What burnout taught me

When our project Powering Up was named a finalist for Best Pilot of the Year at the HSJ Awards, I felt a surge of something that surprised me: not just pride, but relief. The kind of relief that comes when something tender and hard-won is finally seen. 

The project brought together clinicians, creatives, and young people to address health inequalities through co-production and creative expression. It was more than a pilot. It was a provocation. An experiment in what health care could look like if we took equity, imagination, and joy seriously.

To have it recognised on a national stage was meaningful. Yet even as I was being congratulated, I couldn’t ignore the quieter, more sobering reflection underneath: if I want to do this kind of work again at scale, with impact—I need to do it differently. And I need to take better care of myself while doing it.

The truth is working on Powering Up nearly broke me. Behind the glossy case studies and filmed performances were months of stretching to manage emails at midnight, budget gaps, safeguarding dilemmas, and logistical nightmares. 

I cracked two molars from stress. I developed stomach ulcers. At one point, I couldn’t sleep through the night without waking up in a sweat, worrying about someone I felt responsible for—usually a young person, or a colleague who was giving too much of themselves, too.

And yet, I kept going. Because I believed in the work. Because it was beautiful. Because it was needed.

But belief alone isn’t enough. As Donella Meadows reminds us in Thinking in Systems, ​‘a system is perfectly designed to produce the results it gets.’ Our health care system is not yet designed to support creative, co-produced, joyful disruption—at least not sustainably. 

So, like many in the NHS and beyond, I was trying to create miracles with very few tools. It felt like magic at times—but magic, like adrenaline, has a cost.

One of the biggest lessons from being an HSJ finalist was how thin our impact measures really were. We had stories—brilliant, moving, complicated stories. We had artwork, film and poetry. 

We had tears and hugs and that rare alchemy when something shifts in the room. But we didn’t always have numbers. Or frameworks. Or outcomes we could package neatly for funders or commissioners.

I understand why that matters. Improvement science tells us that you can’t improve what you can’t measure. But systems thinker Margaret Wheatley also says, ​‘not everything that can be counted counts, and not everything that counts can be counted.’

The work now is to create a model that is built on both rigour and resonance. I want to take this model forward with stronger tools—mixed methods and approaches that respect both numbers and narratives. I’m building relationships with academic partners to do just that.

This experience has taught me that true, values-led, inclusive leadership is not about control or certainty. It’s about the adaptive capacity that Ronald Heifetz and Marty Linsky describe in Leadership on the Line. They describe a leader who holds the tension, navigates loss, and keeps moving forward without a clear map.

I had to learn to share power for real, not rhetorically. That meant letting young people shape the agenda and letting artists hold space. It meant letting clinicians be vulnerable. It also meant that I didn’t always look like the leader, which was the point. 

We faced moments of deep discomfort. Funders questioned our methods. Partners pulled out. Sometimes I didn’t have the answers. 

Perhaps the moment that was most painful was when I realised I hadn’t built a sustainable plan for myself or the team after the final curtain dropped.

We finished the show and won hearts. But we limped home, tired and overextended.

So, what now? Here’s what I’m taking forward:

• Build evaluation into the foundation. This needs to be an active part of the project, not an afterthought. Impact doesn’t have to mean a randomised control trial, but it does need to be planned and meaningful.
• Ask for help earlier. Whether it’s institutional allies, operational support, or someone to help hold the emotional labour—I won’t do it alone again.
• Design for sustainability from the start. This is key for participants, for staff, and for myself. That means clearer aftercare pathways, realistic timelines, and a culture that doesn’t valorise burnout.
• Champion creativity with confidence, not apology. The NHS needs imagination as much as it needs metrics. Our systems can’t be reformed by logic alone.

Ultimately, what Powering Up has showed me is that people are hungry for work that feels meaningful. Clinicians want to connect. Young people want to be heard. Communities want to co-create, not just be consulted. But the conditions to support that work remain fragile and we who lead it must be careful not to fall through the cracks ourselves.

I celebrate our HSJ recognition with a full heart. But I also carry forward the deeper work: to build braver systems, stronger frameworks, and more sustainable cultures for change.

The miracle isn’t that we did it once. The miracle will be figuring out how to do it again—and still be standing when it’s done.