Boyden UK & Ireland Leadership Consulting with Cwm Taf Morgannwg University Health Board

Boyden’s leadership consulting centre of excellence helps Board of Directors and Executive teams create a performance-based organisation, combining leadership capabilities with purpose for Cwm Taf Morgannwg University Health Board (CTM)

By Josh Blackman

The Client

The NHS in Wales has a unique structure encompassing seven health boards that manage fully integrated regional health services including urgent care, planned care, mental health, community and GP practices. Alongside the executive team managing CTM is the Board of Directors which includes Independent Members (IMs) and a Chair representing the voice of the patient. They are drawn from a wide range of community bodies, reflecting the locally-driven approach to health services in South Wales.

As a result of structural changes to the Health Board, moving away from Integrated Locality Groups (ILGs), running a variety of services in a geographic area, to a whole-CTM ‘Care Group’ structure, focussing on specific aspects of healthcare delivery, the need for unity was evident. In all, CTM employs 13,500 people and has a turnover of £1bn.

The Challenge

The overall challenge for all health boards, apart from the evident financial constraints, is establishing distinct roles for the board of directors, executive team, care group directors and the CEO. Without a ‘chain of command’ clinicians and senior managers tend to escalate most issues to the office of the CEO, creating a reactive culture of fire-fighting across the organisation.

Without a clear and distinct understanding of their roles, the purpose and external message are equally opaque, impacting both clinicians and patients.

Paul Mears was appointed CEO of CTM in September 2020, with a strong reputation for developing integrated care models across primary care, acute hospital care and community services in Somerset and Devon; his pivotal leadership and approach has been featured in the Financial Times, The Economist and the Health Services Journal. With previous experience as an independent management consultant and senior advisor to McKinsey & Company, Paul arrived at CTM well-versed in the value of high performing teams, clearly-defined roles and structured accountability that optimise clinical capabilities and deliver the best possible outcomes against a broad range of patient needs.

Having known Paul for some years, and how much he values organisational culture, I introduced him to our head of leadership consulting, Andy Wolfe, to help address these structural challenges and create a collaborative and cohesive culture.

Key questions to address were:

What is the purpose of the care group director?
What is the purpose of the board of directors?
What do care group directors need from the board of directors?
How can we all be our best individually and collectively?

The Approach

“I am a great believer in story-led change,” comments Andy Wolfe, Boyden Leadership Consulting, UK. “It’s a great way to leverage a different approach to process and system-led change. Stories create the emotional imperative that brings everything together”.

CTM devoted three days to working with Boyden’s consultants, getting to know each other better as individuals and as a team and establishing purpose. “A common purpose sets the foundation for a fairly new team to build trust in each other to fulfil that purpose,” adds Andy.

In curating the discussions, Boyden used a number of different techniques and data from PROPHET Profiling (Predictive Role Profiling for High-Performing Executive Teams), the firm’s exclusive business-focused profiling tool¹. Andy explains, “PROPHET data is very powerful in a team context, revealing insight into the typical preferences of leaders in certain C-suite roles, such as finance and operations”.

The Boyden team structured their approach into six chapters:

Pride and purpose: proud to be here, what is our purpose
What is our current reality
What is our opportunity
What strategies do we need to put in place to address our challenges, grow and change
What roles do we play in bringing this to life, including culture, code of conduct and underpinning values
What is our destination and what will it look like when we get there

These areas were explored with the executive team and then again in a joint session with the executive team and board of directors, focusing on the purpose and performance of the board. Discussions focused on:

Previous success and learnings
What do directors need to bring to the table to win-learn-change
What specifically needs to change to be effective as a board

A dedicated session gathered the deputy/assistant directors who run the corporate functions and cut across the siloes of the different divisions.

This group needed to become a collective, with a major focus on communication, clarity and alignment with the leadership team. “They felt they had a different purpose,” explains Andy. “We enabled a dialogue on closing the communication gap and focusing on their purpose, aligning that purpose with the leadership team’s purpose, both collectively and individually”.

Another dedicated session was run with the care group directors. Each care group focuses on their specific area of speciality. “This group felt out of alignment with the leadership team, so created a ‘care group board’ representing the care groups to senior leadership and operating much more as leaders themselves”. Discussion followed on actions to turn up the dial on leadership and cascade this through the organisation. As a new structure within CTM, the care group directors needed to feel aligned to the rest of the organisation.

“Our group work enabled a sharper focus on applied leadership, contextualised with where CTM is going, encompassing the emotional element of leadership as well as the rational.

We followed what I like to call ‘Wolfe’s leadership law,’ the 80/20 rule: spend 80 percent of your time focusing on delivering your performance as a leader and 20 percent on leading change and enabling others to develop as leaders. And then aligned with that, ‘bring your whole self to work, understand yourself, your own well-being and alignment with purpose and how you manifest that in creating change, leading teams and the organisation’.”

The Results

In summing up the outcome from the practical group work led by Boyden, Paul Mears, CEO, comments, “The session was very positive and a great opportunity for Independent Members and Executives to discuss the challenges facing the organisation and the journey that CTM has been on over the past few years.

Andy Wolfe was able to focus the group on practical work that brought out the views and perspectives from the group, and enabled us to develop a plan for how we evolve the narrative about the organisation’s next stage of development.

Feedback on the session was very positive from Executives and Independent Members alike with a willingness to look for further development in this format.

One of the very positive outcomes was a shift towards talking about leading and culture and creating a performance environment, where previously there was no reference to self-leadership or team leadership."

¹Boyden has 150 certified PROPHET practitioners worldwide. PROPHET data reveals insight into leadership preferences and decision-making styles based on 2,800 C-suite leaders and 10,000 executives.

About the Author

Josh Blackman

Partner, Interim Management, United Kingdom

Josh Blackman is a highly adaptable interim management specialist with over a decade of experience placing senior leaders and board members in healthcare, life sciences and social impact sectors. Known for navigating complex client requirements, Josh has a deep network within his sector, enabling him to deliver impactful, lasting interim executive solutions for organisations undergoing transformation