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Interview: Lauren MacIntyre, Company Secretary of the Year 2021 Winner

“Being a good leader is about getting the best out of people by identifying their strengths and maximising them.”

Lauren MacIntyre was the recipient of the CGIUKI 2021 Award for Company Secretary of the Year. The award recognised Lauren’s commitment and dedication to her work at the North East London NHS Foundation Trust, especially the response to the challenges of the COVID-19 pandemic.

In your nomination for the Company Secretary of the Year Award, you were praised for your exceptional leadership. What qualities would you say make you a good leader?

I think being values-driven is key for any leadership role and this is something I always try to stand by. Integrity and knowing that I’m doing something for the right reason are incredibly important to me. Showing compassion and care towards your colleagues and what you do is also vital.

As a leader, you need to be brave and willing to mix things up and take risks. Sometimes going against the ‘this is how we’ve always done it’ mentality can be challenging. When I first joined North East London NHS Foundation Trust (NELFT), I looked at everything that was in place and thought, ‘How can we make this better?’

Leaders should strive to do their best. It’s about looking for ways to grow and not being complacent. A key part of that is receiving and listening to feedback and taking on board constructive challenge.

I try to develop team members and encourage them to share their ideas and speak up if they think we’re taking the wrong course of action. Being a good leader is about getting the best out of people by identifying their strengths and maximising them.

Your role as Director of Corporate Affairs and Company Secretary of NELFT covers a very broad remit. How do you stay abreast of the work across this portfolio?

It is a very large portfolio and I am often juggling multiple competing priorities, though that’s also part of what I love about it. It keeps me on my toes and provides variety. Just when I start to feel that I’ve cracked one aspect of the portfolio, other bits are added, keeping me on that journey of growth.

Having fantastic team members really helps with managing my broad role. I can trust and empower them to run the day-to-day operations, so they’re just coming to me for guidance and support. I’m very fortunate in that I have a brilliant team who make the juggling a lot easier.

What attracted you to working in the NHS and has the reality lived up to your expectations?

I’ve always wanted to be in healthcare; in fact, my childhood dream was to be a doctor! I wouldn’t be surprised if I stay in the NHS for my whole career.

I love working for the public sector. Sometimes in corporate services, you can feel a bit distant from the patients, but knowing that I’m doing even a little bit to support a patient who is going through a difficult time is truly rewarding.

The NHS is also important to me because, in 2016, I was diagnosed with breast cancer. I’ve now reached my five-year clear of cancer mark and I’m here today thanks to the NHS and its staff who work tirelessly every day. For that reason, I feel I’m forever indebted to the NHS. As such, it’s a pleasure to support its survival – as it did mine – and keep giving back. Going through that journey really made me understand how incredibly lucky we are to have the NHS. I’m going to continue to be its biggest champion and do everything I can to support it going forward.

I have recently been appointed as Director of Corporate Affairs at Mid and South Essex NHS Foundation Trust. I am particularly excited about this as it provides acute services and runs a large cancer centre so I will be working to support the care provision for individuals who have been through a similar journey.

What changes did you have to make to the way that the board worked during the COVID-19 pandemic, and do you think you’ll adopt any of those changes permanently?

The pandemic has highlighted the importance of communication for company secretaries and boards. At NELFT, we adopted a light-touch governance approach during the pandemic. We reviewed the agendas and documents for our committees and put in place a plan of action based on risk. We continued with the vital pieces of work, circulated some items purely for information and deferred those which wouldn’t be negatively impacted by doing so.

We implemented half-hour weekly catch-ups with our board to keep them updated and discussed some of the big-ticket items. One of the main changes was moving our meetings online. We also implemented the option of virtual or in-person appointments for patients. Maintaining a flexible approach on a case-by-case basis is something we’ll retain.

Once we’d got through the first wave of the pandemic, we presented a paper to the audit committee detailing our actions, so that they were kept abreast of developments and to ensure that an audit trail was in place.

Were there any differences in the ways executive and non-executive directors (NEDs) reacted to the pandemic and how were you able to manage those responses?

There were very different responses and that’s due to the very different nature of their roles. The executives were in the thick of it, setting up the Nightingale Hospital at London’s ExCel Centre and trying to keep services running to keep patients safe.

The NEDs sought light-touch assurance while being incredibly supportive and constantly asking what they could do to help. NEDs distributed donated gifts in kind to staff on behalf of NELFT’s NHS Charity, and – at one point – our chair and vice-chair even spent a weekend moving furniture to set up a new ward in response to demand. During this period, keeping two-way communication flowing and ensuring that everyone was comfortable with how the organisation was responding were key.

Can you tell us about your experience working to set up the Nightingale Hospital at the ExCel Centre in London, lead and managed by your trust?

The weeks spent setting up the Nightingale Hospital were some of the hardest of my career, but also some of the most rewarding. Just after Christmas, we were asked to cancel our Christmas leave and were called into an emergency executive team meeting where the task at hand was explained. From that point onwards, I worked 21 days straight; I don’t think I’ve ever felt so tired.

We achieved an incredible amount in such a short time, thanks to teamwork. On 11 January, we admitted our first patient to a ward which, two weeks earlier, had been the ExCel Centre. Each of our teams worked tirelessly, from procuring personal protective equipment (PPE) and supplies, to setting up the estate with beds, showers and equipment, to installing a pharmacy and staffing the hospital. I worked alongside clinical governance colleagues to support patient safety by ensuring that the right structures, policies and processes were in place and risks were considered. It was inspiring to see teamwork from both within the NHS and across the system. We spoke to patients during their journey and afterwards and it was amazing to hear about the care that had been provided.

During the COVID-19 pandemic, you undertook a review of the governance structures at the trust. What motivated you to do that work and what have been the benefits?

This goes back to what I said earlier about continuously improving. Feedback from staff was that they were struggling to get their work done because they were spending so much time in meetings. The pandemic really helped us to address this. Implementing reduced governance structures made everyone realise that we could share information and make decisions without constant meetings. There was a similar challenge with lengthy board and committee papers – there’s a risk that by trying to get everyone to see everything, no one sees anything because it’s just too much.

I looked at alternative ways to cascade information so that meetings could focus on addressing key issues. I put in place clear templates for reports and mechanisms to ensure that we escalate by exception. I also added clarity to the purpose of meetings and where they should report.

I think it’s worked really well; we’re a lot more streamlined with 25% fewer meetings. Now we’re focusing much more on risks, trends and benchmarked data. I’ve produced guidance for report authors, presenters and meeting chairs and managed to align our structure with how we are regulated by the Care Quality Commission.

We’re still in the early stages and we’re getting feedback on the new meeting structure so there may be further tweaks. Remaining on that journey of constant improvement is what keeps standards high.

The Department of Health White Paper has introduced a ‘duty to collaborate’ – how have you been supporting the trust to enact this duty?

I’m the governance lead for the Mid and South Essex Community Collaborative, leading the governance workstream on behalf of NELFT, Provide Community Interest Company and Essex Partnership University NHS Foundation Trust. We run community services in Essex, so we’re coming together to improve patient outcomes collaboratively by reducing variation and establishing integrated health and care services. I was involved with the development of the contractual joint venture agreement between the organisations and we have a joint community collaborative board overseeing our strategic objectives and their delivery. I’m currently working on the development of a joint board assurance framework and looking at some of the structures below board level. One of the things we’ve also recently brought into the Mid and South Essex Community Collaborative is a dashboard to provide visibility of each organisations’ targets and performance.

It’s a huge opportunity nationally because we’re talking about reducing health inequalities, increasing the sustainability of services and creating the chance to learn from one another.

We’re doing some similar work in northeast London and I’m collaborating with my counterparts there on how we might create joint committees. The establishment of the integrated care boards means that we’re working through the delegated authority and how that’s going to look.

What do you think will be the key topics for NHS boards and the company secretaries supporting them in the next 12 months?

I think that, as reforms are implemented, governance is bound to get a little messy while everyone muddles their way through. We’re receiving weekly guidance and we’ve got to establish what works; we’re learning as we go. For boards in the NHS, it’s key that they don’t get distracted by the structures and the governance. They are enablers that can flex and be agile; the most important thing is to keep the patient at the heart of decision-making.

What advice would you offer to others who are starting their careers as governance professionals?

It’s a very rewarding career that you can really thrive in if you’re dedicated. I love that it requires you to use many different facets of your personality. Of course, you need to have a good eye for detail and be precise when you’re looking at policies and legislation, but even more than that, being personable will get you a long way. A huge part of the company secretary role is juggling relationships – with executives, NEDs, governors – and trying to find a balance because sometimes these groups might want slightly different things. You’ve got to be diplomatic and work with all parties to reach solutions that everybody is comfortable with.

Being resourceful is also key. There are sometimes perceptions about the specific qualifications that are required and the type of background that you should come from, but I joined a governance team with a psychology degree, not even knowing what governance meant, and here I am today. The guidance and best-practice advice that you need is out there, it’s just making sure you can source that and learn from it.

I also want to say – governance is not boring. It’s so varied; it’s about problem-solving and you’re constantly doing different tasks and building relationships. All of which keep it fun, exciting and fast-paced.

Lauren MacIntyre – Company Secretary of the Year 2021