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Author: Ali Raza

Ali Raza is an alumnus of the NHS General Management Training Scheme. Ali has worked as a graduate project manager at Guy's and St Thomas' NHS Trust.

Tailored Governance: including the right people at the right time

Inclusion is often used as a blanket term. In this article, I argue that there are different models of inclusion with their own advantages and disadvantages.

In a previous publication (1), I proposed a role for ‘Functional Communities of Practice (COP)’ in nurturing a culture of innovation within organisations.

I believe this COP cohort helps create the conditions for all members of an organisation to participate in strategy development. Crucially, this model of inclusion seeks to tie informal communities to the executive, thereby permitting decision-makers to harness the power of organisation-wide inclusion into concrete action.

However, it’s important to recognise the potential shortcomings of this model of inclusion. With voluntary membership, informal communities may not possess the relevant expertise to deal with specific threats (or opportunities) faced by an organisation at a given time. Hence, they may not be the most suitable reservoir of knowledge for leaders to draw upon in a crisis situation requiring a swift and considered response.

Another model of inclusion which has a unique risk/benefit profile is the permanent representation of particular demographics at board level. A very good example of this is patient representatives who sit on steering groups, providing a voice for other patients at the executive level. Representatives at board level may be empowered through possession of decision-making authority of their own. However, such models of inclusion can also be levelled with the charge of ‘tokenism’. This is defined as ‘The practice of making only perfunctory or symbolic effort to do a particular thing, especially by recruiting a small number of people from under-represented groups in order to give the appearance of…equality within a workforce’ (Encyclopedia.com as cited by Hahn et al., (2017) (2)). Board membership of particular demographics does not necessarily guarantee a fair representation of the wider demographic but can be empowering if representatives (and board members) prioritise the needs of the wider demographic over personal agendas.

One of the most effective ways of dealing with acute challenges and threats is through engendering what I like to call ‘tailored governance’. Tailored governance seeks to unite decision-makers, relevant subject matter experts and impacted stakeholders from across an organisation, to create specific and authorised action to address a new challenge, threat or opportunity. As the issue is likely experienced for the first time, there may not be a set process or governance structure already in place to permit the issue to be tackled or addressed appropriately. Unlike Functional COPs, which are open to all team members and are designed for permanence, teams assembled within tailored governance structures are disbanded once the issue is resolved. In addition to being transient, teams assembled for tailored governance are highly specialised to deal with novel challenges or threats faced by their organisations.

An example of a time when I employed tailored governance was when a third party (leasing space in our hospital) made a proposal for their new entrance into a hospital corridor. With my knowledge of the wider team, I anticipated their proposal requiring input from the in-house site soft services team, Trust branding expert and the site general manager. Table 1 highlights the considerations of these team members in respect of this unique issue.


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Table 1. Team members assembled to consider a third party’s proposal for their new entrance into a hospital corridor.

Governance Role

 

Other comments

 

Team member

 

Requester Approver Consulted/Informed
Third party Yes N/A N/A Seeking approval for their proposal
Site soft services manager N/A Needs to approve material and dimensions of ramp Needs to be privy to final proposal A key member of the in-house operational team
Trust branding expert N/A Needs to approve entrance colour scheme and signage Needs to be privy to final proposal A key member of the in-house operational team
Site General Manager N/A Needs to approve the overall design of the new entrance Needs to be privy to the final proposal and ensure buy-in from operational team A key member of the strategic team

Instances of tailored governance can also be the harbinger for developing formal standard operating procedures. An example of this in my line of work was when I recovered fees owed by a third party for project management services provided by my department. The process for fee recovery was originally not clear, however I liaised with a colleague from Finance and eventually achieved this. As this issue was experienced systemically, I helped Finance create a guidance note for project managers, charting the process for fee recovery from external clients.

A comparison of the three aforementioned models of inclusion is provided in Table 2 below.

Table 2. A summary of three distinct models of inclusion.

Model of Inclusion

 

Summary Pro Con
Tailored Governance Assemble a team to address a specific new challenge or task Selects the most appropriate personnel for dealing with a specific task Non-inclusive to the wider organisation; less suitable for innovation and long-term strategy development
Board level representation A subject matter expert or individual from a specific demographic assists the board with its objectives Board membership likely provides greater clout through direct access to other board members and executive decision-making authority Possibly viewed as ‘tokenistic’ as permanent board membership of a specific demographic may not necessarily represent the wider demographic
Informal Communities (e.g. ‘Functional Communities of Practice’ (COP)) Seeks representation from staff at all levels of the organisation, to support innovation and change management Inclusive of the whole organisation, creating a large bank for knowledge generation Representation in the COP may not have the required expertise to deal with specific challenges, tasks or threats

Tailored governance relies on an important facet of leadership, which is the ability to identify disparate professionals dispersed within different teams and assemble them into a functional team, in order to address specific challenges. Such resourcefulness can be cultivated from an intimate acquaintance with and natural curiosity for the workings of the wider team.

References

  1. PM Times (2020). All Aboard! Functional Communities of Practice: a collective model to inform strategy development. Available at: https://www.projecttimes.com/articles/all-aboard-functional-communities-of-practice-a-collective-model-to-inform-strategy-development.html
  2. Hahn, D.L., Hoffmann, A.E., Felzien, M., LeMaster, J.W., Xu, J., Fagnan, L.J. (2017). Tokenism in patient engagement. Family Practice, 34 (3), pp. 290-295.