Case Study – NHS Digital VMOST


NHS Digital has a bold vision: To harness the power of information and technology to make health and care better and uses VMOST Canvas to visualise and plan how they will achieve it.


VMOST is a simple and effective structured approach to help organisations to plan and focus effort on moving forward aligned to the organisations’ Vision.

VMOST was originated by Rakesh Sondhi in his 1999 book Total Strategy.

VMOST is structured into 5 elements:

  • Vision – By its definition, a vision is what the place we want to get to looks like, so will use words based on the future tense (such as ‘will or shall’) and contain visual descriptions (such as “a place where… “). They often include how the company would look and feel, what products we offer, and what the industry is doing in relation to us. A good vision should be currently out of reach but not completely unimaginable. They are long term in their nature, but unlike beliefs and values they will change – usually when they have been reached.
  • Missions – Missions are action oriented and tend to say what we will do at a high level (“We will … build X” or “We will… do Y”). One or multiple (2-4) missions may be needed to reach the vision and they may last months or even years.
  • Objectives – Objectives are check points to inform us if we have completed an individual mission or not. Usually they are in the form of KPIs which are set when the missions are identified. As well as showing if further work is required to achieve the mission, objectives are also used to ensure that lower level strategies are contributing to achieving the mission.
  • Strategies – Strategies can be thought of Themes of work that we want to explore such as “improve brand appeal to mobile users”, or “Focus on new innovation”
  • Tactics – Each strategy may have a number of tactics which could be undertaken by different business units.

VMOST Canvas

VMOST Canvas is a technique to help visualise an organisations’ VMOST and was originated by Austen Bell and is detailed under the Blended Agile Delivery toolkit.

What were the outcomes

VMOST has really helped the NHS Digital Delivery Centre focus on value and Tactics that really drives the organisation to achieve our Vision. Business value is difficult to measure in a centralised, national NHS service environment, and differs within each area. Some focus on reducing the cost and burden of services, others on improving NHS capabilities and capacity, others on meeting key policy objectives, such as Paperless 2020. VMOST has helped us measure business value by asking the question; how does each Tactic meet or move forward any of our Objectives. Dependent on the answer is how we measure Business Value.

This aligned with WSJF (Weighted Shortest Job First), we are changing the conversation from delivering pet projects to delivering value that meets our objectives and drives us closer to our vision incrementally into service, maximising return on investment and meeting our customers’ needs.

Where next

We are currently working on the 2018/9 VMOST for the NHS Digital Delivery Centre, which will drive our activities and priorities for the next year. We are rolling out VMOST across the organisation, so that each business unit has a clear vision and a plan aligned to realising it.