Why Trust Operating Models matter now more than ever

Will your organisation’s Operating Model enable you to deliver your current operational and financial targets, whilst also making progress on your strategic ambitions to transform how and where care is provided? 

Will it enable you to move from a post-covid recovery era, to one where you meet the tests to be an Advanced Foundation Trust or Integrated Health Organisation? 

Many NHS Providers are asking themselves this question and we’ve been supporting some of them to do this.

At its heart, your Operating Model defines how your organisation delivers care, exercises accountability and ‘gets things done’.  No two organisations are the same, but every effective Operating Model hinges on several interconnected components:

• A clear and actionable strategy, with short and medium plans towards a long-term intent, that is understood and cascaded through the organisation.  We find that many organisations are confident that they have the right strategy ‘on paper’ but are worried that their current OM isn’t designed to deliver it.
• A supportive culture that shapes how things get done, fostering autonomy, accountability and staff engagement.  In our experience, decision making often emerges as a key pain point.  A culture that empowers teams while maintaining oversight is vital for agility and innovation.
• Effective leadership that gives confidence in the delivery at all levels through the organisation.  The triumvirate team remains the bedrock.  Success depends on clearly defined roles, accountabilities and the capacity to deliver.  This means identifying skills gaps, investing in development and making leadership roles rewarding.  Confident, capable leadership teams are needed to drive both day-to-day operations and transformative change.
• An adaptive organisational structure that enables leadership teams to deliver strategic improvements in how/ where services are provided, as well as the day to day.  There has been a lot of organisational change in recent years, with mergers and group models creating larger organisations.  There is an important choice to make about whether the structure should be primarily horizontal (services across an organisation/ geography), vertical (hospital sites/ geography) or a matrix approach.  Details, like spans of control are important. 
• Optimising corporate functions is important.  They play a dual role – enabling frontline delivery while providing necessary assurance.  Striking the right balance is crucial.  What is the right balance between enabling delivery and seeking assurance?  How do they best support local leadership teams (including business partners and embedded roles)?  How can corporate processes reinforce accountability without stifling initiative?

The high point of my NHS career was probably as the CEO of a Trust that mounted a successful application to Monitor to become a Foundation Trust.  It was a real test of whether these Operating Model components were in place, working and getting results.  Throughout the process Monitor would ask “how do you know xx is working” at all levels of our organisation – which drew us into the detail of how our organisation worked.  All applicants remember the high bar set at the Board-to-Board meeting with Monitor at the end of the process.

To become an Advanced Foundation Trust you will need to know and be able to demonstrate that your organisation has the right leadership, quality and governance at all levels and whether you can demonstrate long term direction and sustainability. 

The right Operating Model is crucial to meeting all of these tests. a consultancy that puts people and purpose first, we’d love to hear from you.