How VE3 co-designs a standardised, adaptable operating model across NHS organisations
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How VE3 co-designs a standardised, adaptable operating model across NHS organisations
Designing a future-state operating model for a group of NHS organisations is where transformation succeeds or fails. This case study shows how VE3 co-designs a Target Operating Model that standardises the ‘what’ while localising the ‘how’.
When several healthcare organisations consolidate onto a common ERP, the technology is rarely the hardest part. The defining challenge is agreeing how the future organisation will actually work – the structures, processes, service model, data, performance measures and governance that turn separate Trusts into a coherent shared-services operation. Get the Target Operating Model (TOM) right and the platform amplifies it; get it wrong and even the best software becomes an expensive source of friction.
Across comparable programmes, the evidence is consistent. A shared procurement platform implemented by two NHS trusts replaced five separate legacy systems with a single end-to-end solution, providing a scalable, standardised foundation that met the needs of both organisations while still accommodating local categories and workflows. At far greater scale, a major European healthcare association consolidated two large legacy ERP environments and dozens of auxiliary systems into one standardised platform across eight hospitals and 30,000 staff – a footprint comparable to an NHS Integrated Care System.
VE3 moves beyond the traditional people-process-technology model to a six-layer framework purpose-built for healthcare. Each layer is designed in concert with the others so that decisions about process drive decisions about roles, service design, data and controls.
The process layer defines end-to-end value streams for finance and procurement – from source-to-pay through to financial consolidation – with more than 200 predefined processes adapted to NHS requirements. The people and organisation layer designs a hybrid hub-and-spoke structure that balances centralised shared services with local autonomy, defining over 150 roles across strategic, tactical and operational levels. The service delivery layer architects the Shared Services Centre with clear service towers, tiered support from self-service to specialist, and service catalogues with defined SLAs. The technology and data, performance, and governance layers complete the blueprint.
A TOM imposed on Trusts from a slide deck rarely survives contact with reality. VE3's model is co-designed and co-owned, developed through structured, time-boxed Fit-to-Standard workshops based on the SAP Activate ‘Explore’ phase. The difference from traditional requirements-gathering is fundamental: instead of starting with a blank page, the workshops use a pre-configured SAP S/4HANA ‘Starter System’ so stakeholders can see, touch and interact with future-state processes from day one.
This interactive approach lets teams validate requirements against the standard solution rapidly, focusing discussion on genuine gaps rather than re-inventing established processes. It is in perfect alignment with the ‘adopt not adapt’ philosophy, and it builds early understanding and ownership – the foundations of later adoption. The same principle of broad participation underpinned a gold-standard NHS co-design toolkit developed with more than 200 individuals across 31 health and social-care organisations in fortnightly working sessions.
A well-designed TOM still has to be delivered without disrupting the finance and supply-chain operations that frontline care depends on. VE3 phases delivery in waves rather than a single ‘big bang’, allowing each go-live to stabilise and lessons to flow into the next. In a comparable public-sector transformation, an organisation prioritised its biggest pain points first – tackling financial reporting before other areas – to secure quick wins and maintain stakeholder confidence, completing a full ERP replacement in a focused timeframe.
The art of a multi-organisation TOM is protecting system-wide efficiency without forcing harmful uniformity. VE3 formalises a standardisation/autonomy matrix: core processes, data definitions and controls are standardised across all organisations, while a defined set of local overlays is permitted where clinically or operationally necessary, within agreed guardrails. This balance is precisely what allowed comparable consortia to achieve both efficiency and buy-in from every member organisation.
Operating models designed this way have delivered substantial, quantified benefits in comparable settings – from multi-million-pound procurement savings and dramatically faster transaction cycles to a genuine single source of truth across previously siloed organisations.
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A Target Operating Model is the bridge between strategic intent and operational reality. By co-designing a standardised-yet-adaptable model, sequencing delivery to protect continuity, and anchoring everything in the ‘adopt not adapt’ philosophy, organisations can consolidate the back office in a way that is efficient, owned by its people, and built to last.
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