Unprecedented levels of change and uncertainty are facing us all. Whatever the scale, political or economic, sector or service, organisational or personal, everyone is awaiting or experiencing unrest.

Many health service managers are anxious. Their challenge is to not only sustain but further improve service quality against growing demands with constrained resources and, for many, organisational disruption.

Concern over jobs, livelihoods and careers is emerging.

At the organisations I have been involved with during the past few weeks I have seen some good leadership from managers at all levels. They remain focused, calmly absorb news on the pressures ahead and are carefully pacing themselves and supporting their staff through the uncertainty towards their goals.

In all the turbulence they have not lost their bearings. Whether natural trait or deliberate strategy, they seem to use four points of reference from which they glean information and act.

For one, these managers face and anticipate the future. They are unafraid to read the signs ahead and keep track of what is emerging (and disappearing) on the near and distant horizon. They collect information on the significant changes most likely to impact on their situation - and on how they will impact.

Effective managers prepare to avoid, minimise or even make opportunities out of the impending issues. They put aside potentially paralysing anxiety and channel their energies into action. They make space to be innovative about the way around or through the issue, always looking for what they and their organisation can gain.

They are aware of, but not overly concerned or distracted by, factors that are unlikely to affect them.

Second, they reflect on the near and distant past experience, without seeking to blame, justify or be nostalgic. The learning provides insight into potential “how to” and, perhaps, what not to do. It can also highlight the behaviours that helped and hindered progress.

Understanding the value of collaboration, they look outward to make the utmost of their resources and redesign services accordingly. Working across professional, organisational and sector divides releases everything from ideas and innovation through to economies of scale, while also improving service and patient experience.

Finally, these managers keep their eyes on today. Whatever the future will bring, they remain determined to reach their overall goal - the focus of their job, the remit of their team, the purpose of their organisation, the benefits for service users. They use every practice to encourage their staff to see opportunity in place of threat.

Assessing their priorities, they employ resources to greatest effect and create versatile plans, building in key review dates - especially for significant events.

Keeping our bearings in this and any season of change is essential for continued delivery at the level and quality required. We need to keep our eyes open to the challenges, hunt out solutions, extend our competence and hold fast, confident that we can do it.