Head of Operations

Head of Operations

Time commitment: Full-time

Location: Hybrid working from the London office (Mondays, Wednesdays and Thursdays), with 2 days working from home (Tuesdays and Fridays). If this is not possible, one day per week in the London office (Thursdays) is the minimum requirement.

Reporting to: VP Product & Operations

About Paloma

Paloma’s mission is to make children’s autism and ADHD assessments and care available on the NHS within 4 weeks of GP referral. We believe the NHS can offer quick access to these services, and Paloma is achieving this by redesigning care pathways, developing new software & AI tools, and investing in clinicians' learning & development.

Mark and Darshak founded Paloma as they were frustrated that families are waiting 2-10 years for NHS children’s autism and ADHD assessments. This crisis in NHS children’s neurodevelopmental services has recently been highlighted by the Children’s Commissioner for England here: https://www.childrenscommissioner.gov.uk/blog/childrens-commissioner-warns-of-invisible-crisis-as-delays-and-inequalities-laid-bare-among-children-with-neurodevelopmental-conditions/

We are growing our team purposefully to meet the need for NHS autism and ADHD care, and since launching, we have:

Grown our fantastic team to over 100 people, and are hiring ~100 more over the next 12 months

Raised £5m pre-seed funding from leading healthcare investors (Triple Point Ventures and Heal Capital), helping us to invest in our technology and our team

Achieved financial sustainability

How is Paloma Health different from other Neurodevelopmental providers?

We are clinically-led, Care Quality Commission (CQC) registered, and continuously improve our outcomes and family experiences.

Our in-house product & engineering team ensures we can:

Give families a more consumer-like experience of healthcare

Free our clinicians from documentation to focus on supporting families

Our strong culture, including transparency, a sense of community, and supporting staff career development

The experience of our founders (Dr Mark Jenkins & Darshak Shah), who have previously built tech-enabled NHS obesity and ophthalmology services. Combined, their previous companies have treated over 1 million NHS patients in the last 15 years!

Being backed by leading healthcare investors allows us to move fast

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, bl