What leadership fatigue looks like in real organisations

• Leaders stop making timely calls.
• Meetings multiply but decisions slow.
• Executives become reactive and transactional.
• Good people withdraw, then leave.
• The organisation runs, but it drifts.

Why Boards misread it

1. Leaders still show up Attendance is not capacity. A leader can be present and still operating below safe decision quality.
2. Metrics lag Boards see finances, complaints, incidents, KPIs. Fatigue is a leading indicator, not a lagging one.
3. Healthcare normalises overload Repeated demand pressure can become the baseline. The Board becomes used to crisis language and stops hearing it as a risk signal.
4. “High performers can handle it” High performers often absorb more work until something breaks.

Why 2026 makes this sharper
Retention pressure remains measurable. If a significant group report uncertainty or intent to leave, leaders inherit constant recruitment, coverage, and cultural repair work.

Demand signals remain high. National elective surgery reporting shows ongoing volumes and waiting list activity. These conditions create repeated surge patterns that exhaust leaders.

The cost of ignoring it

1. Poor decisions become normal Fatigue reduces strategic thinking and increases short-term fixes.
2. Executive turnover rises People exit when the role becomes unsustainable.
3. Clinical and operational risk increases Slow decisions and weak communication increase incident likelihood.
4. Culture degrades Teams copy leadership behaviour. If leaders become abrupt or absent, culture follows.

What the Board should measure
Make fatigue visible without making it personal. Examples of governance-friendly indicators.

• Executive leave usage and patterns
• After-hours load and sustained meeting volume
• Vacancy rates in critical areas and time-to-fill
• Rework rates, projects restarted, priorities changing
• Executive attrition and “near miss” exits
• Repeated delayed decisions on known risks

What works in practice
Boards can support structured wellbeing programs, but success depends on implementation quality and local adoption. Australian work in this area highlights the value of initiatives that embed sustainable practices rather than one-off activities.

Practical moves

• Reduce agenda load, prioritise decisions that only the CEO can make
• Protect two hours per week for strategic work, treat it as non-negotiable
• Set a deputy coverage model so the CEO is not the only escalation point
• Create a quarterly “leadership sustainability” review, separate to performance review
• Use external coaching sparingly, focus on role design and decision rights

Boards do not need to diagnose fatigue. They need to recognise it as a predictable by-product of sustained pressure and manage it like any other operational risk. Leaders who can think clearly and act decisively are an asset worth protecting.

If leadership fatigue is showing up in your executive team, we can help you assess risk and strengthen leadership capacity. Contact Steve Hockey at Predictus Search for a confidential discussion.