In this episode, I sit down with Steve Moore, former Chief Executive of NHS Devon and a senior NHS leader with more than 15 years’ experience operating at board and system level across complex, highly regulated environments. We explore what it really takes to lead public sector organisations successfully: setting direction in ambiguity, balancing performance with purpose, leading through financial and operational pressure, building trust with stakeholders, and creating cultures that can sustain improvement. This is a conversation about leadership in the real world: how to make difficult decisions, carry people through change, and keep outcomes for communities at the centre.