Background COVID-19 pandemic exposed leadership teams to novel challenges that required many changes to their practices. This has been the most volatile, uncertain, complex and ambiguous (VUCA) times in healthcare.

Interventions This brief report uses experiences at Oxford University Hospitals to propose that an organisation’s culture serves as a bedrock on which management of a crisis such as the COVID-19 pandemic is reliant. The other two critical factors are partnership working and clarity of the strategic intent of the organisation.

Conclusions While many of the actions described in this report are likely to be in common with those of other leadership teams across the National Health Service, some organisations seem to manage the response to the VUCA situations better than others and the three factors are repeatedly observed in these organisations. This brief report explores what actions support the three critical factors that make some organisations more resilient and their leaders’ actions more effective.