Welcome to Delivery by Design, the podcast that explores how organisations move from good ideas to real impact.
Hosted by Alastair Mitchell-Baker from Tricordant, this podcast looks at what it truly takes to deliver results in complex organisations. Each episode brings conversations with leaders, consultants, and practitioners who are working on the front lines of organisational change, leadership, and system transformation.
From strategy and organisation design to leadership development and systems thinking, Delivery by Design uncovers how successful organisations align people, structure, and culture to achieve meaningful outcomes. Whether you're navigating transformation, improving how teams work together, or shaping the future direction of your organisation, this podcast offers practical perspectives and real-world experiences from those doing the work.
Tricordant has spent years helping organisations design healthier, more effective systems that allow people and teams to perform at their best. In this podcast, those ideas come to life through stories, lessons, and conversations that show what it takes to turn vision into delivery.
If you care about leadership, organisational effectiveness, and creating workplaces that truly work, Delivery by Design brings the thinking and experience behind successful change.
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Ian explains why an operating model should provide a practical way of translating an organisation’s purpose and strategy into how people, processes, systems, data, structure, culture, and behaviours work together. He reflects on his time leading East Coast Community Healthcare, the importance of building relationships and momentum across organisational boundaries, and why senior leaders need to create the conditions for others to succeed rather than becoming consumed by running day-to-day operations.
Key Takeaways:
Why an operating model should connect strategy and purpose with people, processes, systems, data, culture, and organisational design.
How a target operating model differs from strategy and a transformation plan.
Why operating models can become barriers to delivery when organisations lose control of critical capabilities.
How changing external circumstances should influence operating model and leadership decisions.
How too many organisational layers can slow decision-making and disconnect strategy from frontline delivery.
Why leadership at every level is fundamental to consistently high-performing organisations.
Why leaders should focus outward rather than spending all their time running day-to-day operations.
How leaders can maintain their own energy while continuing to provide direction and momentum during periods of change.
Noteworthy Quotes:
“In simple terms, it’s a way of working that helps you deliver your core purpose.” – Ian Hutchison
“Nine times out of ten, it comes down to effective leadership.” – Ian Hutchison
“Your job isn’t to tell them and hold them to account. It’s to enable and create the conditions for them to be successful.” – Ian Hutchison
“Good organisations are generally good organisations because they’re well led.” – Ian Hutchison
“Leadership is just so important and leaders cast such long shadows.” – Ian Hutchison
“Your job as leader isn’t to run the organisation.” – Ian Hutchison
“Your job as a leader is to keep it on the road or the rail.” – Ian Hutchison
Key Timestamps
00:00 - Why leaders should not spend their time running the organisation
01:06 - Introduction to Ian Hutchison and his leadership journey
01:52 - What does an operating model really mean?
04:50 - When operating models help or hinder delivery
09:35 - Adapting operating models when the external environment changes
16:23 - Finding the right balance of organisational layers
20:05 - What consistently high-performing organisations get right
23:27 - Context, trust, and high-performing teams
28:32 - Why trust takes time to build and seconds to lose
35:04 - Leadership lessons from East Coast Community Healthcare
36:09 - Building relationships, collaboration, and momentum
43:30 - Why leaders cast such a long shadow
45:57 - Closing reflections
Disclosure: Portions of this episode (such as the introduction or promotional segments) use AI-generated voice narration produced under human editorial review.
Chike Ify explains why an effective operating model starts with purpose and connects values, strategy, culture, leadership, clinical delivery, and partnerships. Drawing on his experience as a consultant psychiatrist, medical director, and chief executive, he discusses the importance of communicating in plain English, developing leaders at every level, and creating an organisation where both patients and staff can thrive.
The conversation also explores the distinctive challenges of leading community and mental health services, from managing clinical risk across dispersed teams to designing neighborhood-based care. Chike Ify reflects on prevention, population health, social determinants of health, resilience in leadership, and why the NHS must balance today’s pressures with investing in better outcomes for the future.
Key Takeaways:
Why an effective operating model begins with a clear organisational purpose.
How values, strategy, culture, leadership, and clinical delivery need to work together.
Why NHS leaders should communicate complex ideas in plain English.
How dispersed mental health and community services create distinctive leadership and risk challenges.
Why neighborhood-based care should combine accessible local services with specialist expertise.
How social determinants of health and early intervention can improve long-term outcomes.
Why developing leadership capability at every level is essential for sustainable change.
What the NHS Needs to Get Right About Operating Models? with Suzanne Rankin
Suzanne shares her journey from registered nurse and Royal Navy medical service leader to chief executive of large and complex healthcare organisations. She explains why an operating model is more than organisational structure.
The conversation explores lessons from military leadership doctrine, the importance of consistency and organisational memory, and how healthcare systems can work across organisational boundaries to deliver more integrated, neighbourhood-based care. Suzanne also reflects on how her nursing values have shaped her leadership approach, the changing role of ward leadership, and why visible, compassionate leadership remains essential in modern healthcare.
Key Takeaways:
Why an operating model must connect strategy, culture, systems, and behaviours to effective delivery.
How military leadership doctrine provides lessons for consistency, trust, and organisational alignment.
Why continuity of leadership and corporate memory are critical for long-term organisational performance.
How integrated planning across health and care systems can improve patient pathways.
Why neighbourhood health models require new ways of working across acute, community, primary, and social care.
How Suzanne’s nursing values continue to shape her approach to leadership.
How visible leadership and listening to staff and patients help create sustainable change.
Can Healthcare Executives Lift KPIs through a People-First Strategy? with Giovanna Leeks
Gio explains why an effective people operating model goes beyond HR policies and processes. She discusses balancing data and structure with the human side of leadership, building psychological safety and a just culture, and making leadership more visible and accessible.
The conversation also explores the new hospital programme, moving appropriate services into community settings, and redesigning care around local needs. Gio explains why collaboration across acute care, primary care, community services, social care, and local authorities is essential for improving patient care and making better use of resources.
Key Takeaways:
Why NHS operating models need to balance structure and data with a people-centred approach.
How psychological safety, just culture, and visible leadership can strengthen workplace culture.
Why moving suitable services into community settings can improve patient and staff experience.
How collaboration across acute, primary, community, and social care can reduce organisational silos.
Why Chief People Officers need to play a wider role in culture and organisational transformation.
Noteworthy Quotes:
“If you have a people-led organisation, people will, because they feel valued, give their 100%.” – Giovanna Leeks
“It’s all about those people soft skills, but actually they are absolutely integral.” – Giovanna Leeks
What Healthcare Leaders Get Wrong About Coordinating Patient Care with Matthew Winn
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.
How Risk-Based Operating Models and Five Things Rule Fix Failing Organisations with James Sumner
Wednesday, July 22, 2026 • Duration 47:09
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:
How leadership visibility transforms outcomes & why hope is the leadership tool with Claus Madsen
Wednesday, July 8, 2026 • Duration 49:33
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
How Centralised Healthcare Fails and Place-Based Care Is the Future of the NHS with Matthew Kershaw
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
How Hospitals Are Outdated and Overloaded and Patients Are Paying the Price with Shane Gordon
Wednesday, June 10, 2026 • Duration 50:25
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
How Healthcare Operating Models Fail Without Culture and Leadership with Andrew Hines
Wednesday, May 27, 2026 • Duration 46:12
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
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“People need to know why we exist.” – Chike Ify Okocha
“I go to work every day to improve my life.” – Chike Ify Okocha
“If you are really good at something, you should be able to describe it in plain English.” – Chike Ify Okocha
“We’re not linear. We’re just not linear.” – Chike Ify Okocha
“The health of a nation isn’t just in the hands of a national health service.” – Chike Ify Okocha
“I really see this as a real service to people.” – Chike Ify Okocha
“Use every opportunity to develop yourself, not just be technical, but really push and challenge yourself.” – Chike Ify Okocha
Key Timestamps
00:00 - Introduction to Chike Ify Okocha and his leadership journey
02:04 - What does an NHS operating model really mean?
04:49 - Purpose, values, and creating a great place to work
06:26 - Strategy, quality improvement, and clinical leadership
09:00 - Developing leaders at every level
12:20 - Why NHS leadership needs to avoid jargon
16:12 - The unique challenges of mental health and community services
23:34 - Managing risk and clinical judgement in mental healthcare
27:23 - Balancing neighbourhood services with specialist expertise
31:25 - Social determinants of health and prevention
36:08 - Working across boroughs and organisational boundaries
40:21 - Finding resilience through faith, family, and purpose
43:08 - The future of community and mental health services
45:19 - Developing the next generation of NHS leaders
46:00 - Continuous improvement and closing reflections
Disclosure: Portions of this episode (such as the introduction or promotional segments) use AI-generated voice narration produced under human editorial review.
“An operating model is the way we organise ourselves, and that can be structure, but it is certainly not structure alone.” – Suzanne Rankin
“Linking strategy to delivery is the bit between — that is your operating model.” – Suzanne Rankin
“If you have to use your rank to get something done, then you are failing as a leader.” – Suzanne Rankin
“Consistency in the NHS is not spoken about enough and should be sought more often.” – Suzanne Rankin
“Designing an operating model is quite straightforward. Implementing one is a whole different beast.” – Suzanne Rankin
“The best clinical tool in your toolbox is your eyeball followed by your nose and your ears and your mouth.” – Suzanne Rankin
“Every day I’m learning something.” – Suzanne Rankin
Key Timestamps
00:00 - Introduction: Suzanne Rankin’s leadership journey from nursing to chief executive
01:57 - What does an operating model mean in practice?
05:34 - The challenges facing modern healthcare organisations
08:51 - Building consistent leadership approaches across healthcare
14:32 - Relationships, trust, and leading across healthcare systems
16:20 - Creating integrated, patient-centred pathways across organisations
21:03 - Breaking down barriers between primary, community, and acute care
26:10 - Challenging outdated processes and removing unnecessary rules
28:12 - How nursing values shaped Suzanne’s leadership approach
31:33 - How healthcare delivery has changed for frontline nurses
35:48 - Strengthening ward leadership and empowering frontline teams
39:01 - Beginning a new leadership role through listening and learning
40:33 - Resilience, vulnerability, and leading through difficult times
43:05 - Closing reflections on leadership and healthcare transformation
Disclosure: Portions of this episode (such as the introduction or promotional segments) use AI-generated voice narration produced under human editorial review.
“You cannot make the judgement from the start that they are guilty.” – Giovanna Leeks
“You have to keep checking the temperature.” – Giovanna Leeks
“It is about talking to people. It’s about being accessible.” – Giovanna Leeks
“There’s no way back. We need to keep working together for a better use of the resources, but also for better patient care.” – Giovanna Leeks
“It’s not just about HR policies and processes. We need to be looking at people. We need to be supporting our community.” – Giovanna Leeks
Key Timestamps
00:00 - Introduction: People-first leadership and the purpose of the NHS
01:54 - What does an operating model mean in practice?
04:47 - Building a people-focused HR operating model
07:20 - Moving from a finance-led to a people-led organisation
10:46 - Psychological safety and encouraging staff to raise concerns
17:23 - The new hospital programme and transforming services
22:57 - Improving the experience for patients, staff, and the community
25:16 - Developing and maintaining organisational culture
29:30 - The importance of executive visibility and listening to frontline staff
33:23 - Can a people-first approach work in larger organisations?
37:47 - Breaking down silos across healthcare organisations
40:00 - Developing collaboration across acute and primary care
42:23 - The future role of Chief People Officers in the NHS
44:38 - Closing reflections and Gio’s move to Whittington Health
Disclosure: Portions of this episode (such as the introduction or promotional segments) use AI-generated voice narration produced under human editorial review.
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.
