Head of Operations

Head of Operations Time commitment: Full-time Location: Hybrid working from the London office 3 days per week, with flexibility for individual needs. Reporting to: Aoife Barron, VP Product & Operations About Paloma Our mission is to make NHS autism and ADHD care accessible within 4 weeks and, in turn, help every child achieve their potential. In 2024, our founders, Mark and Darshak, were shocked to find that children needing an NHS autism or ADHD assessment were waiting 4-10 years. Delays result in children being more likely to develop mental health conditions and fall behind in education. Furthermore, the much-needed pre/post-assessment support (outside of ADHD medications) is typically not funded by the NHS. These long waits have built up because of increased recognition and understanding of neurodevelopmental conditions, and a lack of investment and innovation within the NHS to meet growing demand. Mark and Darshak, with their 25 years of combined NHS experience, including building services that have treated over 1,000,000 patients in obesity & ophthalmology, founded Paloma to change this. We have successfully reduced waits to less than 3 months by; Taking a product-first approach to redesign the care pathway to give families a more consumer-like experience of care Our in-house product, engineering and AI team have built our own autism- and ADHD specific electronic health record and AI support tool to free clinicians from documentation to refocus on supporting families Investing in up- and cross-skilling our clinicians We are proud that Paloma is: Loved by families, with 4.9 out of 5 on Google and 4.8 out of 5 on Trustpilot Care Quality Commission (CQC) registered and quality-focused Clinically led, with over 100 clinicians who support families through their care journey. A community of passionate, mission-driven and innovative team members who challenge the status quo and test and learn from new ideas and approaches. In control of our own destiny, as we are profitable and backed by leading healthcare investors Triple Point and Heal Capital Growing fast, hiring over 100 more roles in the next 12 months. What’s next? Whilst we have reduced wait times, it is estimated that up to 500,000 children are still waiting for an NHS autism or ADHD assessment, and potentially millions more are waiting for post-assessment care. We won’t rest until this comes down. We will build new services to support families and children diagnosed with autism or The Opportunity We are looking for a Head of Operations to lead and scale our operations function. This is a high-impact role where you will lead a rapidly scaling operations function of 100+ people, including our Care Delivery team (Team Managers, Clinicians, Care Coordination administration team) and our Scheduling and Governance (including safeguarding) teams. Your mission is to ensure that as we scale to help thousands of families, our service remains high-quality, safe, efficient, and financially sustainable. Your will orchestrate this complex function, ensuring every step of our care pathway—from the NHS referral to exit—works in perfect sync. As Paloma scales, there will be opportunities for further responsibility and progression in this role. About you Leader of leaders: You have a proven track record of managing large, multi-tiered teams. You know how to motivate and develop managers who, in turn, manage our Delivery Team, Care Coordinators, Scheduling, and Governance Teams Thrive at scale: Managing a rapidly growing team of over 100 people doesn't intimidate you; you have the organisational skills to keep a large workforce aligned and productive, and are excited to grow the team significantly more. Systems thinker: You see how a change in scheduling impacts care delivery, how a governance update affects the Care Coordination Team, and how changes in our technology impact clinician throughput. You manage the "ripple effects." Operationally & financially rigorous: You thrive on metrics, KPIs, and unit economics. You use data to identify key opportunities or risks such as capacity bottlenecks, cost inefficiencies, or potential safeguarding risks before they become issues. Empathetic but decisive: You understand the high-stakes nature of healthcare and can make calm, authoritative decisions that balance patient safety and clinical quality with operational speed and financial efficiency. Product partner: You know the value of technology as a lever for operational scale. You can articulate operational pain points and priorities to Product Managers. Adaptable to change: You are comfortable working in a dynamic environment, leading teams through structural change, and embracing the fast-paced evolution of a scaling organisation. Mission-driven: You are genuinely excited about using technology and innovation to solve the NHS waiting list crisis. Hands-on leader: You are a strategic thinker who can identify opportunities and risks, and who is equally happy to dive into operational details, audit workflows, and drive execution yourself directly to support and unblock your team. Responsibilities: Integrated Operational Leadership & Team Scaling Provide strategic direction and leadership to the managers of Delivery, Scheduling & Capacity, and Governance. Build a high-performing culture focused on continuous learning, retention, and development, mentoring direct reports into Paloma’s next generation of senior leaders. Oversee team growth and hiring strategy within the Operations function, partnering with Talent to recruit, onboard, and retain high-quality team members Represent the Operations function at a senior level, working cross-functionally with relevant function leads. Partner with our Business Intelligence Team to build relationships, data models, and dashboards that enable you to identify operational red flags and address them before they impact service delivery. Capacity Planning & Commercial Performance Define the strategic "math" of the service, working with the Marketing Team and Scheduling & Capacity Manager to build and maintain dynamic demand forecasts that directly inform headcount planning, recruitment priorities, and scheduling requirements to hit NHS targets while protecting staff well-being. Drive commercial performance and operational throughput by holding teams accountable for hitting revenue targets, achieving gross margin goals, maximising utilisation, and eliminating pathway bottlenecks as the service scales. Product & Process Optimisation Partner closely with Product as a key operational stakeholder to scope, co-design, and drive adoption for internal platform changes, automation, and AI workflows. Ensure rigorous Standard Operating Procedures (SOPs) and documentation exist across the function to establish a "Single Source of Truth" (SSoT) and prevent quality risks as headcount increases. Drive continuous operational process optimisation together with the relevant teams. Quality, CQC Governance & Risk Management Act as CQC Registered Manager, holding accountability for service CQC compliance and quality assurance. Ensure safeguarding and risk management protocols are deeply embedded into every team member’s workflows, maintaining high-quality audit readiness. Oversee operational escalation protocols across the function and business continuity planning Maintain and oversee robust policies and associated processes. Qualifications and experience: Required: 7+ years of operational leadership experience in fast-paced, high-headcount, complex service environments (whether in healthcare or other large-scale service operations). 5+ years of experience overseeing tiered teams and managing managers. Advanced experience overseeing complex workforce capacity and scheduling models for a large, varied workforce, where supply and demand can fluctuate rapidly. A track record of "productising" operations—taking a growing service and building the robust structures, blueprints, SOPs, and documentation needed to support 100+ staff members. Demonstrable experience of a commercial mindset and prior accountability for operational financial targets, managing budget trade-offs, and optimising utilisation. A proven ability to balance high-level strategy with a "lead from the front" mentality, diving into the details to solve problems on the ground. Proven experience in being data-driven with decisions and prioritisation, and comfortable providing detailed updates to wider stakeholders at all levels of the business. Experience leading a large team through periods of rapid organisational change, e.g. a fast-paced startup/scaleup environment where roles and processes evolve quickly. Desirable: Experience acting as a key operations partner to internal Product teams to help scope and adopt workflow changes and automation. Experience managing a mixed team of clinical and non-clinical staff. Experience acting as a CQC Registered Manager. Experience in Data Protection and Data Protection Officer responsibilities <str