During the UK’s initial response to the COVID-19 pandemic, the NHS witnessed drastic and rapid changes to the way work was done. Not only were changes implemented at an organisational level, but at a more local level, staff across the service adapted and developed methods of coping to keep the healthcare system functioning. As a result of this, ideas and innovations that emerged during the initial response may be helpful not only in the immediate future but also in the longer term. This study from Miles et al. applied a systems approach to explore the changes and adaptations to work in the physiotherapy department of a large acute trust in the UK during the initial response to COVID-19 (April 2020).