RT Journal Article SR Electronic T1 What can we learn about systems leadership from the building of a Welsh surge hospital and how might this be applied beyond the current COVID-19 response? JF BMJ Leader JO BMJ Leader FD BMJ Publishing Group Ltd SP 93 OP 97 DO 10.1136/leader-2020-000311 VO 5 IS 2 A1 William Beharrell A1 Len Richards A1 Martin Driscoll A1 Jonathon Gray YR 2021 UL http://bmjleader.bmj.com/content/5/2/93.abstract AB Methods It draws on a series of 20 interviews with key protagonists and employs a Bakhtinian approach to narrative analysis, which explores the interplay between individual accounts and larger sociocultural themes.Conclusions It concludes that the success in managing the complexity of this project can largely be attributed to a systems leader approach that draws on the power of an agile network to be replenished and redeployed against rapidly evolving strategic objectives. This effectively constitutes a parallel operating structure, which is devoted to the design and implementation of strategy based on a continual assessment of the organisation and serves to strengthen rather than supersede established hierarchical structures of authority.Data are available on reasonable request. All data have been gathered from colleagues employed by the NHS and is recorded in the form of Microsoft Word files. If required, data can be accessed via the innovation and improvement manager at the Cardiff and Vale Health Board. No patient data have been collected.