Health Education and Improvement Wales (HEIW) commissioned NHS Arden & GEM to support a review of its operating model as part of a wider programme focused on strengthening the organisation’s ways of working.
Through a structured and collaborative approach, Arden & GEM supported HEIW to assess its current operating arrangements and develop a proposed future Target Operating Model (TOM). An accompanying roadmap, high-level implementation plan and communications framework have provided a foundation for the implementation phase, which will be led by HEIW. The project outputs, and their implementation, are intended to support more consistent, compassionate and sustainable ways of working.
The challenge
Health Education and Improvement Wales (HEIW) is the strategic workforce organisation for NHS Wales and a special health authority with an all-Wales remit. HEIW brings together national responsibilities for workforce planning, education, training, leadership and workforce development. Working with partners across health and care, education and government, it provides national workforce leadership and helps NHS Wales develop a workforce that can meet the changing health and care needs of people in Wales.
Since its formation in 2018, HEIW has grown and evolved, with its operating arrangements adapting to incorporate new functions and responsibilities. While these arrangements have supported delivery and governance, HEIW recognised the need to formally review and refresh its ways of working to ensure they remain fit for the future in a complex and financially constrained environment.
Arden & GEM was commissioned to support this review, working with HEIW to develop a proposed future TOM intended to support sustainable delivery and more effective working across the organisation. The review formed part of a wider programme of work focused on strengthening HEIW’s organisational effectiveness.
Our approach
Arden & GEM brought together expertise in research, engagement, organisational development and programme management as part of a multidisciplinary team. The approach combined robust analysis with co-design to develop a practical proposed future operating model.
Understanding the current state
The project began with a comprehensive discovery phase, covering:
- Organisational systems, processes and behaviours
- Governance arrangements and information flows
- Organisational structure and design principles
- Matrix and multidisciplinary working
- Digitally enabled ways of working.
The project team used a number of sources to understand HEIW’s current operating arrangements, including:
- Staff interviews: 36 people took part in one-to-one, in-depth interviews
- Staff surveys: a staff survey received 94 responses (approximately 14% of the workforce)
- Stakeholder reference group survey: to capture external perspectives
- Document review: covering organisational documents and strategies.
The information gathered was analysed collectively to identify themes relating to HEIW’s operating arrangements. These included the balance between vertical accountability and end-to-end ownership, and between effective assurance and timely decision-making. Emerging findings were tested with staff groups to inform the development of the proposed model.
Co-designing the future operating model
Building on the discovery insights, a co-design team was established to help develop the proposed future ways of working. The resulting TOM focuses on creating the system conditions that can support more consistent ways of working. Key proposed design features included:
- Clear articulation of organisational purpose and the basis for decision-making
- Governance designed to support effective assurance and decision-making
- Cross-functional working with clearer ownership
- Digital and data considerations embedded in the design of work from the outset
- Compassionate leadership supported by clear and consistent organisational routines.
The TOM was designed as a practical framework that can be used by leaders to inform decision-making, governance and assurance as implementation progresses.
Transitioning to the future state
To support HEIW in preparing for implementation, the project team developed a high-level implementation plan. This included priority actions, a phased roadmap, a maturity matrix and practical examples relating to each implementation opportunity. A communications framework for senior leaders was also provided to support the next phase of work.
The outcomes
Through a structured and collaborative approach, Arden & GEM supported HEIW to assess its current operating arrangements and develop a proposed future TOM. The proposed TOM provides a framework intended to support more consistent, efficient and sustainable ways of working.
The project provided a foundation for the next phase of HEIW’s organisational development, including:
- Current-state assessment: the discovery phase brought together a range of evidence and perspectives on what was working well and where improvements could be considered
- Proposed future model: HEIW has a proposed TOM informed by the discovery work and co-design process
- A framework for greater organisational clarity: the TOM is intended to support clearer roles, decision-making responsibilities, cross-functional ownership and accountability
- Foundation for sustainable delivery: the model is intended to support more consistent and sustainable delivery as implementation progresses.
Find out more about our support for Target Operating Model development.