Thorough examination for an important medical body

British Society for Allergy & Clinical Immunology

“I felt David completely wanted to get to the bottom of what it was we needed and he was really thorough in doing that. Where things weren’t very clear he would dig a bit deeper and I just felt that he was on our side all the time, he really wanted this to happen. He teased a lot out of us, things I had never even thought about. I now feel like I’ve got this green light and to build upon his recommendations and I can use my skills far more effectively.” 

Fiona Rayner, CEO, BSACI

The British Society for Allergy & Clinical Immunology (BSACI) is the professional and academic society for UK allergy specialists. Its aim is to improve the management of allergies and related diseases of the immune system through education, training and research.

BSACI had a Board Council of 34 members, four of whom were Trustees and seven elected members. This leadership structure, with the Trustees always in the minority, was proving inadequate to steer the organisation to serve its growing membership. Numerous sub-committees had been formed, but over time the leadership team’s  capacity to oversee them effectively became challenging.

CEO Fiona Rayner has been at the society for about 20 years and has seen the subject matter of allergy change considerably in that time. She and the Trustees recognised that the organisation needed to be more fluid and responsive in order to advocate on behalf of the patient in terms of service delivery. One of the strategic objectives, which Fiona and the Trustees was keen to drive forward, was to look at the organisational structure, a) with a view to increasing the senior leadership team and b) to make the Council less of a reporting mechanism and more of a discussion forum, as it was intended to be.

After researching options, and receiving a recommendation from one of her team, Fiona came to Action Planning and met with David Saint several times to discuss what exactly was needed.

The exam question was as follows: “We’ve got an organisational structure that’s not moving forward, no decisions are being made, we’re just growing, but we don’t know how to put ourselves into a position where we can work more effectively. How do you manage that in a way which will yield some great things? How do we make Council and the organisation work more effectively?”

Reshaping an organisational structure can mean a lot of unpicking at first, to understand exactly what processes are in place, what isn’t working and what would make it work better. So David began by interviewing Fiona and the four Trustees, observing Council meetings and reviewing documentation. This gave him a detailed insight into the workings of BSACI and he was able to present his findings and recommendations in a report to the Trustees.

Fiona and her Chair started to implement David’s recommendations for a new structure, but realised they needed further direction and so asked for more help. They had a subsequent meeting on Zoom to go over their structural chart and refine it into a clear organigram, highlighting in particular the need for deadlines and efficient reporting to ensure that plans and objectives were seen through. David also reviewed the draft role description for Trustees, to bring greater clarity and focus to the core documentation.

David helped to bring clarity to BSACI’s organisational structure. “There was a big cloud around what we should be doing and he’s made us really focus on what the main areas should be and how we should restructure things,” says Fiona. “It’s enabled us to build a structure which is really fit for purpose. I believe it will enable us to be far more effective and efficient in reaching our goals..”

The responsibility and decision-making  has shifted now more to the TrusteesThe process for making decisions has been streamlined. Working groups now have a start and finish date for their tasks, and a reporting mechanism has been set up and  is much more efficient.

BSACI Council were happy with David’s first report and recommendations and Trustees  didn’t expect any push-back as the recommendations are implemented, but they intend to take it slowly. Meanwhile, Fiona (CEO) is enjoying a more autonomous role, able to make spot decisions and steer the organisation in the direction it needs to go.

“I’m very driven and I felt slightly inhibited,” she says. “Now, if I want to go out and build partnerships I can do it and I’m doing it now.”

Consultant’s insight:

As is so often the case with organisations, custom and practice had grown and evolved over time, so that what was originally relatively clear and straightforward had become obscure, convoluted and almost unworkable. Bringing an external perspective to bear meant that it was possible to see the wood, despite the trees, and cut through to what was really needed to help the organisation increase efficiency and effectiveness.

It was great to work with Fiona and the Trustees, who were really open to what was simultaneously common-sensical yet radical. BSACI is now on a clear path for future effectiveness and it is great to hear that Fiona has been, as she says, liberated as a result of the process.

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