Following a turbulent period in the Operating Theatre Rachel agreed to act as Perioperative Services Manager during an active recruiting process. Rachel stepped into a senior management role with limited previous management experience. The theatre complex had experienced an extended period without clear, well defined leadership and direction. The morale was low and the culture was suffering greatly. Rachel led from the front to create positive change engaging staff and others in the process. Her open communication and collaborative style has earnt the trust of her team and VMO’s and has resulted in visible improvement in the culture and atmosphere within the theatre complex.