My role as Divisional Medical Director for Goodall Division of CNWL encompasses approximately one third of CNWL's clinical services. This Division provides physical and mental health services to the inner and outer boroughs of London. Our aim is to make joined up health care a reality, and to inspire our staff to bring quality improvement into the centre of their daily working lives. Prior to moving to Central & North West London NHSFT, I was a substantive consultant at Southern Health and its predecessor organisations between 2002 and 2015. During this period I took on substantial clinical management roles, as well as lead roles with the University of Southampton and the Wessex Strategic Clinical Network. The world is changing at an exponential rate. Within 10-20 years healthcare will be almost unrecognisably different. The role of leadership is to make it easier for our staff and citizens to shape this future, to remove barriers, and to make continuous learning an everyday reality.