The need for public sector reform is clearer than ever, with the current government committed to driving it forward. But how about the energy to make it happen and create lasting change?

As the NHS embarks on ambitious reform - shifting towards more devolved, diverse, and integrated models of care - one challenge looms large: how do we understand and respond to need in a dynamic, human-centred way? In other words, how do we get better at listening?

Culture is often treated as a backdrop - something static, atmospheric, and confusingly important. But when you look closer, culture is the living, breathing outcome of how people relate, respond, and adapt.

Every leader talks about culture, yet few pause to wrestle with what it really is. If you’re serious about influencing culture in complex environments, here are seven reality checks to ground your ambitions and help you succeed.