Senior Leadership Support in Group Hospital Models: Learning from the Association of Groups (2018–2025)

The Association of Groups (AoG) was established in 2018 and serves as a learning network for senior leaders from NHS Trusts that operate as a hospital group. A hospital group is a collection of NHS hospitals that work together to provide healthcare services to enhance patient care and service delivery. The network provides a platform for Trust leaders to share learning, experiences and best practice in delivering services at scale.

From its inception, the AoG was supported by the NHS Transformation Unit (TU) through the ‘Office of AoG’, with input from Sir David Dalton as Strategic Advisor. Our team worked closely with the AoG Chair, who was appointed by network members, to deliver the ‘Office of the AoG’, which supported the network to meet its aims through an annual co-produced programme of activity based on members priorities and areas of interest. Our support involved providing a range of services including programme and event management, stakeholder engagement, the distillation of knowledge and learning and the recruitment and onboarding of new members.

The TU also managed and co-ordinated a range of specialist subnetworks, including a core network for Chief Executives alongside those for Senior Operational Leads and Chief People Officers helping to strengthen cross‑organisational collaboration, enable shared learning and drive improvement across provider collaboratives.

The Challenge

AoG required support to deliver a network management function that fostered a vibrant, well-connected network promoting the benefits of the NHS Group Model for improving population outcomes, service efficiency and improving operational and financial performance. The network also needed to provide a safe space for Chief Executives and their teams to build relationships, share learning knowledge and best practice, ultimately contributing to policy through learning around operating at scale and collective decision making.

The NHS has undergone significant change since AoG was established in 2018. We worked with AoG members between 2018 and 2025 to develop and deliver a meaningful and bespoke programme of learning and development for AoG members that addressed key developments in the NHS. Each year focused on a distinct theme and set of key aims, tailored to the broader NHS landscape and current system conditions. Key themes over the last few years have included:

Commission	Proposal Themes
2020/2021	Influence and Impact Operational Excellence Accelerated change in response to COVID-19
2021/2022	Knowledge Exchange Network Building Influence and Impact
2022/2023	Workforce Transformation Supporting people to Wait Well Health and Social Care Integration
2024/2025	Realising Benefits of Operating Models at Scale Supporting our people to contribute to improving productivity Navigating increasingly complex systems
2025/2026	Supporting our people to give their best Delivering safe care efficiently Getting the best from technology and digital

Our Approach

We provided a full programme of support that included provision of a project management function, membership management, event management, design and delivery of learning content and the bringing in of specialist expertise based upon the learning needs of the network.

Our approach included regular stakeholder engagement through monthly member calls and horizon scanning to ensure the network remained informative, proactive and we were able to deliver key outputs that added meaningful value for members.

The team developed an annual bespoke proposal focused on members’ key challenges and priority topics. This evolved year on year to address emerging issues and provided a clear benchmark for measuring network success and areas for development and improvement.

In a time where face-to face collaboration opportunities are limited, the Office of AoG stayed committed to delivering an annual event where AoG members and sub-networks could come together and share their progress and best practice.

The Outcome and Impact

The TU, through the Office of AoG:

• Enabled members to connect to share learning, challenges and opportunities and develop peer relationships with other NHS organisations who are working at scale.
• Supported development of NHSE’s maturity matrix through direct engagement with the NHSE team
• Ran annual face-to-face events with keynote speakers including Amanda Pritchard and Julian Kelly in 2024 and Sir Jim Mackay and Elizabeth O’Mahoney in 2025 to provide valuable insights on the wider NHS landscape and its opportunities and challenges.
• Supported collaboration and engagement activities resulting in several resources including a publicly available resource to support those embarking on/undertaking a NHS Group model journey ‘Collaborative Care-Creating Value from Scale’ (https://transformationunit.nhs.uk/collaborative-care-creating-value-from-scale/)

These contributed to a more mature, coherent and connected NHS Group community with enhanced national alignment, ensuring NHS Group development supports wider NHS transformation priorities. They also increased organisational confidence and capability, supported by the peer networks, national engagement, and access to strategic insights.

Each engagement and event helped to significantly strengthen collaboration across the AoG community, deepening collaboration and generating practical insights that can be applied to groups nationally. The opportunity for structured sub-network groups to come together on a regular basis enabled senior NHS group employees to identify shared challenges, exchange expertise and co-develop actionable solutions and outputs to share nationally.

As of 2025, the network comprised 7 Group Trusts from across the country. You can see the membership spread in the below graphic:

 Figure 1 – AoG member organisations as of 25/26 (Illustrative Map of England).

Feedback

The TU received valuable feedback from the AoG members throughout the commission. Most notably that the annual Face to Face (F2F) events played a key role in strengthening collaboration across the AoG community, deepening connections and generating practical insights that can be applied nationally. All 7 members reported that the most valuable elements of the event were the opportunity for like‑minded, solution‑focused discussion, the informal networking that strengthened professional relationships and the space to explore common challenges alongside national colleagues.

It was not only the annual event that was valued by AoG members:

“The TU’s responsiveness and summarising of national policy/guidance was particularly useful”

“Moving to the annual conference approach and providing a clear set of priorities has been beneficial for focus and outputs”

“Being part of AoG has provided a means of peer support and shared learning. For example, with group operating models and the key drivers behind these in different organisations. It’s also been a source of learning on productivity opportunities”

Next Steps

The AoG continues to operate in a new format, without TU support, as part of the next phase of its evolution.

If you are interested in finding out more about the work we did with the AoG or would like support with large scale programme/project management expertise or strategic network design and mobilisation, please get in touch via our website contact page. Our highly skilled team would be very happy to have a conversation about your requirements.