Change programmes are more likely to be successful in organisations that have worked to develop a high cultural maturity in the business area of the change. A higher maturity level and understanding of what this ‘maturity’ looks like should make it easier for your organisation to improve its capability when adapting to change. This remains true when adopting a health by design approach. We recognise that an organisation’s capability in implementing this approach effectively relies on more than ‘buying in’ to the benefits that health by design brings, both in terms of health and commercial benefit. It is about committing to the development or use of process, skills, experience, knowledge, personnel and culture required to be capable of making ‘meaningful’ health design decisions.