Lucie Lleshi
Drawing on 27 years' experience across the NHS and wider health and care system, I provide flexible strategic and operational support, helping organisations turn complex challenges into practical, achievable solutions that strengthen partnerships and improve outcomes.
Clear thinking. Practical delivery. Flexible support.
How I can help
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Analyse complex information to identify key issues and priorities
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Support effective decision-making with clear, evidence-based insight
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Develop ideas into implementation-ready solutions
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Bring together complex stakeholder priorities to build consensus
Clear thinking
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Develop funding bids and tender responses
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Support all phases of strategic commissioning cycle
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Produce pragmatic guides, support tools, and frameworks
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Deliver end-to-end project management
Practical delivery
Flexible support
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Adaptable approach tailored to your needs
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Versatile leadership; strategic, operational, or hands-on
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Available for ad hoc work or structured fixed-term arrangements
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Scalable input – increase or step back support as priorities evolve
I offer flexible support tailored to your needs and budget. Rates start from £60 per hour, or £400 per day.
Get in touch to discuss how I could help.
Who I support
After 27 years in the NHS, I know how to get things done in complex environments. I bring that experience to health and care organisations across the third sector and charities, the NHS, the independent sector, and local authorities.
Whether you need bid and tender support, a fresh perspective on a complex challenge, capacity for a specific piece of work, or simply an extra pair of experienced hands, I'm here to help.
Third sector and charities
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Bid and tender support
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Partnership working and service development
NHS and
independent sector
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Commissioning and procurement
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Clinical effectiveness and service improvement
Local authorities and public health
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Population health and prevention
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Programme delivery and strategic projects
Read what colleagues and partners have said about working with me on my Testimonials page
Clear thinking
Transforming complex information into practical insights and usable tools
These examples show how I approach complex challenges and develop frameworks, tools and recommendations that people can actually use.
Developing frameworks
Integrated Care Board outcomes framework: Helped partners from across the health and care system agree a shared outcomes framework.
Informed by population health needs and local and national policy priorities, using logic models to bring the 'why', 'what' and 'how' together.
Used by teams to design, deliver, measure, and realise clinical outcomes, patient reported outcome measures, and patient-reported experience measures across all-age physical and mental health.
Supporting difficult decisions
Service review and decommissioning: Managed the service review, options appraisal and safe closure of an urgent care walk-in service. A politically sensitive project with significant local interest and scrutiny.
Gathered, analysed and presented evidence on service utilisation, performance, costs, outcomes, patient experience and the availability of safe alternative services, supported by clear recommendations.
Closure enabled reinvestment in priority services to better meet local population need within financial constraints. Ongoing monitoring demonstrated no adverse impacts.
Testing assumptions
Pharmacy turn-around times in a large acute hospital: Deployed to lead a rapid improvement project to reduce discharge medication turnaround times and improve patient flow.
Worked with teams to define and scope the problem, map the process, use root cause analysis and consider human factors. It became clear that delays were caused by late requests rather than dispensing times.
Testing assumptions rather than jumping to an assumed solution revealed the true cause of the delays, enabling teams to focus their improvement efforts where they would have the greatest impact.
Creating consistant ways of working
Changing admin processes across radiology departments: Led administration teams to streamline and standardise radiology processes, reducing referral-to-appointment times.
Overcame resistance to change by asking teams to develop their own weighted scoring criteria, then use them to collectively assess each process.
Teams surprised themselves with the results and worked together to agree a standardised approach that suited everyone, while retaining flexibility for minor departmental differences.
Practical delivery
Turning complex plans into workable solutions and meaningful change
These examples show how I help bridge the gap between strategic thinking and implementation, making plans and processes easier to put into practice.
Embedding strategy into practice
Organisational approach to learning health system: Co-designed an organisational approach to embed continuous learning, improvement, research, innovation, and clinical effectiveness into everyday practice.
Developed the model as a practical toolkit, enabling staff and teams to use data and evidence to identify improvement opportunities, test ideas, apply research and drive change.
Designed to build capability and shift ownership from specialist teams to the wider workforce, embedding learning and improvement into everyday practice.
Adapting best-practice locally
Map of Medicine: Managed a three-year programme developing evidence-based referral management pathways with health and care professionals across the local system.
Convened and led multidisciplinary clinical working groups to adapt national best practice into practical local referral pathways, ensuring clinical consensus and patient safety.
More than 150 primary care pathways adopted, reducing referral rates, increasing intervention conversion rates, improving patient and clinician experience, and reducing unwarranted variation.
Simplifying commissioning processes
Commissioning guide: Developed a practical guide and supporting resources for an Integrated Care Board to help less experienced staff understand and manage the full commissioning cycle.
Written in straightforward language, it breaks the commissioning cycle into manageable stages with practical examples and links to supporting tools.
Adopted within teams as the 'bible' for new staff and an aide-mémoire for experienced colleagues. Also used by colleagues wanting to understand commissioning or prepare for commissioning roles.
Community liver diagnostics: Co-designed, tested and implemented an out-of-hospital FibroScan service. Initially developed as a proof of concept, with the intention of creating a blueprint for wider adoption.
Worked with liver consultants and GPs to develop an evidence-based referral and management pathway. Successfully piloted in primary care before being scaled up as a commissioned community service.
One of the first direct-access FibroScan pathways in the country, improving patient attendance, engagement, experience and outcomes, while reducing hospital attendances, costs and waiting times.
Developing care pathways
Flexible support
Adapting to your needs and priorities
An experienced pair of safe hands, ready to get to grips with your priorities from day one.
Optimising: pathway redesign
Optimising: pathway redesign
Pathway redesign: using evidence-ba
Optimising: pathway redesign
Pathway redesign: using evide
How I work
Ready to step in quickly with minimal onboarding, I work by:
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Quickly building relationships with teams
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Building trust and open communication
- Building consensus across stakeholders
- Keeping things practical and proportionate
- Adapting to different teams and environments
- Working independently with minimal oversight
Where I can help
Support available across a range of areas, including:
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Developing tenders and funding bids
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Commissioning and procurement
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Service mobilisation and transition
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Service improvement and redesign
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Project and programme management
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Clinical value and effectiveness
Keeping work on track
Helping to maintain momentum and reduce risk by:
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Identifying risks early
- Supporting effective governance
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Breaking work down into managable steps
- Ensuring alignment with strategic goals
- Maintaining momentum through change
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Conducting robust reviews
Flexible capacity
Support that flexes as priorities change:
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Matching your required level, from strategic input to hands-on delivery
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Balancing strategy with execution
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Aligning to your budget
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Stepping in to bridge gaps and ease capacity pressures
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Focussing on what adds most value
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Working to your timescales
I offer flexible support tailored to your needs and budget. Rates start from £60 per hour, or £400 per day.
Get in touch to discuss how I could help.