Amid the extensive news coverage of the vaccine developed by researchers at Oxford University in partnership with Astrazeneca, a report in The Times on Tuesday caught my eye.

The report described the expertise of scientists at Oxford and their understanding back in February that Covid-19 was going to be a global pandemic with serious consequences for people’s health and the health care system. The scientists were confident that their experience would enable them to develop a vaccine but were aware of the need to demonstrate its safety as well as efficacy at unprecedented speed. They also knew that they had to be able to work with a manufacturer to make the vaccine available in large quantities and at an affordable price to achieve the desired outcome.

To cut a long story short, the vaccine experts and colleagues involved in running large scale clinical trials came together to work on vaccine development and its testing. According to The Times, this meant each senior scientist agreeing to give up ‘their personal academic fiefdom and promise to work as a team’. They then sought a partner who would agreed to manufacture the vaccine and to do so in a way that would be affordable to all countries. In April this resulted in an agreement with Astrazeneca which had both the capacity and the willingness to work in this way.

When I read The Times report, I was reminded of the work of Harvard professor Amy Edmondson on the role of teams in leading innovation in complex environments. Edmondson’s essential insight is that many contemporary challenges require unprecedented levels of collaboration between teams that come together from different professions and organisations. This is because of the explosion of specialised knowledge together with the complex and multifaceted nature of the problems facing societies – Covid-19 being a signature case.

Edmondson uses the term ‘extreme teaming’ to describe these collaborations and she identifies four key characteristics of leadership needed in effective teams. They include building an engaging vision to motivate team members, cultivating psychological safety to overcome personal challenges, developing shared mental models to facilitate communication and collaboration, and above all empowering agile execution in uncertain environments where experimentation and learning are essential. Edmondson argues that leaders need to be ambidextrous, addressing both interpersonal and technical challenges and moving between facilitation and motivation-oriented practices.

Whether and how these approaches were used in the Oxford/Astrazeneca partnership will only become clear when researchers have the time and opportunity to study how it operated in much greater depth, no doubt creating a business school case study in the process. For now, the main take home point for me is the relevance of this example for the work many of us are doing in emerging integrated care systems. These systems are test beds for extreme teaming and the leadership characteristics Edmondson identifies.

In the current environment, agile execution is especially important as the NHS and its partners continue to respond to Covid-19 as well as restoring services for non-Covid patients and planning the biggest vaccination programme ever seen. Delivering these priorities requires multiple teams to be brought together from many different professions and organisations, leaders who can motivate team members and create psychological safety, and shared mental models to aid communication and collaboration. Like Oxford’s academics, leaders and followers must be willing to sacrifice their freedoms for the greater good in the face of a common threat.


Chris Ham is chair of the Coventry and Warwickshire Health and Care Partnership and adviser to CF