Abstract The UK has experienced a prolonged economic downturn and, as a result, all NHS Trusts operate in a volatile, uncertain, complex, and ambiguous context which is considered to be the modus operandi of teams within this research context. This context has had a significant impact on staff, patients, and the stakeholders of such organisations. In 2012, 94% of NHS employees self-reported that they belonged to a team. A literature review was conducted to gain insight into ‘teams’, particularly high performing teams (HPTs), to identify concepts and develop new understanding thereof. To elicit the lived experience of HPTs, Q methodology has been employed to explore the modus operandi of HPTs within a nationally recognised, high-performing NHS hospital trust. A Q methodology is a mixed method approach that uses both face-to-face interviews and factor analysis to access complex and adaptive environments of dynamic teams. A preliminary study used ten one-hour interviews to develop a concourse of 44 statements that are considered representative of the lived experience of the HPT members. These statements were prioritised in order of importance by each of the 40 participants in the main study as well as a post prioritisation interview and the data was statistically analysed to determine the shared viewpoints. The findings reveal an initial high level framework of themes that are found to be significant in the modus operandi to HPTs and these include supportive learning systems, shared community, courageous leadership, employment relationship synergy, courageous followership, and improving together. The resultant framework is intended to guide the learning and development of more HPTs within the context of the NHS. Key words: - High performance team framework, Q methodolog