What “succession risk” looks like in healthcare

Succession risk is not only “who replaces the CEO.” It is the organisation’s exposure to disruption if leadership changes at the wrong time. In health services, that disruption can show up fast through delayed decisions, stalled reform, loss of clinical confidence, and weakened stakeholder trust.

Why 2026 heightens CEO succession risk

Capacity pressure does not pause. Public hospital access pressure remains visible in national reporting on elective surgery volumes and waiting lists. When operations run hot, CEO decisions carry more consequence and less slack.

Workforce retention remains unstable. When a measurable share of registered practitioners report uncertainty or intent to leave within one year, the signal for Boards is clear, the employment market stays volatile, and volatility travels upward.

Change programs keep stacking. Digital, safety, governance, and workforce initiatives keep moving. The CEO often becomes the integration point, which makes the role harder to sustain without a strong deputy bench.

The common Board blind spots

1. “We have a name in mind” is not a plan

A likely internal successor without exposure to Board level scrutiny, external stakeholder management, and crisis leadership is still an untested risk.

2. Overreliance on one deputy

A single heir apparent creates fragility. If that person leaves, is unavailable, or underperforms in acting capacity, the Board has no fast alternative.

3. No transition rehearsals

Boards rarely run a real simulation. Acting arrangements, decision rights, media handling, and clinical governance escalation pathways should be tested before a crisis.

4. Assuming recruitment speed

Executive recruitment can take longer in healthcare, and the best candidates often have long notice periods. If the organisation waits for the resignation to start planning, the gap becomes expensive.

What strong Boards do differently

Build a CEO succession map, not a list

Map 3 layers, CEO now, acting CEO options, and 12 to 24 month successors. Rate each person against real requirements.

Separate capability from tenure

Time in the system does not equal readiness. Test for capability under pressure and strategic judgment.

Protect the acting role

If the CEO steps out, the acting CEO needs clear decision authority, protected time, and Board access.

Create early warning signals

Track leading indicators, executive leave, sustained overtime, repeated short absences, stakeholder complaints, and delayed decisions.

Link succession to workforce strategy

Workforce shocks land on the executive team. Boards should treat CEO succession as part of workforce risk management, not as a one-off governance task.

Practical steps you can take this quarter

Step 1. Define the CEO role deliverables for the next 18 months

List the top 5 outcomes, not generic competencies.

Step 2. Identify two acting options and test the plan

Document who takes what decisions, and who covers clinical governance escalation.

Step 3. Run a one-hour scenario with the Board and executive team

Pick a plausible event, CEO leave, safety incident, funding shock, and rehearse the first 72 hours.

Step 4. Commission an external market scan

Know what comparable CEO candidates look like, what motivates them, and what it will cost to attract them.

CEO succession risk is not a future problem. It becomes a current problem the moment an organisation cannot make fast, confident decisions. 2026 is the year to treat succession as a standing agenda item, with a plan you can execute at short notice.

If CEO succession is on your agenda for 2026, we can help you reduce transition risk and strengthen your executive bench. Contact Steve Hockey at Predictus Search for a confidential discussion.