Background The renal transplant team in Northern Ireland performed 70 transplants in 61 days during the first wave of COVID-19, an 8-fold increase in their typical activity. Mobilising diverse professional skills to achieve this number, especially under COVID-19 conditions, required extraordinary effort on the part of everyone involved along the transplant patient pathway, management and staff from other patient groups.

Methods Fifteen transplant team members were interviewed to explore their experiences during this time.

Results Seven key leadership and followership lessons, contextualised within The Healthcare Leadership model, were learnt from these experiences.

Conclusions While circumstances were untypical, the achievement and motivation of staff were no less commendable. We contend that this was not only because of the unusual circumstances but as a result of extraordinary leadership and followership, teamworking and individual agility.

Recommendations for those leading services which require a quick response and collaborative effort are made.