Empowered staff can make meaningful change. Empowerment involves recognising the potential that lies within staff and providing them with the time and space to reflect, be creative, action change and ultimately thrive both as individuals and as team members. The authors will discuss the value of utilising human-centred service design in co-producing transformative change with empowered staff and ‘extreme teams’ within a complex health and social care system traditionally viewed as a linear machine system. They will question the value of the predominance of visualising a linear machine system model in twenty-first-century health care and explore the importance of delivering change through the lens of health and social care as an ecosystem of people and interconnected relationships. The value of human-centred service design will be illustrated with case studies from the authors’ work, which involve collaborations between undergraduate students from the Innovation School at The Glasgow School of Art and a local National Health Service (NHS) health board, NHS Ayrshire and Arran (NHS A&A), both pre-pandemic and within the pandemic response. As health and social care services move out of the emergency response to the remobilisation phase with a focus on recover, restore and renew, opportunities for consolidating pandemic changes and initiating further systems change arise. The authors will reflect on the use of human-centred service design as an enabler of transformation to new models of care that recognise the importance of empowered and valued staff owning and driving journeys of possibilities.