Highlights ► Challenging road safety paradigm currently in place. ► Transformational leadership and deep change key to this. ► Deep change examples: mobility management, active travel, reconsidering time. ► Holistically oriented management systems needed to facilitate systemic change. ► Integration of Vision Zero approaches with sustainable transport agenda.

Abstract In an earlier paper in this journal, we argued that current road safety programs and thinking are constructed within a paradigm that tends to accept existing cultural arrangements. The current paper is a sequel to the earlier one, and outlines significant policy themes emerging from a research project on a holistic approach to road safety. Two overarching themes include the importance of leadership for policy change and implementation, and addressing the more transformative aspects of intervening in a system. A distinction can be drawn between “deep” sustainable change, which usually requires fundamental redesign of the systems involved, and “shallow” adaptive change. Examples of deep change discussed include the much wider application of mobility management, a strong shift to active travel and public transport, and a reconsideration of how time is structured in society, as with the adoption of “Slow Cities” principles. Transformational leadership can draw on a variety of “knowledge cultures”, which can all share in collective decision-making and possible actions for the future. We discuss especially leadership at the worldview, organisational, and community levels. Vision Zero approaches are valuable, but need to be integrated with a common vision for a sustainable transport system developed in conjunction with energy, transport, health, environment, and education agencies. In addition, Vision Zero approaches can be assisted by greater attention to and questioning of embedded cultural practices and behaviour.