During the pandemic, the phrase ‘The world has never changed so quickly, but will never change so slowly again’ became commonplace. Few would argue with this today

What does this era of disruption mean for organisational strategy? Is there a point in even having a strategy in such unpredictable times? And given that strategy is invariably about growth, how valid is such an approach when most hospices are struggling to stand still, let alone go forward?

Everyone has their own understanding of strategy. I have always tried to keep it simple i.e. ‘Where we are now, where we want to get to and broadly how we plan to get there.’

A hugely simplified history of strategy reads like this. The ‘analogue’ approach grew out of corporate America in the 60s and 70s. Long timescales, detailed plans, big aspirations, clear targets linked to dates many years ahead. A linear, one-dimensional route forward. We will get from A to B by doing C. Or, to use the journey analogy often lined to strategy,
we could call it the ‘Package Holiday' option.

More recently, the ‘digital’ approach has stressed more flexibility and an emergent journey, but again normally over a five year, or more, timescale. There is still normally a master route, but an appreciation that we might need to make some changes over time. So, more of an approach that we will go from A to B and start off by car, but might need to change our mode of transport on the way. So, more like ‘Around the World in 80 days’.

Contemporary thinking, or the ‘AI approach’ is less deterministic. We have a sense of the direction we want to go, but not the exact destination. And there is no single anticipated route; more a range of options that we will have to decide upon as we go and which we might switch to and from several times. More of a ‘Race Around the World’ approach?

Why AI? Because if you ask the same question to several AI models they may well give you quite different answers. And if you changed the question slightly, each might give you quite different feedback to the previous response. This reflects the unpredictable nature of the world today.

So, I thought I would ask AI tools to analyse 10 randomly picked (by them, not me) hospice strategies and propose improvements. Below is a summary of their responses. 

                                The Central Argument: a Different Design for Strategy

The dominant model of hospice strategy — a five-year document structured around aspirational pillars, reviewed annually but rarely substantively revised — is built for a more predictable environment than that hospices actually inhabit.

The case for change is not an argument against strategy. It’s an argument for a better kind of strategy — one that distinguishes what should be durable (direction, values, big-picture objectives) from what must be adaptive (annual priorities, resource allocation, delivery models). The recommended architecture for hospice strategy looks like this:

A durable strategic frame — three to five years, directional, publicly stated — that answers: What kind of organisation are we? Who do we serve? What does success look like for our community? What makes us distinct? This frame should guide decisions and communicate intent to funders and commissioners. It should not be a plan.

An annual strategic cycle — twelve-month objectives, resource allocation, and delivery priorities set each year in light of current conditions, reviewed against the strategic frame. These should be specific, measurable, and genuinely revisable. Trustees should hold the annual cycle accountable, not the five-year frame.

Scenario-sensitive checkpoints — explicit triggers built into governance that require leadership to revisit strategic assumptions when defined thresholds are crossed: a material change in NHS commissioning, a funding shortfall beyond a defined threshold, a workforce crisis above a defined vacancy rate.

A capability-building focus — investment in the organisation's capacity to respond rapidly to change: financial reserves adequate to bridge uncertainty, leadership skills in adaptive decision-making, and a culture that treats changing course as evidence of good judgement rather than failure of planning.

Concrete recommendations: Stop, Start, What Good Looks Like
✕  STOP
Writing detailed five-year operational plans that embed specific Year 3–5 objectives as if conditions were knowable. If you have income targets, patient volume figures, staffing ratios, or capital commitments in a document labelled 'Strategy 2025–2030,' they are not strategic assets — they are liabilities that will require explaining when they are missed.

✕  STOP
Conflating strategic direction with annual planning in the same document. The aspiration to reach more people in the community is strategic direction. The target to recruit four additional community nurses by Q3 is an annual objective. Mixing these up creates governance confusion and makes it harder to distinguish what is truly fixed from what should flex.

✕  STOP
Treating strategy revision as a governance crisis. For some boards, changing the strategy mid-period is treated as an admission of failure. This is precisely backwards. In a volatile environment, a strategy that never changes is not a sign of clarity — it is a sign of disconnection from reality.

+  START
Running annual strategy conversations alongside your annual planning cycle — distinct from each other. The annual plan is operational: what will we do, resource, and measure this year? The strategy conversation asks: does last year's experience give us reason to revise our direction, our model, or our core objectives? 

+  START
Using multiple future scenario planning as a governance tool, not just a strategy exercise. Instead of one scenario, build three: The Growth Path, The Resilience Path (Consolidation), and The Pivot Path (Partnership-heavy).

For each scenario, identify which of your current commitments remain sensible and which become fragile. This is not pessimism — it is the basis for genuinely adaptive governance.

+  START                                                                                                                                        Asking the harder strategic questions your current document probably avoids. What would we stop doing if we had to? What is the minimum viable version of this organisation's mission? Where are we genuinely irreplaceable — and where are we doing things others could do? Rumelt's concept of the 'crux' is useful here: what is the single most critical challenge your hospice faces, and is your strategy genuinely designed around solving it?


→  What Good Looks Like
A hospice with good modern strategy has a clear, compelling, publicly stated mission and a small number (three to five) of big-picture strategic objectives — directional, durable, and genuinely distinctive. 

It has an annual operational plan, specific and measurable, reviewed quarterly against real conditions. 

It has a scenario-aware financial model that plans for multiple funding futures. Its board receives a regular strategic health check — not just performance data — that flags when assumptions have changed. 

And it has pre-agreed decision rules for when the strategy itself will be revisited: not annually by default, but in response to defined triggers.

Conclusion:
The hospice sector is operating in one of the most genuinely uncertain policy and funding environments it has ever faced. Demand is rising. Funding is structurally contested. Workforce availability is constrained. NHS commissioning is in flux. The assisted dying debate will reshape service landscapes in ways that cannot yet be modelled. 

Against this backdrop, a sector-standard five-year strategy built on detailed projections is not a governance asset. It is a comfort blanket that may actively impede the honest, adaptive leadership that this moment requires.

The hospices that will serve their communities best over the next decade will not be those with the most detailed strategies. They will be those with the clearest sense of who they are, the most honest assessment of what they cannot know, and the governance architecture to move decisively when the environment demands it. That is the kind of strategy worth writing — and worth governing.

It’s important to remember that AI is our servant, not the master. But I hope the above helps you on your own strategy journey.