Case Study

Driving Adoption: Change Management Across a Multi-Site ERP Rollout

How VE3's Elevate™ framework provides the blueprint for consolidating seven NHS organisations onto a single cloud ERP – unifying finance and procurement for a care system serving 2.4 million residents.

How VE3 builds user ownership and capability – the bridge between go-live and benefits

Replace all legacy systems with a single, modern, cloud-based ERP providing a unified foundation for finance and procurement across all seven Trusts – and use it as the core enabler for an in-house Shared Services operating model.

The challenge

seven organisations, seven ways of working

One of the largest and most complex Integrated Care Systems (ICS) in England set out to fundamentally modernise the back office that underpins its frontline care. Spanning seven NHS Trusts, serving roughly 2.4 million residents and supporting around 65,000 staff, the system had grown over decades into a patchwork of disparate finance and procurement platforms.

Each Trust ran its own systems – a mix of Oracle E-Business Suite 12.1.3, Agresso/Unit4 and SAP – all heavily customised and poorly integrated. The consequences were familiar to anyone who has worked in multi-entity public-sector finance: manual, repetitive workarounds (notably extensive use of spreadsheets), inconsistent processes and data definitions across organisations, limited interoperability, and poor visibility of spend, inventory and supplier performance across the system.

The approach

the VE3 Elevate™ framework

This was never a conventional software procurement; it was a major business-transformation initiative requiring a strategic partner accountable for solution design, data migration, business-process re-engineering, change management, testing, cutover, go-live support and ongoing benefit realisation. VE3's response is built on the Elevate™ framework – a purpose-built approach for multi-entity healthcare ERP transformations that synthesises proven NHS shared-services practice with disciplined delivery methodology.

The three pillars are interdependent rather than sequential. Foundation Excellence provides the blueprint that guides implementation and informs operational design. Transformation Velocity tests and refines that blueprint through real-world delivery while building the capabilities and culture that sustain it. Continuous Evolution validates the design through live operation and protects the momentum established during delivery.

Pillar 1 – Foundation Excellence: designing the future state

Foundation Excellence establishes the architectural blueprint for the transformed operating model. Rather than the traditional people-process-technology model, VE3 employs a six-layer Target Operating Model tailored for healthcare – spanning process, people and organisation, service delivery, technology and data, performance and insights, and governance.

Crucially, the Target Operating Model is not a theoretical document imposed on the Trusts. It is co-designed and co-owned, developed through structured, time-boxed Fit-to-Standard workshops driven by the SAP Activate ‘Explore’ phase. Unlike traditional requirements-gathering that begins with a blank page, these workshops use a pre-configured SAP S/4HANA ‘Starter System’ from VE3's accelerator suite – so stakeholders can see, touch and interact with future-state finance and procurement processes from day one. Discussion focuses on genuine gaps rather than re-inventing standard processes, which directly supports the ICS's ‘adopt not adapt’ philosophy and dramatically accelerates the design phase while building early buy-in.

Pillar 2 – Transformation Velocity: accelerating implementation

Transformation Velocity engineers the journey – the methodology, accelerators, tools and change enablers that compress timelines, reduce risk and embed adoption. The target is a 36-month full deployment (against 48–60 months typical), a 60% reduction in testing effort through automation, more than 90% user adoption within three months of go-live, and zero patient-safety incidents attributable to the transition.

Delivery is phased in waves rather than attempted as a single ‘big bang’. The first Trusts go live early, with a tightly managed hypercare period; lessons from each wave are systematically applied to the next. This staggered approach lets operations continue without disruption while the new operating model takes shape – the same controlled sequencing that has underpinned successful NHS consortium rollouts elsewhere.

Pillar 3 – Continuous Evolution: sustaining and optimising value

Continuous Evolution makes the transformation permanent. It embeds a continuous-improvement culture, manages ongoing operations, tracks benefits realisation and evolves the platform to meet future needs – targeting substantial recurring annual benefits within 24 months of final go-live, 99.9% system availability, 95%+ SLA compliance, and progression to a higher process-maturity level. Because the platform is built on standard cloud foundations, it can readily absorb additional modules such as HR and Payroll and extend to new organisations.

Governance: balancing standardisation with local autonomy

Uniting seven organisations demands governance that protects system-wide consistency while respecting legitimate local difference. VE3 applies a three-layer model aligned to NHS shared-services exemplars.

Change management: the bridge to benefits

An ERP-driven operating model is as much a people transformation as a technical one. Finance, procurement and operational staff are asked to change long-standing processes, learn new systems and often take on new roles in a shared-services structure. VE3 treats change management as a core workstream resourced on a par with the technical build.

Evidence from comparable programmes is unambiguous: a national NHS usability survey of more than 10,000 clinicians found that two-thirds of the user experience is determined by the implementation approach and only a third by the software itself. Where training and process readiness are neglected, the costs are severe – one large public healthcare rollout required tens of millions in unplanned remediation. VE3's model establishes a coalition of executive sponsors across every Trust, a network of 250+ super users and 150+ change champions, and role-based training reinforced by readiness checks before each go-live.

Outcomes the model is designed to deliver

Drawing on results achieved in comparable anonymised NHS and public-sector transformations, the programme is engineered to deliver measurable, sustained value:

  • All seven Trusts migrated to a single cloud ERP within a 36-month phased programme.
  • A single source of truth for finance and procurement data across the system.
  • Automation of routine transactions – comparable programmes have reached 94% purchase-order automation and cut requisition-to-PO time from two days to ten minutes.
  • More than 90% user adoption within three months of each go-live.
  • A scalable foundation ready for HR/Payroll and for onboarding further organisations.

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Multi-trust ERP transformation is hard, but it is achievable with the right operating-model design and a relentless focus on change. By combining a co-designed Target Operating Model with disciplined, wave-based delivery and a people-first adoption strategy, this programme is positioned to become a national exemplar for NHS shared services – standardising the back office not as an end in itself, but to strengthen the backbone of healthcare delivery.

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