In this episode of the Delivery by Design Podcast, Alastair Mitchell-Baker speaks with Matthew Winn, Chief Executive Officer at East of England Community Health and Care NHS Trust & Member Board of Trustees at Cambridge United Foundation, about designing operating models that enable better integrated care, stronger leadership, and improved outcomes for local communities.

Matthew shares his experience leading a newly merged community health and care organisation and explains why an effective operating model is not just about structure, but about delegation, culture, leadership capability, governance, and empowering teams to make the right decisions locally. He discusses how large geographically spread organisations can balance consistency of standards with flexibility for different communities and populations.

The conversation explores the challenges of NHS mergers, building a shared culture, creating integrated neighbourhood care, and redesigning services around population needs. Matthew also discusses the future of health and social care integration, the importance of cross-organisational leadership, and why better care requires organisations to move beyond traditional boundaries.

Key Takeaways:

• Why operating models should focus on enabling leaders, delegating responsibility, and supporting frontline teams to make effective decisions.
• How community health organisations can balance local flexibility with consistent standards of care.
• Why leadership development is essential for creating successful delegated operating models.
• How merging organisations requires creating a new culture rather than simply combining existing ways of working.
• The importance of collaboration between NHS providers, primary care, local authorities, and voluntary organisations.
• Why integrated neighbourhood care requires shared accountability, aligned incentives, and better use of population data.
• How frailty care can be redesigned through early identification, prevention, and community-based support.
• Why healthcare leaders need to think beyond organisational boundaries and focus on population outcomes.

Noteworthy Quotes:

• “Our roles as public servants are to support great health and care being delivered. Otherwise, we have no purpose in the organisation.” – Matthew Winn
• “An operating model is not one thing. It is a whole culture, a whole training, and a whole delegation process.” – Matthew Winn
• “If you don’t train your leaders, they won’t be able to take responsibility and do that work.” – Matthew Winn
• “We’re not going to replicate things that weren’t working. We’re going to do what the evidence shows us is the right way.” – Matthew Winn
• “The NHS can only do a tiny part. Integrated care is about the totality of support around people.” – Matthew Winn
• “Leadership is about redesigning care.” – Matthew Winn

Key Timestamps

00:00 - Introduction to Matthew Winn and East of England Community Health and Care NHS Trust

02:08 - What an operating model means in a large community healthcare organisation

05:38 - Governance, delegated leadership, and service assurance

09:23 - Why leadership development is essential for delegated responsibility

12:51 - Merging two NHS organisations and creating a new culture

18:42 - Balancing consistent care standards with local flexibility

23:02 - Building integrated neighbourhood care across organisations

25:01 - Redesigning frailty care around population needs

29:17 - Working with local authorities and community partners

34:52 - New leadership capabilities for integrated health and social care

39:42 - Understanding the total cost of care across organisations

43:25 - Redesigning fragmented health and social care pathways

44:33 - NHS Continuing Healthcare and the challenges of fragmented funding

47:13 - Why disconnected services create challenges for patients and families

48:29 - Leading across organisational boundaries to redesign care

Disclosure: Portions of this episode (such as the introduction or promotional segments) use AI-generated voice narration produced under human editorial review.

Follow Our Guest, Matthew Winn:

• Matthew Winn LinkedIn: https://www.linkedin.com/in/matthew-winn-b750b67a/
• East of England Community Health and Care NHS Trust Website: https://www.eastofenglandcommunityhealthandcare.nhs.uk/
• Cambridge United Foundation LinkedIn: https://www.linkedin.com/company/cambridge-united-foundation/

Connect with the Host, Alastair Mitchell-Baker:

• LinkedIn: https://www.linkedin.com/in/alastair-mitchell-baker-a01babb/

Follow our Colleagues from Tricordant:

• Andrew Liles: https://www.linkedin.com/in/andrew-liles-282b1792/
• Yasmin Wills: https://www.linkedin.com/in/yasmin-wills-b72535146/
• Nick Richmond: https://www.linkedin.com/in/nickgmrichmond/
• Helen Blanchard: https://www.linkedin.com/in/helenblanchard21/

More from Tricordant:

• Website: https://www.tricordant.com/
• YouTube: https://www.youtube.com/channel/UCo2WP_UCnm-tszOIc87O36Q
• LinkedIn: https://www.linkedin.com/company/tricordant-ltd/
• Email: [email protected]

Follow the Podcast:

• Apple Podcasts: https://podcasts.apple.com/us/podcast/delivery-by-design/id1884004753
• Spotify: https://open.spotify.com/show/1FZ3DP0DcivWcXv8bJH3Hw?si=64f2414b3fbd44cc

In this episode of the Delivery by Design Podcast, Alastair Mitchell-Baker speaks with James Sumner, Group Chief Executive Officer at NHS University Hospitals of Liverpool Group, about how operating models, governance, and leadership can transform complex healthcare organisations. Drawing on his experience leading one of the UK's largest NHS hospital groups, James explains why operating models are much more than organisational charts, they define governance, decision-making, leadership behaviours, and accountability across large-scale healthcare systems.

The conversation explores how a risk-based governance model has helped drive performance improvement, strengthen assurance, and support large-scale organisational transformation following major NHS mergers. James shares practical insights into devolved leadership, group operating models, clinical leadership, and how focusing on a small number of strategic priorities can create sustainable improvements in patient safety, quality, and organisational performance.

Key Takeaways:

• Why an effective operating model extends beyond structure to include governance, leadership, risk management, and decision-making.
• How risk-based governance improves organisational assurance and uncovers hidden operational risks.
• Why focusing on a small number of strategic improvement priorities leads to faster and more sustainable transformation.
• How devolved leadership empowers local decision-making while maintaining consistency across large hospital groups.
• The role of clinical leadership and multidisciplinary collaboration in improving patient care.
• How group operating models enable organisations to share expertise, improve services, and deliver better outcomes across multiple hospitals.

Noteworthy Quotes:

• “An operating model is much more than just the wiring diagram.” – James Sumner
• “The only way to really understand your organisation is to embed a different approach to managing risk.” – James Sumner
• “Let's sit down and work out the five to ten things that matter most, then relentlessly pursue those.” – James Sumner
• “You need clarity about where ownership sits and how decisions are made.” – James Sumner
• “Ninety-five percent of the decisions should be made at the hospital level.” – James Sumner
• “Once people start understanding risk, you'll discover things about your organisation that you never knew existed.” – James Sumner

Key Timestamps

00:00 - Introduction to James Sumner and the University Hospitals of Liverpool Group

02:23 - What an operating model means in modern NHS organisations

06:50 - Why risk-based governance uncovers hidden organisational issues

12:22 - Embedding continuous improvement across complex healthcare systems

15:54 - Leadership structures, accountability, and organisational design

16:53 - Clinical leadership and devolved decision-making within hospital groups

23:48 - Managing services across multiple hospitals within a group model

24:21 - The benefits of group operating models for patients, staff, and healthcare delivery

30:23 - Workforce development, talent deployment, and executive board experience

32:28 - Issues retained for group-level oversight

35:29 - Group-level opportunities and cross-site collaboration

37:25 - Role of NHS providers in system-wide planning and ten-year strategy

43:04 - Population segmentation, diagnostics, and neighbourhood care integration

43:57 - Practical applications and benefits of AI in clinical and administrative workflows

Follow Our Guest, James Sumner:

• James Sumner LinkedIn: https://www.linkedin.com/in/james-sumner-201640357/
• NHS University Hospitals of Liverpool Group LinkedIn:
• https://www.linkedin.com/company/nhs-university-hospitals-of-liverpool-group/

Connect with the Host, Alastair Mitchell-Baker:

• LinkedIn: https://www.linkedin.com/in/alastair-mitchell-baker-a01babb/

Follow our Colleagues from Tricordant:

• Andrew Liles: https://www.linkedin.com/in/andrew-liles-282b1792/
• Yasmin Wills: https://www.linkedin.com/in/yasmin-wills-b72535146/
• Nick Richmond: https://www.linkedin.com/in/nickgmrichmond/
• Helen Blanchard: https://www.linkedin.com/in/helenblanchard21/

More from Tricordant:

• Website: https://www.tricordant.com/
• YouTube: https://www.youtube.com/channel/UCo2WP_UCnm-tszOIc87O36Q
• LinkedIn: https://www.linkedin.com/company/tricordant-ltd/
• Email: [email protected]

Follow the Podcast:

• Apple Podcasts: https://podcasts.apple.com/us/podcast/delivery-by-design/id1884004753
• Spotify: https://open.spotify.com/show/1FZ3DP0DcivWcXv8bJH3Hw?si=64f2414b3fbd44cc

In this episode of Delivery by Design Podcast, Alastair Mitchell-Baker speaks with Claus Madsen, Chief People Officer at Greater Manchester Mental Health NHS Foundation Trust, about the critical role leadership, culture, and operating models play in transforming healthcare organisations. Drawing on experience across both public and private sectors, Claus explains how operating models shape the way organisations function and why successful change requires much more than structural redesign.

The conversation explores Greater Manchester Mental Health NHS Foundation Trust’s transformation journey following significant organisational challenges, including the aftermath of the BBC Panorama investigation and regulatory intervention. Claus shares how a new executive team introduced clearer governance, a stronger strategic direction, leadership development programmes, and a renewed focus on culture. He also discusses the importance of psychological safety, employee engagement, and creating hope within organisations to improve staff experience, retention, and ultimately patient care.

Key Takeaways:

• Why culture has a greater influence on success than strategy alone.
• How leadership visibility and accountability can rebuild trust within organisations.
• The importance of creating hope and a clear sense of direction during transformation.
• Why co-designing change with staff leads to better adoption and outcomes.
• How leadership development helps sustain long-term cultural change.
• The connection between staff experience, retention, and quality of patient care.

Noteworthy Quotes:

• “Culture will dictate what can happen and how.” – Claus Madsen
• “You can have the best plans in the world, but if the culture isn’t ripe for it, it will be very difficult.” – Claus Madsen
• “We can say we want psychological safety, but if people don’t experience it, then it doesn’t exist.” – Claus Madsen
• “What we generated in the organisation was hope.” – Claus Madsen
• “Everybody deserves to come to work and be happy at work.” – Claus Madsen
• “Being kind and compassionate doesn’t cost anything.” – Claus Madsen

Key Timestamps

00:00 - Introduction to Claus Madsen and Greater Manchester Mental Health NHS Foundation Trust

02:25 - What operating models mean from a people and HR perspective

05:47 - Why culture often determines whether change succeeds or fails

10:38 - Leadership, structure and organisational layers

12:15 - The impact of the BBC Panorama investigation and organisational challenges

15:17 - Leadership visibility and reconnecting with frontline staff

23:34 - Building leadership development programmes across the organisation

33:11 - How hope became a catalyst for cultural transformation

39:14 - Understanding why employees leave and how to improve retention

45:37 - The role of kindness, compassion and psychological safety

Follow Our Guest, Claus Madsen:

• Claus Madsen LinkedIn: https://www.linkedin.com/in/clausmadsennhs/
• Greater Manchester Mental Health NHS Foundation Trust LinkedIn: https://www.linkedin.com/company/greatermanchestermentalhealthnhsfoundationtrust/
• Greater Manchester Mental Health NHS Foundation Trust Website: https://www.gmmh.nhs.uk/

Connect with the Host, Alastair Mitchell-Baker:

• LinkedIn: https://www.linkedin.com/in/alastair-mitchell-baker-a01babb/

Follow our Colleagues from Tricordant:

• Andrew Liles: https://www.linkedin.com/in/andrew-liles-282b1792/
• Yasmin Wills: https://www.linkedin.com/in/yasmin-wills-b72535146/
• Nick Richmond: https://www.linkedin.com/in/nickgmrichmond/
• Helen Blanchard: https://www.linkedin.com/in/helenblanchard21/

More from Tricordant:

• Website: https://www.tricordant.com/
• YouTube: https://www.youtube.com/channel/UCo2WP_UCnm-tszOIc87O36Q
• LinkedIn: https://www.linkedin.com/company/tricordant-ltd/
• Email: [email protected]

Follow the Podcast:

• Apple Podcasts: https://podcasts.apple.com/us/podcast/delivery-by-design/id1884004753
• Spotify: https://open.spotify.com/show/1FZ3DP0DcivWcXv8bJH3Hw?si=64f2414b3fbd44cc

In this episode of Delivery by Design, host Alastair Mitchell-Baker is joined by Matthew Kershaw Chief Executive of Croydon Health Services NHS Trust to discuss the role of place-based leadership in transforming health and care services.

Drawing on more than 30 years of NHS leadership experience, Matthew shares how Croydon has developed a collaborative approach that brings together healthcare providers, local government, primary care, and the voluntary sector to improve outcomes for residents. He explains why devolved decision-making, strong relationships, and shared accountability are essential for delivering better services and tackling the growing challenges facing the NHS.

Key Takeaways

• Why place-based leadership can improve health and care outcomes
• How Croydon has built a collaborative model across health, social care, and the voluntary sector
• The importance of strong relationships in delivering system-wide change
• Why decisions should be made closer to the communities they affect
• The challenges and opportunities of devolved budgets and local accountability
• Why governance structures must evolve to support integrated care
• The role of innovation, flexibility, and local autonomy in NHS transformation
• Practical advice for leaders looking to develop place-based healthcare models

Noteworthy Quotes:

• “The closer we can make decisions to the population, the better.” – Matthew Kershaw
• “I’m not chasing the badge, I’m chasing the outcome.” – Matthew Kershaw
• “The trust will not be successful if the place isn’t, and vice versa.” – Matthew Kershaw
• “It’s built on strong relationships across the system.” – Matthew Kershaw
• “We are working together as a single integrated whole.” – Matthew Kershaw
• “The NHS is a super tanker; it takes time to turn around.” – Matthew Kershaw

Key Timestamps

00:00 - What the NHS operating model means in practice

02:13 - Balancing the responsibilities of trust chief executive and place leader

08:35 - The benefits of a place-based approach in Croydon

11:59 - Devolved budgets and local decision-making

13:35 - Matthew's perspective on Advanced Foundation Trusts

16:48 - Governance through the One Croydon Health and Care Board

19:54 - Integrated neighbourhood teams and reducing hospital admissions

21:58 - Building sustainable relationships and long-term collaboration

33:50 - What policy changes would accelerate place-based working

40:57 - Advice for leaders pursuing integrated and neighbourhood-based care

Follow Our Guest, Matthew Kershaw

• Matthew Kershaw LinkedIn: https://www.linkedin.com/in/andyheeps/
• Croydon Health Services NHS Trust: https://www.linkedin.com/company/croydon-health-services-nhs-trust/

Connect with the Host, Alastair Mitchell-Baker:

• LinkedIn: https://www.linkedin.com/in/alastair-mitchell-baker-a01babb/

Follow our Colleagues from Tricordant:

• Andrew Liles: https://www.linkedin.com/in/andrew-liles-282b1792/
• Yasmin Wills: https://www.linkedin.com/in/yasmin-wills-b72535146/
• Nick Richmond: https://www.linkedin.com/in/nickgmrichmond/
• Helen Blanchard: https://www.linkedin.com/in/helenblanchard21/

More from Tricordant:

• Website: https://www.tricordant.com/
• YouTube: https://www.youtube.com/channel/UCo2WP_UCnm-tszOIc87O36Q
• LinkedIn: https://www.linkedin.com/company/tricordant-ltd/
• Email: [email protected]

Follow the Podcast:

• Apple Podcast: https://podcasts.apple.com/us/podcast/delivery-by-design/id1884004753
• Spotify: https://open.spotify.com/show/1FZ3DP0DcivWcXv8bJH3Hw?si=64f2414b3fbd44cc

In this episode of Delivery by Design Podcast, Alastair Mitchell-Baker speaks with Shane Gordon, Executive Managing Director of Norfolk and Norwich University Hospitals NHS Foundation Trust, about the development of the Norfolk Acute Hospital Group and the challenges of creating a collaborative operating model across multiple NHS trusts. Shane shares insights into balancing site autonomy with group-wide governance, improving clinical collaboration, and driving system-wide transformation in a complex healthcare environment.

The conversation explores how the newly formed hospital group is approaching service integration, risk management, digital transformation, and neighbourhood healthcare. Shane also discusses the importance of virtual care, mobile healthcare services, and population health management in reducing pressure on acute hospitals while improving patient outcomes.

Key Takeaways:

• How the Norfolk Acute Hospital Group is balancing local autonomy with group-wide collaboration.
• Why risk management plays a central role in the group’s operating model.
• The importance of clinical collaboration in stabilising fragile healthcare services.
• How virtual clinics, virtual wards, and mobile diagnostics can reduce pressure on hospitals.
• Why shifting care into community and neighbourhood settings is essential for the future of healthcare delivery.

Noteworthy Quotes:

• “We are trying to provide all services for all patients in all places, which is really a model from the 1950s.” – Shane Gordon
• “The challenge as leaders is finding the optimal way to provide the best care for our patients, and that can’t mean no change.” – Shane Gordon
• “Advice and guidance works for nobody if it takes three weeks to get a response.” – Shane Gordon
• “We have to use a population health management approach and identify where patients can be cared for better outside acute hospitals.” – Shane Gordon
• “Virtual clinics and virtual wards are central to how we shift care back into communities.” – Shane Gordon
• “We’ve closed escalation spaces and flow has actually improved, which feels counterintuitive.” – Shane Gordon

Key Timestamps

00:00 - Introduction to Shane Gordon and Norfolk Acute Hospital Group

02:38 - Understanding the group operating model

10:45 - Risk management and governance across the hospital group

14:28 - Clinical collaboration and service integration across hospitals

19:18 - Comparing group models with NHS mergers

21:33 - The role of executive managing directors within the group structure

25:15 - Early improvements in operational and financial performance

31:34 - How Shane’s GP background shapes leadership and system working

35:45 - The future of neighbourhood healthcare and left shift

39:09 - Virtual clinics and specialist advice models

43:06 - Mobile diagnostics and reducing unnecessary admissions

45:14 - Improving patient flow and reducing escalation spaces

47:11 - Final thoughts on healthcare transformation and innovation

Follow Our Guest, Shane Gordon:

• Shane Gordon: https://www.linkedin.com/in/shane-gordon-99549516/
• Norfolk and Norwich University Hospitals NHS Foundation Trust LinkedIn: https://www.linkedin.com/company/nnuh/
• Norfolk and Norwich University Hospitals NHS Foundation Trust Website: https://www.nnuh.nhs.uk/

Connect with the Host, Alastair Mitchell-Baker:

• LinkedIn: https://www.linkedin.com/in/alastair-mitchell-baker-a01babb/

Follow our Colleagues from Tricordant:

• Andrew Liles: https://www.linkedin.com/in/andrew-liles-282b1792/
• Yasmin Wills: https://www.linkedin.com/in/yasmin-wills-b72535146/
• Nick Richmond: https://www.linkedin.com/in/nickgmrichmond/
• Helen Blanchard: https://www.linkedin.com/in/helenblanchard21/

More from Tricordant:

• Website: https://www.tricordant.com/
• YouTube: https://www.youtube.com/channel/UCo2WP_UCnm-tszOIc87O36Q
• LinkedIn: https://www.linkedin.com/company/tricordant-ltd/
• Email: [email protected]

Follow the Podcast:

• Apple Podcasts: https://podcasts.apple.com/us/podcast/delivery-by-design/id1884004753
• Spotify: https://open.spotify.com/show/1FZ3DP0DcivWcXv8bJH3Hw?si=64f2414b3fbd44cc

In this episode of the Healthcare Leadership Podcast, host Alastair Mitchell-Baker speaks with Andrew Hines, the recently appointed Chief Executive Officer of Surrey and Sussex Healthcare NHS Trust. Andrew, with extensive experience in NHS management, shares insights from his journey into SASH, touching on the organisation’s challenges and how he is steering it through a transformative phase. He discusses the importance of leadership, organisational culture, and the development of a unified operating model to improve healthcare delivery.

Andrew highlights key challenges, including emergency flow management, financial sustainability, and enhancing staff engagement post-COVID. He also shares how SASH’s commitment to quality improvement and a robust management system, like SASH Plus, is helping drive operational excellence. With a focus on integrated healthcare, Andrew outlines his vision for SASH’s role in the evolving NHS landscape, including its potential involvement in integrated healthcare organisations (IHOs).

Key Takeaways:

• Leadership & Culture: Effective leadership and a strong organisational culture are key to managing change in healthcare systems.
• Quality Improvement: SASH’s long-standing quality management system, SASH Plus, fosters a culture of continuous improvement.
• Emergency Flow & Financial Sustainability: Addressing emergency department congestion and aligning workforce growth with demand are ongoing challenges.
• Staff Engagement: Ensuring staff feel valued and engaged is essential for maintaining high-quality care and organisational effectiveness.
• Partnership Working: Collaborating with community providers and primary care is essential to creating an integrated health system.

Key Timestamps:

00:00 - Introduction to Andrew Hines and SASH Healthcare

02:40 - What is an operating model and why it matters

08:06 - The legacy of SASH’s quality management approach and future plans

11:49 - Overcoming barriers in applying quality management to large-scale changes

14:53 - Balancing bottom-up and top-down leadership in healthcare transformations

17:21 - Approaching change and leadership continuity at SASH

21:09 - Insights from Andrew's previous role at Barts Health

24:07 - The evolving system in Surrey and Sussex and SASH’s role in integrated care

30:21 - Working with primary care, community services, and social care

33:13 - The future of integrated healthcare organisations (IHOs)

36:50 - The value of leadership development in navigating complex healthcare change

44:32 - Advice for other leaders in healthcare facing organisational challenges

Follow Our Guest, Andrew Hines:

• Andrew Hines LinkedIn: https://www.linkedin.com/in/andrew-hines-87bbb151/
• Surrey and Sussex Healthcare NHS Trust LinkedIn: https://www.linkedin.com/company/surrey-&-sussex-healthcare-nhs-trust/
• Surrey and Sussex Healthcare NHS Trust Website: https://www.surreyandsussex.nhs.uk/

Connect with the Host, Alastair Mitchell-Baker:

• LinkedIn: https://www.linkedin.com/in/alastair-mitchell-baker-a01babb/

Follow our Colleagues from Tricordant:

• Andrew Liles: https://www.linkedin.com/in/andrew-liles-282b1792/
• Yasmin Wills: https://www.linkedin.com/in/yasmin-wills-b72535146/
• Nick Richmond: https://www.linkedin.com/in/nickgmrichmond/
• Helen Blanchard: https://www.linkedin.com/in/helenblanchard21/

More from Tricordant:

• Website: https://www.tricordant.com/
• YouTube: https://www.youtube.com/channel/UCo2WP_UCnm-tszOIc87O36Q
• LinkedIn: https://www.linkedin.com/company/tricordant-ltd/
• Email: [email protected]

Follow the Podcast:

• Apple Podcast: https://podcasts.apple.com/us/podcast/delivery-by-design/id1884004753
• Spotify: https://open.spotify.com/show/1FZ3DP0DcivWcXv8bJH3Hw?si=64f2414b3fbd44cc

In this episode of Delivery By Design Podcast, Alastair Mitchell-Baker talks to Andy Heeps, Chief Executive Officer of University Hospitals Sussex NHS Foundation Trust and a Generation Q Fellow at The Health Foundation, about the trust's transformation following its 2021 merger. Andy Heeps shares the challenges and successes of integrating multiple hospital sites under a unified leadership model, particularly during the COVID-19 pandemic.

He discusses the importance of co-designing a new operating model, fostering clear leadership, and focusing on clinical leadership to improve patient care and operational efficiency. The conversation highlights key strategies for overcoming post-merger challenges and shaping the future of integrated healthcare at University Hospital Sussex.

Key Takeaways

• The benefits and challenges of operating as a unified healthcare organisation post-merger.
• How leadership clarity and co-designing with staff contribute to a successful transformation.
• The role of clinical leadership in driving operational efficiency and improving patient care.
• The importance of balancing local autonomy with group-wide consistency.
• How University Hospital Sussex is focusing on innovation and leadership development to improve healthcare delivery.

Key Timestamps

00:00 - Introduction to Andy Heeps & University Hospital Sussex

02:03 - Merger of Western Sussex & Brighton Hospitals

07:05 - Integration challenges and early operating model

12:44 - Co-designing the new operating model

21:01 - Shifting to unified clinical leadership

29:16 - Addressing unwarranted variation & improving efficiency

31:07 - Leadership development in new model

33:20 - Empowering local leaders for better decisions

34:52 - Impact of new model on patient care

37:28 - Closing thoughts on future vision

Follow Our Guest, Andy Heeps

• Andy Heeps LinkedIn: https://www.linkedin.com/in/andyheeps/
• University Hospitals Sussex NHS Foundation Trust LinkedIn: https://www.linkedin.com/company/uhsussex/
• The Health Foundation LinkedIn: https://www.linkedin.com/company/the-health-foundation/
• University Hospitals Sussex NHS Foundation Trust Website: https://www.uhsussex.nhs.uk/

Connect with the Host, Alastair Mitchell-Baker:

• LinkedIn: https://www.linkedin.com/in/alastair-mitchell-baker-a01babb/

Follow our Colleagues from Tricordant:

• Andrew Liles: https://www.linkedin.com/in/andrew-liles-282b1792/
• Yasmin Wills: https://www.linkedin.com/in/yasmin-wills-b72535146/
• Nick Richmond: https://www.linkedin.com/in/nickgmrichmond/
• Helen Blanchard: https://www.linkedin.com/in/helenblanchard21/

More from Tricordant:

• Website: https://www.tricordant.com/
• YouTube: https://www.youtube.com/channel/UCo2WP_UCnm-tszOIc87O36Q
• LinkedIn: https://www.linkedin.com/company/tricordant-ltd/
• Email: [email protected]

Follow the Podcast:

• Apple Podcast: https://podcasts.apple.com/us/podcast/delivery-by-design/id1884004753
• Spotify: https://open.spotify.com/show/1FZ3DP0DcivWcXv8bJH3Hw?si=64f2414b3fbd44cc

In this episode, Alastair Mitchell-Baker sits down with Shane DeGaris, Group CEO of Barts Health NHS Trust, to talk about the complexities and successes of running one of the UK’s largest healthcare groups. Shane discusses the evolution of operating models in the NHS, the benefits and challenges of the group model, and the importance of collaboration across multiple hospitals to ensure better patient outcomes.

Shane outlines how leadership at both the local and group levels plays a crucial role in the transformation of healthcare systems. He also shares how Barts Health is leveraging innovation, digital technologies, and AI to improve efficiency and patient care across their network. The conversation delves into the future of integrated healthcare, including how the "left shift" toward community and preventative care is reshaping the NHS landscape.

From workforce development and leadership to the digital shift and collaboration within the NHS, Shane provides actionable insights for leaders in healthcare and beyond.

Key Takeaways

• The benefits and challenges of operating in a large healthcare group model.
• How local autonomy and group-wide consistency can coexist to improve patient care.
• The role of digital innovation and AI in driving healthcare efficiency.
• Why collaboration within the NHS and with external partners is critical for success.
• How Barts Health is positioning itself for the future of integrated care and community-based health services.

Key Timestamps

00:00 - Introduction to Shane DeGaris and Barts Health NHS Trust

06:23 - The benefits of the group model in managing multiple hospitals

09:50 - Workforce development and leadership across a large healthcare network

13:46 - Balancing local variation and group-wide consistency in healthcare standards

15:59 - Transitioning to integrated care: The "left shift" towards community and prevention

18:33 - The role of digital innovation and AI in transforming healthcare

20:08 - Collaboration within the NHS and with external partners

22:14 - Managing clinical leadership across a large and diverse healthcare group

29:35 - Barts Health’s role in driving innovation and economic growth in East London

33:18 - The impact of life sciences and job creation on local communities

35:35 - The opportunities and challenges of adopting AI and automation in healthcare

39:35 - Closing Thoughts: Shane’s vision for the future of healthcare and NHS transformation

Follow Our Guest, Shane DeGaris

• Shane DeGaris LinkedIn: https://www.linkedin.com/in/shane-degaris-12a7684?originalSubdomain=uk
• Barts Health NHS Trust LinkedIn: https://www.linkedin.com/company/barts-health-nhs-trust/
• Barts Health NHS Trust Website: https://www.bartshealth.nhs.uk/

Connect with the Host, Alastair Mitchell-Baker:

• LinkedIn: https://www.linkedin.com/in/alastair-mitchell-baker-a01babb/

More from Tricordant:

• Website: https://www.tricordant.com/
• YouTube: https://www.youtube.com/channel/UCo2WP_UCnm-tszOIc87O36Q
• LinkedIn: https://www.linkedin.com/company/tricordant-ltd/
• Email: [email protected]

Follow the Podcast:

• Apple Podcast: https://podcasts.apple.com/us/podcast/delivery-by-design/id1884004753
• Spotify: https://open.spotify.com/show/1FZ3DP0DcivWcXv8bJH3Hw?si=64f2414b3fbd44cc

In this episode of Delivery by Design, Alastair Mitchell-Baker speaks with Dr. Andrew Murray, a GP and senior NHS leader, about the reality behind clinical leadership and operating models in NHS organisations.

What sounds like dry organisational jargon turns out to be deeply connected to frontline outcomes. Andrew breaks down how operating models influence decision-making, staff morale, and ultimately patient care.

• Operating Models Shape Real Outcomes: An operating model is not just structure on paper. It defines how decisions are made, how teams interact, and how quickly change can happen. Poor models create delays, frustration, and reduced quality of care.
• Clinical Leadership Drives Performance: Strong leadership is reflected in team morale, clarity, and effectiveness. When leaders align across disciplines, teams perform better and deliver safer, more efficient care.
• Hierarchy Can Limit Collaboration: Traditional medical hierarchies can discourage input from other professionals. A flatter, more inclusive leadership approach improves problem-solving and encourages people to speak up.
• Shared Responsibility Needs Clear Roles: High-performing teams balance shared ownership with clear accountability. Everyone feels responsible for outcomes, but roles and decisions remain clearly defined.
• Culture Is as Important as Structure: Even the best-designed operating model fails without the right culture. Psychological safety, trust, and open communication are critical to making systems work.
• Healthcare Must Move Beyond Hospital Walls: Future care models require stronger integration between hospitals and community services. Clinicians will need to think beyond departments and work across systems to improve patient outcomes.

[00:01:50] – What Is an Operating Model: Why the term often confuses clinicians and what it actually means in practice.

[00:03:50] – The Impact of Poor Systems: How bureaucracy and slow decision-making affect staff motivation and patient care.

[00:04:16] – What Effective Clinical Leadership Looks Like: Measuring leadership through team performance, morale, and outcomes.

[00:07:27] – Challenges in Medical Leadership Culture: Time constraints, training, and mindset barriers that affect collaboration.

[00:16:21] – Leadership at Different Levels of the System: How multidisciplinary leadership changes from ward level to board level.

[00:22:21] – Aligning Culture with Operating Models: The importance of connecting structural design with organisational culture.

[00:26:46] – Integration Between Hospital and Community Care: Why healthcare systems must shift toward more connected models of care.

[00:29:20] – The Future of Neighbourhood-Based Care: How roles and responsibilities will evolve beyond traditional hospital settings.

[00:31:15] – Rethinking Risk in Healthcare Delivery: Differences between hospital and community approaches to managing patient risk.

[00:36:18] – The Power of Relationships in Healthcare Systems: Why trust and time together matter more than over-engineered structures.

[00:37:12] – Final Thoughts on Simplicity and Leadership: Why simpler systems and empowered teams lead to better results.

Connect with the Guest Dr. Andrew Murray:

• LinkedIn: https://www.linkedin.com/in/andrew-murray-360a0b83/

Connect with the Host Alastair Mitchell-Baker:

• LinkedIn: https://www.linkedin.com/in/alastair-mitchell-baker-a01babb/

More from Tricordant:

• Website: https://www.tricordant.com/
• YouTube: https://www.youtube.com/channel/UCo2WP_UCnm-tszOIc87O36Q
• LinkedIn: https://www.linkedin.com/company/tricordant-ltd/
• Email: [email protected]

Follow the Podcast:

• Apple Podcast: https://podcasts.apple.com/us/podcast/delivery-by-design/id1884004753
• Spotify: https://open.spotify.com/show/1FZ3DP0DcivWcXv8bJH3Hw?si=64f2414b3fbd44cc

In this episode of the Delivery by Design Podcast, host Alastair Mitchell-Baker is joined by John Deverell and Andrew Liles to discuss the "Operating Model" - the essential bridge between a strategy and its execution. They explore why many NHS organizations are stuck in a cycle of "firefighting" and how a well-designed model can empower clinicians and improve population health.

1. The "How" vs. The "What": Strategy is the destination, but the operating model is the machinery and culture that actually delivers the results.
2. Firefighting as a Symptom: Constant operational crises usually indicate that the staff doesn't believe in or understand the current operating model.
3. Post-COVID Shift: The NHS must transition from "command and control" recovery back to a model that empowers local providers and communities.
4. The Foundation Trust Blueprint: Reflecting on the "high point" of the first Foundation Trusts as a model for systemic strength and clinical leadership.
5. Clinical Design: For a model to work, clinicians must be architects of the system rather than just subjects of external targets.

1. [00:00:00] - Introduction - Defining the operating model as the "how" behind the strategy.
2. [00:02:10] - Guest Introductions - John Deverell and Andrew Liles’ backgrounds in NHS leadership.
3. [00:03:18] - John and Andrew discuss the meaning and importance of operating models in healthcare.
4. [00:12:34] -The need for NHS organizations to rethink their operating models post-Covid.
5. [00:18:10] - Focus on rebuilding operating models for long-term transformation in the NHS.
6. [00:44:10] - Max raises the question of creating citizen-centered operating models in healthcare.
7. [00:49:27] - Closing remarks and a preview of future webinars on operating model design

🔗 Connect with the Guests:

👉 John Deverill: https://www.linkedin.com/in/john-deverill-a04a7b1/

👉 Andrew Liles: https://www.linkedin.com/in/andrew-liles-282b1792/

🔗 Connect with the Host Alastair Mitchell-Baker:

👉 LinkedIn: https://www.linkedin.com/in/alastair-mitchell-baker-a01babb/

🔗 More from Tricordant:

👉 Website: https://www.tricordant.com/

👉 YouTube: https://www.youtube.com/channel/UCo2WP_UCnm-tszOIc87O36Q

👉 LinkedIn: https://www.linkedin.com/company/tricordant-ltd/

👉 Email: [email protected]

🔗 Follow the Podcast:

👉 Apple Podcast: https://podcasts.apple.com/us/podcast/delivery-by-design/id1884004753

👉 Spotify: https://open.spotify.com/show/1FZ3DP0DcivWcXv8bJH3Hw?si=64f2414b3fbd44cc

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