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Maturity Matrices as a Tool to Deliver True System Transformation

Friday 6th September 2019

By Debbie Goulding and Sarah Fountain, Yorkshire Consultancy Team at NECS

In the developing world of integrated care and large scale transformational change, strong health and care leaders need to allow the time to engage all system partners to reflect on their journey, celebrate their successes but also allow space for honest and sometimes uncomfortable conversations.

Sarah Fountain and Debbie Goulding from NECS Consultancy discuss the growing trend of maturity matrices and how such tools can help health and care partners to understand the progress of large scale system transformation – both the processes and human elements, and help to create a collaborative road map to drive system maturity.

Complex transformation comes with significant organisational and cultural change; the need to operate in new ways and find new digital and technological solutions.  A maturity matrix tool simply identifies common themes along a transformation journey and concisely highlights the ‘must do’s’ for success, provides reassurance that the focus is on the right priorities, and brings to light areas that are in need of more attention.

In 2018 published the Home Office 7 Lenses Maturity Matrix to help teams reflect on their transformation programmes and have focused, honest discussions about action planning 1.  The Home Office developed the matrix to help their executive team understand transformation through the 7 lenses of Vision, Design, Plan, Transformation Leadership, Collaboration, Accountability, and People.

We have seen many adaptations of the maturity matrix tool. They have been particularly helpful in supporting the NHS in driving forward the ambitions of the NHS Long Term Plan (LTP).

The LTP made a pledge to continually move forward with integrating care so that we have a service fit for the future.  This means that Sustainable Transformation Partnerships (STPs) and Integrated Care Systems (ICSs) have to work through how they share responsibilities and resources.  The LTP outlines many different ways of working for the benefit of local populations and this undoubtedly raises tricky challenges to navigate.  Finding the right approach that serves the needs of local populations requires real engagement from all system partners, time to collaborate to agree a system vision and set a course for getting there.   The maturity matrix can help with some of these discussions around the system form and functions, internal governance and decision making, new and innovative ways of working, and finances.

NHS England has developed at least 5 maturity matrices to support NHS Long Term Planning in the areas of ICS system maturity, Primary Care Networks (PCNs), Mental Health, Workforce and Population Health Management.  These maturity matrices can provide a system health check at any single point and can be repeated 6 or 12 months down the line to track progress.  They help to provide a consistent and common language and showcase what good looks like in a simple evidence-based road map to maturity format.

One of the most useful outputs of a maturity matrix is that it allows difficult conversations to happen, that may not take place in other forums such as the Board room.  By creating an anonymised maturity matrix feedback tool, you can begin to really unpick the challenges that are faced and help to remove barriers and open the door for progress in a safe and non-judgemental space.

NECS Consultancy has recently worked with the Primary Care & System Transformation team at NHS England to develop the ICS Maturity Matrix into an online anonymised tool.  Built into the development of this was the option for stakeholders to leave free text on where they feel their strengths and challenges lie in relation to each ICS maturity theme.  By adding this option it provided even more insightful qualitative information that helps to understand the “why” behind what the quantitative data is telling us. This tool has been made available to all STPs and ICSs and is helping systems to focus their Long Term Plans, understand their strengths and challenges and create action plans to address these.

Are you are a health and care transformation leader that is brave enough to engage all (including the less friendly) of your system partners? By encompassing senior leaders from all of your Trusts and CCGs, Clinical Directors and PCNs, as well as your local authority, voluntary and wider public services, patients, public and carers, you will gain an extremely insightful understanding of your system architecture, finances, culture and people. You will also gain a greater understanding of the journey you are on as a developing system; where you are now and where you need to get to.

To find out more information about NECS’ work in relation to maturity matrices please contact


  1. uk. 2018. 7 lenses maturity matrix. [Accessed: August 2019]. Available from URL: