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Delivery by Design

Delivery by Design

By: 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.Copyright 2026 Alastair Mitchell-Baker Economics Management Management & Leadership
Episodes
  • How Centralised Healthcare Fails and Place-Based Care Is the Future of the NHS with Matthew Kershaw

    How Centralised Healthcare Fails and Place-Based Care Is the Future of the NHS with Matthew Kershaw
    Jun 24 2026
    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 TakeawaysWhy place-based leadership can improve health and care outcomesHow Croydon has built a collaborative model across health, social care, and the voluntary sectorThe importance of strong relationships in delivering system-wide changeWhy decisions should be made closer to the communities they affectThe challenges and opportunities of devolved budgets and local accountabilityWhy governance structures must evolve to support integrated careThe role of innovation, flexibility, and local autonomy in NHS transformationPractical advice for leaders looking to develop place-based healthcare modelsNoteworthy 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 KershawKey Timestamps00:00 - What the NHS operating model means in practice02:13 - Balancing the responsibilities of trust chief executive and place leader08:35 - The benefits of a place-based approach in Croydon11:59 - Devolved budgets and local decision-making13:35 - Matthew's perspective on Advanced Foundation Trusts16:48 - Governance through the One Croydon Health and Care Board19:54 - Integrated neighbourhood teams and reducing hospital admissions21:58 - Building sustainable relationships and long-term collaboration33:50 - What policy changes would accelerate place-based working40:57 - Advice for leaders pursuing integrated and neighbourhood-based careFollow 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-tszOIc87O36QLinkedIn: https://www.linkedin.com/company/tricordant-ltd/Email: office@tricordant.comFollow the Podcast:Apple Podcast: https://podcasts.apple.com/us/podcast/delivery-by-design/id1884004753Spotify: https://open.spotify.com/show/1FZ3DP0DcivWcXv8bJH3Hw?si=64f2414b3fbd44cc
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    44 mins
  • How Hospitals Are Outdated and Overloaded and Patients Are Paying the Price with Shane Gordon

    How Hospitals Are Outdated and Overloaded and Patients Are Paying the Price with Shane Gordon
    Jun 10 2026
    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 GordonKey Timestamps00:00 - Introduction to Shane Gordon and Norfolk Acute Hospital Group02:38 - Understanding the group operating model10:45 - Risk management and governance across the hospital group14:28 - Clinical collaboration and service integration across hospitals19:18 - Comparing group models with NHS mergers21:33 - The role of executive managing directors within the group structure25:15 - Early improvements in operational and financial performance31:34 - How Shane’s GP background shapes leadership and system working35:45 - The future of neighbourhood healthcare and left shift39:09 - Virtual clinics and specialist advice models43:06 - Mobile diagnostics and reducing unnecessary admissions45:14 - Improving patient flow and reducing escalation spaces47:11 - Final thoughts on healthcare transformation and innovationFollow 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.comFollow the Podcast:Apple Podcasts: https://podcasts.apple.com/us/podcast/delivery-by-design/id1884004753Spotify: https://open.spotify.com/show/1FZ3DP0DcivWcXv8bJH3Hw?si=64f2414b3fbd44cc
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    50 mins
  • How Healthcare Operating Models Fail Without Culture and Leadership with Andrew Hines

    How Healthcare Operating Models Fail Without Culture and Leadership with Andrew Hines
    May 27 2026
    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 Healthcare02:40 - What is an operating model and why it matters08:06 - The legacy of SASH’s quality management approach and future plans11:49 - Overcoming barriers in applying quality management to large-scale changes14:53 - Balancing bottom-up and top-down leadership in healthcare transformations17:21 - Approaching change and leadership continuity at SASH21:09 - Insights from Andrew's previous role at Barts Health24:07 - The evolving system in Surrey and Sussex and SASH’s role in integrated care30:21 - Working with primary care, community services, and social care33:13 - The future of integrated healthcare organisations (IHOs)36:50 - The value of leadership development in navigating complex healthcare change44:32 - Advice for other leaders in healthcare facing organisational challengesFollow 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.comFollow the Podcast:Apple Podcast: https://podcasts.apple.com/us/podcast/delivery-by-design/id1884004753Spotify: https://open.spotify.com/show/1FZ3DP0DcivWcXv8bJH3Hw?si=64f2414b3fbd44cc
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    46 mins
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