Delivery by Design

Alastair Mitchell-Baker
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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.

Episodes

  1. How Hospitals Are Outdated and Overloaded and Patients Are Paying the Price with Shane Gordon

    5d ago

    How Hospitals Are Outdated and Overloaded and Patients Are Paying the Price with Shane Gordon

    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-tszOIc87O36QLinkedIn: https://www.linkedin.com/company/tricordant-ltd/Email: office@tricordant.com Follow the Podcast: Apple Podcasts: https://podcasts.apple.com/us/podcast/delivery-by-design/id1884004753Spotify: https://open.spotify.com/show/1FZ3DP0DcivWcXv8bJH3Hw?si=64f2414b3fbd44cc

    50 min
  2. How Healthcare Operating Models Fail Without Culture and Leadership with Andrew Hines

    May 27

    How Healthcare Operating Models Fail Without Culture and Leadership with Andrew Hines

    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-tszOIc87O36QLinkedIn: https://www.linkedin.com/company/tricordant-ltd/Email: office@tricordant.com Follow the Podcast: Apple Podcast: https://podcasts.apple.com/us/podcast/delivery-by-design/id1884004753Spotify: https://open.spotify.com/show/1FZ3DP0DcivWcXv8bJH3Hw?si=64f2414b3fbd44cc

    46 min
  3. The Redesigning Operating Models After Mergers to Improve Performance in Healthcare with Andy Heeps

    May 13

    The Redesigning Operating Models After Mergers to Improve Performance in Healthcare with Andy Heeps

    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-tszOIc87O36QLinkedIn: https://www.linkedin.com/company/tricordant-ltd/Email: office@tricordant.com Follow the Podcast: Apple Podcast: https://podcasts.apple.com/us/podcast/delivery-by-design/id1884004753Spotify: https://open.spotify.com/show/1FZ3DP0DcivWcXv8bJH3Hw?si=64f2414b3fbd44cc

    38 min
  4. NHS Trusts Can Scale and Succeed for Health Leaders Using the Group Model with Shane DeGaris

    Apr 29

    NHS Trusts Can Scale and Succeed for Health Leaders Using the Group Model with Shane DeGaris

    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-tszOIc87O36QLinkedIn: https://www.linkedin.com/company/tricordant-ltd/Email: office@tricordant.com Follow the Podcast: Apple Podcast: https://podcasts.apple.com/us/podcast/delivery-by-design/id1884004753Spotify: https://open.spotify.com/show/1FZ3DP0DcivWcXv8bJH3Hw?si=64f2414b3fbd44cc

    40 min
  5. NHS Leadership Crisis for Healthcare Executives to Transform Patient Care with Andrew Murray

    Apr 15

    NHS Leadership Crisis for Healthcare Executives to Transform Patient Care with Andrew Murray

    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. Key Takeaways: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. Episode Timestamps:[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-tszOIc87O36QLinkedIn: https://www.linkedin.com/company/tricordant-ltd/Email: office@tricordant.com Follow the Podcast: Apple Podcast: https://podcasts.apple.com/us/podcast/delivery-by-design/id1884004753Spotify: https://open.spotify.com/show/1FZ3DP0DcivWcXv8bJH3Hw?si=64f2414b3fbd44cc

    33 min
  6. The NHS Operating Model Broke for Healthcare Leaders to Rebuild Systems & Restore Care

    Mar 25

    The NHS Operating Model Broke for Healthcare Leaders to Rebuild Systems & Restore Care

    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. Key Takeaways:The "How" vs. The "What": Strategy is the destination, but the operating model is the machinery and culture that actually delivers the results.Firefighting as a Symptom: Constant operational crises usually indicate that the staff doesn't believe in or understand the current operating model.Post-COVID Shift: The NHS must transition from "command and control" recovery back to a model that empowers local providers and communities.The Foundation Trust Blueprint: Reflecting on the "high point" of the first Foundation Trusts as a model for systemic strength and clinical leadership.Clinical Design: For a model to work, clinicians must be architects of the system rather than just subjects of external targets. Episode Timestamps:[00:00:00] - Introduction - Defining the operating model as the "how" behind the strategy.[00:02:10] - Guest Introductions - John Deverell and Andrew Liles’ backgrounds in NHS leadership.[00:03:18] - John and Andrew discuss the meaning and importance of operating models in healthcare.[00:12:34] -The need for NHS organizations to rethink their operating models post-Covid.[00:18:10] - Focus on rebuilding operating models for long-term transformation in the NHS.[00:44:10] - Max raises the question of creating citizen-centered operating models in healthcare.[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: office@tricordant.com 🔗 Follow the Podcast: 👉 Apple Podcast: https://podcasts.apple.com/us/podcast/delivery-by-design/id1884004753 👉 Spotify: https://open.spotify.com/show/1FZ3DP0DcivWcXv8bJH3Hw?si=64f2414b3fbd44cc #NHS #HealthcareLeadership #OperatingModels #Tricordant #HealthSystems #ClinicalLeadership #NHSStrategy #HealthManagement

    50 min

  7. Mar 10

    New Episode Coming Soon!

    Welcome to Delivery by Design, hosted by Alastair Mitchell-Baker, leadership consultant and director at Tricordant. This podcast explores how organisations turn strategy into meaningful results through thoughtful organisation design, strong leadership, and systems thinking. In each episode, Alastair speaks with leaders, practitioners, and change-makers who are working inside complex organisations to improve how people, teams, and systems function together. The conversations look at the real challenges behind transformation, from aligning strategy with structure to building cultures that support long-term performance. Drawing on Tricordant’s experience in organisational consulting, the podcast examines practical approaches to leadership development, organisational effectiveness, and navigating large-scale change. Guests share lessons from the field, offering perspectives that help leaders design organisations that deliver, adapt, and thrive in an increasingly complex world. Whether you're leading transformation, managing organisational change, or exploring new ways to improve how your organisation works, Delivery by Design brings thoughtful conversations and practical insights from those shaping the future of leadership and organisational design.

    1 min
  • 7 Episodes

About

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.

Information

  • Creator
    Alastair Mitchell-Baker
  • Years Active
    2K
  • Episodes
    7
  • Rating
    Clean
  • Copyright
    © Copyright 2026 Alastair Mitchell-Baker
  • Show Website
    Delivery by Design