Governance Operations Manager

Time commitment: Full-time
Location: Hybrid working, 3 days per week in our London office, 2 days from home. If this is not possible, we will consider alternative requests, though the minimum is 1 day per week in our London office.
Reporting to: Head of Operations (VP Operations in interim)

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 ADHD who feel lost after their assessments when the NHS is no longer there for them.

The opportunity

Are you an organised and skilled operations manager passionate about improving children’s mental health? We are seeking a Governance Operations Manager to lead our governance, safeguarding and care quality operations.

Paloma is a Care Quality Commission (CQC) regulated provider, and you will support our Registered Manager to build and improve our systems to demonstrate our care is safe, effective and well led. 

This work includes line managing our Safeguarding team and working closely with the Medical Director and senior clinicians to build robust processes around:

• Clinical governance and patient safety: keeping our families, team and organisation safe.
• Safeguarding: protecting the children and young people we work with.
• Care quality: ensuring all families receive care that we are proud of.

Importantly, this is not a clinical role. It is an operations expert who supports our senior clinicians. 

With strong performance in this role, you can progress to a Senior Manager.

About You

This role is great for someone who:

• Loves building, delivering and improving processes
• Enjoys leading and managing a (small) team of 2
• Communicates clearly and succinctly both verbally and in writing
• Relishes challenging constructively where you see things can be improved
• Manages their work with project management tools or spreadsheets
• Can work in Google Sheets/Excel to understand and analyse data
• Understands the importance of keeping sensitive data confidential 
• Has a passion for healthcare safety
• Wants to be part of an always-learning environment that embraces software and AI tools and wins as a positive and collaborative team.

Key responsibilities

• Partner with the Registered Manager and Medical Director to ensure all governance topics are mapped, monitored and delivered, so that we can demonstrate Paloma is safe, effective and well-led. 
• Line manage the Safeguarding team, including:
• Setting clear objectives, monitoring KPIs, and building a high-performing team
• Support the safeguarding team with operational processes, including case tracking, safeguarding supervision records, and multi-agency liaison.
• Make sure safeguarding activity and audit findings, led by the Senior Safeguarding Officer, are reported to the governance meeting.
• Drive our governance processes, including:
• Setting annual quality priorities
• Run our governance forums (including agendas/actions/follow ups)
• Producing a monthly integrated quality and safety report for the leadership team
• Maintain our organisational risk register, including clear risk owners, controls and review dates, and escalate emerging risks
• Manage the day-to-day complaints process: logging, acknowledgement, investigation, response and learning, within agreed timeframes.
• Drive our patient safety and incident management processes, including:
• Manage the day-to-day incident and risk reporting process: logging, triage, response and closure, identifying themes and trends, and reporting them to the governance meeting.
• Manage Paloma’s Patient Safety Incident Response Framework
• Coordinate learning responses (e.g. after-action reviews, thematic reviews and patient safety incident investigations), and track actions to completion.
• Ensure the Duty of Candour is met, and that CQC statutory notifications are submitted on time.
• Drive our clinical audit and effectiveness, including
• Run an annual clinical audit programme aligned to NICE guidance (CG128 autism in under 19s; NG87 ADHD), covering areas such as record keeping, consent and waiting-list safety.
• Coordinate the audit cycle: schedule audits with clinical leads, collate results, track actions to completion, and organise re-audits to show improvement.
• Work with the Learning & Development Team so that audit, incident and complaint findings become targeted training.
• Ensure clear policies and document control, including:
• Own the policy and SOP library (clinical and non-clinical, including information governance), with version control, review dates, ratification and staff sign-off.
• Make sure every policy is current, reflects how we actually work, and is understood by the team.
• Run our CQC compliance processes, including:
• Act as the internal operational lead for compliance with CQC regulations and the quality statements of the single assessment framework.
• Maintain an up-to-date evidence library, run mock inspections and gap analyses, and track improvement actions.
• Support the Registered Manager and nominated individual with their regulatory duties.
• Lead preparation for CQC inspections and deliver post-inspection action plans.
• Own our information governance approach:
• Act as Paloma's internal Information Governance Lead, supporting the Caldicott Guardian and SIRO, including managing data breaches.
• Manage the relationship with our external Data Protection Officer, liaising with them as needed.
• Act as the escalation point for subject access requests where Care Coordination teams need input, so responses are complete and on time.
• Foster a culture of openness and learning:
• Foster a culture of openness, accountability, collaboration and continuous improvement across the whole Paloma team.
• Make sure staff know how to raise concerns safely, including through our Freedom to Speak Up Guardian, and share learning through regular safety and quality bulletins.
• Lead on innovation in governance, such as incident management systems and quality dashboards.

Success metrics for this role include:

• Incidents and complaints acknowledged, reviewed and closed within agreed timeframes.
• 100% of CQC statutory notifications and Duty of Candour requirements met on time.
• All clinical policies and SOPs are kept in date.
• The annual clinical audit programme is delivered, with actions closed on time.
• Risk register reviewed monthly, with no overdue actions on high risks.
• CQC evidence library complete and current, and an inspection outcome of Good or better.

Qualifications and experience

Required

• At least 2 years of operational experience. This could be in quality, governance or compliance roles, but does not have to be.
• At least 1 year of line management experience, preferably in a commercial, high-growth environment.
• A demonstrable track record of building or improving compliance, quality or risk processes that delivered results against deadlines.
• Strong data and reporting skills

Desirable

• Knowledge of CQC regulation and the single assessment framework.
• Experience with incident management or project management software.
• Experience of incident management and complaints handling.
• Experience working alongside clinicians within NHS services
• Knowledge of information governance (e.g. UK GDPR, DSPT) or clinical safety standards for digital health (DCB0129 and DCB0160).
• A quality improvement, patient safety or project management qualification.

Don’t meet every requirement? 

Studies have shown that women and people from ethnic minority groups are less likely to apply for jobs unless they meet every qualification. Paloma is dedicated to building a diverse and top-performing workplace, so if you’re excited about this role but your past experience doesn’t align with every qualification, we strongly encourage you to apply. You may be just the right candidate for this or other roles!

Why join Paloma?

You will be part of a mission-driven organisation that’s transforming access to autism and ADHD care in England. For all employees, we offer:

• A strong and positive culture that prioritises staff well-being, transparency, and career development. This includes quarterly development conversations and clear career progression pathways.
• Protected time and budget for team connection, learning, and community-building.
• Comprehensive compensation, including:
• Salary of £60,000 per year, with some flexibility based on experience. 
• Annual salary reviews, ensuring they are competitive
• 5% employer pension contribution
• Equity compensation through Share Options in Paloma Health 
• Private Medical Insurance
• Employee Assistance Programme
• Home Office Equipment Allowance
• A unique annual leave benefits package which includes:
• 37 days of annual leave. This is 28 standard days, plus eight bank holidays, plus your birthday off.
• Option to buy an additional 5 days per year (giving a maximum of 42 days)
• Where required, 2 days per year of special leave, for events that can happen in life, whether personal or family-related
• Additional benefits include:
• A premium performance company laptop
• NHS discounts, including the Blue Light Card (as we are an NHS provider).

Equality & Diversity

Paloma Health is an equal opportunity employer committed to diversity and inclusion in the workplace and throughout the application process. We do not discriminate based on any protected characteristic.

Accommodations

We’re glad to accommodate candidates who need adjustments throughout the hiring process. We encourage you to be open about the adjustments you need, so we can adapt our interview process accordingly.

Safer Recruitment & Pre-Employment Checks

Paloma Health ensures that supporting people to be safe is at the heart of our work and a key priority across all areas of the organisation. As part of our pre-employment checks, you will be asked to complete a Disclosure and Barring Service (DBS) check. Depending on your role within the business, this will be at either an Enhanced, Standard, or Basic level. We are committed to safer recruitment practices and expect all applicants to share our dedication to safeguarding. Our recruitment processes are designed to ensure we appoint individuals who align with our values and will help maintain a safe and supportive environment for everyone we work with.

Application process

Please apply via our website. We understand that applying for a new job requires significant effort, and we appreciate your time. We look forward to reviewing your application.

Join us and be part of our journey to revolutionise access to NHS autism and ADHD care!