Footnotes

• Contributors This is an original commentary of which BH was the primary author. GMS provided input regarding organisational change theories. The paper is being exclusively submitted for consideration to publish in BMJ Leader.

• Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

• Competing interests None declared.

• Provenance and peer review Not commissioned; externally peer reviewed.