Finding colleagues who are equipped to perform in senior roles in the NHS is difficult; the NHS isn’t exactly ‘spoilt for choice’ when filling senior vacancies. The average tenure for a chief executive is 2½ years, and almost a third of all NHS trusts have at least one vacancy for an interim executive board member. Evidence tells us that board-level vacancies have a negative impact on organisations, affecting staff morale and engagement and sometimes causing strategic instability. There’s also irrefutable evidence of the link between patient safety, teamwork and team leadership. Leaders have a direct impact on engagement by inspiring commitment and providing recognition, growth and development opportunities.