Thought Garden

Weeknote

Borrow before you build

2 min read

Next week is appointments quarterly planning. This week was what came before it.

The main work was on the delivery lifecycle — how we actually run this programme at scale. On Tuesday we ran a workshop that brought together the delivery handbook and operating model thinking we've been building, and used the NHS App team's cluster model as a useful reference point. They're further along than we are, and there are genuine differences, but there's enough common ground to be worth the comparison. On Thursday I had a conversation with the app team to go deeper on that — where we're the same, where we're not.

We used All Hands this week to share what we took from the St George's visit. The thing that stayed with me most was the flow room — the hospital's operational nerve centre, where live data makes pressure, constraints and patient flow visible in real time. Standing in front of that screen, you could see exactly where the system was under strain and why decisions were being made. In our world we'd call that observability. We've still got a way to go, but that's where I want us to get to — and it's worth exploring just how close we could get.

I also sat in on the referrals quarterly planning session to get context before our own. The prep that the delivery and product teams have put in gives us a solid foundation going into next week. The goal isn't a slide deck — it's a set of plans that people actually own.

Linked notes

Lesson learned

Borrowing from something road-tested beats designing from scratch — as long as you stay honest about where the differences are. The NHS App model isn't a template, but it's a much better starting point than a blank page.

Reading this week: Storyworthy by Matthew Dicks. His argument is that every great story is about one five-second moment of transformation — not a list of things that happened. I tried to apply that to my All Hands presentation this week. I think I got there eventually.