The paper reflects on the implications of selecting local multifunctional networks as a principal method of achieving improvement in the transition experience of young people with life-limiting conditions, given the range of blocking factors identified. It summarises a programme of work that aimed to tackle these blocks through developing local systems responses. It then offers a review of organisation development that sets a context for the work and helps consider its implications, including a five-part model that emerged. Finally, learning and insights for practitioners engaged with local complex systems are offered, taking account of leadership, emergent boundaries and actor-network dynamics.