Listen to this episode below, or on Apple Podcasts, Spotify or wherever you listen to your podcasts. The RCPCH Learning page for 'Leading the way' hosts all episodes, along with the transcript and more leadership resources.
Take an unconventional path
One of the strongest themes from the conversation is the importance of being willing to take an unconventional path. We discussed Nadeem’s decision to undertake an MBA while working in demanding full-time roles. It was undoubtedly a significant challenge, but one that helped equip him with new skills, perspectives and confidence to lead differently.
The lesson is clear: professional growth often requires stepping outside our comfort zones. Sometimes the opportunities that have the greatest impact on our careers are those that initially appear the most difficult or atypical.
Lead for change
Another key takeaway is the distinction between simply leading and leading for change. Leadership is not just about managing teams or holding positions of responsibility. Effective leadership creates impact. Nadeem feels that leadership should ultimately result in positive change, whether that is improving services, transforming systems or creating better outcomes for the communities we serve.
I like to talk about leading change, 'cause fundamentally, leadership is not just about the badge. It's about what are you doing with the idea of leadership?
What are you changing? What decisions are you making? And what, and why is it so difficult? Because it's got to be hard work to do this, otherwise, everybody would be at it, and they're not.
It is a useful challenge for all leaders to ask themselves: What change am I helping to deliver?
How can we build better services?
The conversation also explored the challenge of building better services in increasingly complex systems. Using the example of paediatric services, Nadeem discussed the fragility that can exist within healthcare systems and the importance of understanding population needs.
Strong decision-making relies on robust data and insight. By analysing the characteristics and requirements of local populations, organisations can design and commission services that are better aligned to real-world needs.
We use data, we look at how people are accessing service, why are they accessing service, how they move through the system.
This highlights the growing importance of evidence-based leadership and a system-wide perspective when planning for the future.
Commit to making a difference
I was particularly struck by Nadeem’s emphasis on motivation and purpose. Nadeem suggested that leaders should reflect honestly on whether they truly want to do the roles they occupy. While this may seem like a simple question, it goes to the heart of effective leadership. Passion, commitment and personal investment often determine whether individuals excel in leadership positions. When people are motivated by a genuine desire to make a difference, they are far more likely to inspire others and sustain high performance over time.
I need to understand people. I need to understand how people work together. Why aren't people working? What's the collaboration challenge? What's the idea? How do we define medical professionalism, right?
Be prepared for inevitable setbacks
Of course, meaningful change rarely comes without challenges. Another important reflection from the discussion was the need to be prepared for setbacks and personal difficulties along the way. Leading change can be demanding, requiring resilience, persistence and the ability to navigate uncertainty. I recognise that difficult periods are often an inevitable part of transformation and that leaders need strategies and support systems to help them manage these pressures.
The importance of your support network
This links closely to the final insight: the importance of having the right support around you. Nadeem spoke about the value of having “wing cover” from his board – people who understood his objectives and were willing to back his decisions.
Leadership is rarely a solitary endeavour. Whether it comes from colleagues, mentors, stakeholders or organisational leaders, support can provide both practical assistance and encouragement during challenging times. It is worth considering who forms your own support network and how those individuals can help you achieve your goals.
Create lasting impact
The conversation was both productive and thought-provoking. It serves as a reminder that effective leadership is about continuous learning, embracing challenge, staying focused on meaningful change and ensuring we have the support needed to succeed.
For anyone leading teams, services or wider organisational transformation, these reflections offer valuable lessons on what it takes to create lasting impact.
What resonated most strongly is that leadership is not simply about directing others; it is about having the courage to grow, the determination to drive change and the resilience to persevere when the path becomes difficult.
- About Nadeem
Most healthcare consultants observe the system from the outside. Nadeem Moghal has spent over 30 years inside it, as a clinician, a senior leader, and a patient. That combination of perspectives shapes everything he does at Strasys.
Nadeem trained as a Consultant Paediatric Nephrologist before moving into senior leadership, leading change across multiple healthcare organisations. He has held roles as Clinical Director, Director of Strategy, and Medical Director. He has led critical transformations improving clinical capability, standards, leadership, engagement, and culture. He has served as a Fellow at the NHS Institute for Innovation and Improvement, learned from the Institute of Healthcare Improvement in Boston, and attended Harvard's Kennedy School of Government as a member of the NHS Leadership Academy. He holds an MBA from Newcastle University, has been an external examiner at the Royal College of Surgeons of Ireland, and was an Honorary Senior Clinical Fellow at the Nuffield Trust. He was awarded an honorary fellowship by the Royal College of Physicians in Ireland, for his focus on improving services for children and young people,
A prolonged battle with cancer forced a career break. He returned to health services with renewed clarity about what matters: working with people, organisations, and ideas to serve those who need the best the service has to offer.
At Strasys, Nadeem leads the firm's clinical and innovation agenda. He is passionate about improving healthcare equality and life chances, and has been pioneering population-centric healthcare reform. His recent work includes supporting the reshaping of care for children and young people with Alder Hey, developing national healthcare quality governance capability, and enabling integrated care health systems to think and operate differently.
He questions current approaches, encourages different thinking, and works with leaders to build more equitable communities. Thinking differently, underpinned by data analytics and connected to real stories, is what makes Strasys his natural home.
Nadeem was a regular contributor to the British Medical Journal and the Health Service Journal. He now writes a regular newsletter - Friday Fish and Chip Paper - landing it in his LinkedIn profile. He continues to coach and develop future clinical and executive leaders through mentoring and the Strasys Academy.
- Authors to read: recommended by Nadeem in the podcast
- Peter Drucker
- W Edward Demining
- Henry Mitzberg
- Peter Senge
- Ivan Illich
- Byung - Chul Han
- Deborah Himsel - Leadership Sopranos Style
- Edgar H Shein - Humble Inquiry
- VS Naipaul - Miguel Street
- Nadeem's newsletter, comment pieces and briefing paper