Executive Conversations: Belinda Phipps on Leadership Under Pressure
What does it really take to lead when the consequences of failure are significant, uncertainty is constant, and every decision carries weight? In this edition of Leadership Conversations, Simon Pickerell speaks with Belinda Phipps, Interim Chief Executive of the British Refugee Council, about the realities of leading complex organisations through periods of significant change. Drawing on a career spanning healthcare, the public sector and the charity sector, Belinda reflects on the experiences that have shaped her leadership approach, from her first chief executive role in the NHS to leading transformation in organisations facing financial, operational and societal pressures. Together, they explore what creates a genuine burning platform for change, how to build momentum in the face of scepticism, why the most effective leaders focus on solving dilemmas rather than accepting compromise, and the personal resilience required to lead when the stakes are high. — 1. What first drew you to transformation work? Was there a defining moment early in your career? Early in my career, the defining moment came when I took on my first chief executive role, leading the regional Blood Transfusion Service for the South East. I arrived feeling proud and excited, and like any new CEO, I went out to see how things worked on the ground. On only my second or third day, I visited the team that takes orders from hospitals for blood products. I stood and listened as call handlers repeatedly told hospitals they couldn’t have what they were asking for, effectively negotiating and arguing over orders. In my naivety, I asked what would happen if we didn’t deliver the blood. The answer was that operations would be delayed or cancelled. Then I asked, “What happens if it’s an emergency?” There was a deathly silence. The unspoken truth was that the patient might not get the blood they needed and might not survive. That was a chill‑down‑the‑spine moment. I suddenly understood that I was responsible for an organisation that could, in effect, be contributing to people dying if it failed. I had to ask myself, “Do I really want to do this?” Because if I stayed, then I had to fix it. Fresh from an MBA, I decided to radically change how the service operated so it could reliably provide the blood required. My initial toolkit wasn’t enough, so I went back for more help and brought in a different methodology. Within about 18 months, we had enough blood not only for our own region but also to support other centres, and we stopped missing orders. The transformation changed everything. We went from the fear of failing patients to the pride of staff who were genuinely delighted with what they were achieving and hungry to improve further. That success helped drive a national merger of the separate blood services, so the same approach could be rolled out everywhere. Seeing that kind of turnaround, the impact on patients and the pride in staff, can be almost addictive. That experience was my entry point into real transformation work 2. What was the real burning platform that convinced you this transformation was non‑negotiable? In the blood service, the burning platform was stark: you cannot be killing people. If the organisation fails to deliver blood when it’s needed, you are putting lives at risk. In that situation, transformation isn’t a strategic option—it’s an ethical necessity. Continuing as you are simply isn’t morally defensible. In other transformations I’ve led, the burning platform has often been financial and existential. Organisations reach a point where their financial sustainability, and therefore their future, is in serious doubt. By the time I’m asked to step in, most of the incremental fixes have already been tried. So the burning platform often sounds like: “We’re running out of options. If we carry on like this, we may not survive.” At that point, a significant transformation, not just marginal change, is non‑negotiable. 3. What has been the most difficult trade‑off you’ve had to make in a transformation so far? I’m actually not a great believer in trade‑offs as they’re commonly framed. “Trade‑off” often becomes a respectable word for “we’ve decided to compromise,” and that can be a sign we haven’t done enough deep thinking. Take the NHS as an example. The system constantly wrestles with three pressures: The typical response is to “balance” these, focus on one at the expense of the others, then shift back again. You end up institutionalising a permanent sense of compromise. Whenever I’m told, “This is a trade‑off,” I try to treat it instead as a dilemma to be solved. I ask: how can we improve quality and quantity of service, and be financially sustainable at the same time? It’s not that everything is easy or that you never make hard calls, but often, when you really apply yourself to the problem, you can find creative win‑win solutions instead of living forever with unhappy compromises. The real work of transformation is less about tolerating trade‑offs and more about resolving long‑standing dilemmas that people have assumed are unfixable. 4. How do you bring sceptics and “fence sitters” in the organisation along on the journey? At the beginning, I don’t. Every organisation has three groups: If you start by focusing on sceptics and fence sitters, you burn a lot of time and emotional energy for very little progress. So early on, I focus on finding and working with the willing. I have a lot of individual conversations to identify those who really want to give change a go. I then work closely with them to build momentum and deliver visible progress. Once things are moving and good things start to happen, the dynamics change: In short, I lead with the willing, let success become the persuader, and allow sceptics to make their own decisions once the direction of travel is obvious. 5. Can you share a moment when a transformation nearly went off the rails, and what you did about it? When a transformation feels like it’s going off the rails, my first move is to look in the mirror. In my experience, things often wobble when: Transformations are emotionally intense. They involve high stakes, conflict, and