – better outcomes for communities – even when everything feels on fire.
This isn’t toxic positivity. It’s perspective. While this moment feels unique, the fundamental task remains unchanged: delivering public services that work for real people in real communities.
The 2025-2027 NHS transformation window isn’t apocalyptic – it’s an opportunity. When systems are under genuine pressure, there’s permission to do things differently. To strip away what doesn’t work. To focus resources where they’ll make a difference.
Some of the best integration work emerges not despite crisis but because of it. When public sector partners and community organisations finally stop circling each other politely and start actually working together, it’s usually because the alternative is unthinkable.
So what does this mean practically?
Stop waiting for things to calm down. They won’t. Transformation needs to happen now, in the mess, with imperfect information and competing pressures.
Focus ruthlessly on what will move the dial. Not what looks good in a board paper, but what will genuinely improve outcomes in six months.
Build your resilience infrastructure now – the relationships, the trust, the systems that will hold when the next crisis hits. Because there will be a next crisis.
The world isn’t ending. But it is changing. The organisations that understand the difference will be the ones still standing when the dust settles – delivering better services than before.
Because that’s what we do. We navigate impossible situations and make them work. It’s not glamorous, it’s often exhausting, but it’s never been more important.
Policy is easy. Delivery isn’t.
