New ways of organising
New ways of organising is a theme I come back to time and again. As I included in Multiplied:
Teams and organisations are more than the sum of their parts, with individuals aligned around shared goals able to deliver impressive results. The question is how to organise to make the best use of the skills, experience, knowledge, energy and focus that each individual brings to their work.
Organising models are always there if you are willing to look hard enough. These models are commonly our default settings, based on how things have always worked, or how businesses were designed to function in a different era. Many organising models which determine how our businesses function in reality are both:
Internally focused: These models start with the needs of the organisation, rather than the needs of service users or citizens. As a consequence, business activities are most dependent on internal perspectives and business-as-usual priorities. This leads to the reinforcement of existing decision-making rather than the ability to challenge existing structures and hierarchies. People (HR), technology (IT departments), policy and delivery functions mostly work separately under layers of management to solve what are determined to be business problems.
Technology-oriented: This is the extension of internally focused businesses. It is when the way an organisation works is determined by its technology and system choices, and the constraints in place due to the way IT systems have been set up and must be maintained.
These approaches, along with how they shape team structures and ways of working, limit the reach and impact of the services our organisations can deliver. At their worst, they focus on what’s best for maintaining systems and existing team structures, over what needs to happen to create the greatest benefits, improving outcomes for citizens and society.
The book goes on to talk about the alternative, which is a service-oriented approach: aligning all internal business activities to support improved service outcomes.
This isn’t a new idea, and Kate Tarling’s book The Service Organisation explains the ideas of service-oriented approaches and leadership in much greater detail.
What’s most interesting to me in 2025 is that we still need new ways of organising. It’s hard to point to places that we can truly call service organisations, at least outside of individual policy areas or transformation programmes.
The NHS 10 Year Plan
With the recent release of the NHS 10 Year Plan, I was interested to read this LinkedIn post by Chris Fleming at Public Digital. He explains the key challenge that the NHS now faces:
“The organising principle for NHSE (and indeed the wider civil service and many large private sector organisations) is a Project and Programme Management mentality. Don’t get me wrong, PPM practices have their place, but where it can be harmful is where PPM practice overlays a siloed and waterfall governance model across what’s at its core should be iterating existing activity through a prioritised backlog.
The reality is that all the 10YP projects will be reaching for the same core delivery levers to effect change. Making stuff, buying stuff, changing the rules. A huge number of the 10YP commitments will require changes to the core services, platforms and products that underpin care across the NHS. When lots of projects spin up seeking change across lots of those products and services at the same time it causes absolute chaos for the people working on them and destroy[s] delivery momentum.”
Read the whole post, but Chris goes on to share his view that:
“What NHSE should try to do instead […] is abandon PPM as the dominant organising principle and instead take a service-oriented approach, where coherent backlogs of work to improve particular groups of services can be compared and traded off with each other. It is simply not possible to do everything everywhere all at once. Trying to do everything means you achieve nothing.”
Convening powers as an organising principle
Convening can be a powerful organising principle for achieving the goals being described here. In the NHS, I have already seen examples of this type of system collaboration. The work bringing together 8 acute providers in the East Midlands, shared here by Iain O’Neil, explains the challenges and also the necessity of being able to work in this way. As Iain’s post explains, the challenges are significant: from finding the time and space for organisations and their leaders to collaborate, to balancing trust-level work with system-wide opportunities, and dealing with the lack of existing financial and governance structures.
Iain shares how building a central team has been key to this group making rapid progress, but, most of all, the key aspect of this work has been the trust that’s grown between leaders empowered to shape and own outcomes together. This means they are already challenging delivery norms by sharing resources across organisations, including adopting new ways of working, even without pre-existing structures in place. It’s the type of model that relies on open and honest communication, enabling trade-offs to happen openly and with transparency in the room.
System collaboration leading organisational change
My framing of service-oriented approaches in the past has been more around re-wiring individual organisations and teams through new ways of working. What I would call the fundamentals of digital delivery (service standards). But I think (a) that’s hard at a whole-organisational level, and (b) systems like the NHS have a much bigger challenge in how they align and work together to achieve more meaningful transformation – what Chris has articulated so well above.
Being service-oriented is increasingly about how you convene and work with the right groups of people to prioritise and align work in user-centred ways. It’s the hardest, and possibly the slowest, most complex work you will ever need to do in a system like health. This is because it’s built on trust and relationships over ownership of budgets, permissions and individual organisations’ priorities or governance-based incentives.
I think this is the same in government. To meaningfully transform whole service or policy areas requires a convening of all parts of a system, including central government teams, local government delivery mechanisms, and the charity, voluntary and community sectors. It’s these types of joined-up initiatives that can build new momentum.
For this to work in the NHS, as well as in major policy areas of government, there’s the importance of having alignment to clear purpose and vision. This is the inspiration and ambition needed to draw people together beyond immediate delivery pressures and priorities.
Service movements and moments
As I concluded in Multiplied:
Service organisations are multipliers. What we are describing is a process of change that is achieved by looking outwards. Where an organisation will optimise and plan its internal functions, organising its capabilities around what needs to happen externally.
It’s the looking outwards part that’s still most important. Being service-oriented can be about how you align, collaborate and work with others, and less about needing to fix your own organisation design. Increasingly, taking this approach feels closer to the necessity of organising from the ground up, building trust and buy-in from groups of leaders. This then challenges a system’s willingness to work beyond individual remits, funding and targets.
“…a service-oriented approach, where coherent backlogs of work to improve particular groups of services can be compared and traded off with each other.”
Chris Fleming
At a time where AI priorities are increasingly driving organisations back to technology-oriented delivery models, it’s this type of organising principle that I think we can look to – service-oriented as being less about control and ownership of organisation design, and more about the power to convene, organise and align how progress is made.
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