Good Governance in Sleep and Healthcare: Proportionality and Success!

Over a virtual coffee, Terry Hook of the Sleep and Health Clinic and I discussed how to apply governance proportionately to a fast-growing health services company, specifically in sleep and healthcare.

The corporate governance code nudges directors to reflect on the organisation’s purpose first, which, in this case, is to improve the lives of patients and their families, particularly those affected by sleep issues.

Since most referrals come via the NHS, the purpose here encompasses the entire value chain, with Sleep and Health Clinic supporting this by providing high-quality, professional, dependable, and cost-effective services. These services can scale as needed, buffer variations in demand, and add follow-on support to patients and the NHS.

Short- and medium-term objectives are set to reflect these servicing demands. This includes rapidly engaging with referred patients, welcoming them into the process, explaining what they will encounter and how to prepare, and supporting them at every stage, ultimately signing them off or maintaining an ongoing connection.

Key measures will help the management team and oversight board track progress against objectives and delivery of the committed purpose. This includes identifying key risks and implementing essential controls. These efforts aim to demonstrate the clinics ‘safe to deal with’ existence to all stakeholders, including the NHS, regulators, doctors, employees, funders—and, of course, patients and their families.

A caring culture is crucial to demonstrating empathy for every patient, regardless of how tough or repetitive cases may appear to pressure staff and processes. We must never underestimate the positive effects of improving sleep and healthcare on individuals and their families or the potential negativity of ‘dropping the ball,’ such as missed commitments or cyber and data breaches.

The financial services sector is implementing ‘Consumer Duty,’ which expects a constant focus on good outcomes with minimal harms, rather than a transactional interaction with each consumer. A good organisation should always strive for these standards without needing reminders or threats from regulators or others.

A common challenge is the perception that good governance may not be affordable. However, it’s proven that a solid ‘house’ built brick-by-brick on solid foundations almost certainly costs no more than a roughly painted shed. Good governance should be proportionate to the clinic’s maturity and stage of development, as well as affordability. Smaller budgets and staff counts don’t mean a slackening of overall standards, which are committed to and expected by those we interact with.

Unfortunately, many governance standards are documented in heavyweight publications designed for listed and large private firms or highly regulated behemoths. Fortunately, there is also consumable guidance available, such as the Risk Coalition’s new ‘Raising Your Game’ principles, a practical checklist for leaders to work with.

We concluded our virtual coffee agreeing on the importance of Purpose (our North Star for difficult board decisions), our culture, and our ability to make judgements that create the positive outcomes our users and supporters rely on. This comes with the assurance and proof that we can sustain and even improve over time. Governance is for all, even for our relatively small but near-perfectly formed link in the value chain!

Bryan Foss chairs Hope Macy Ltd, an FCA authorised credit reference agency supporting responsible lenders, he is a board member of Caretek Medical Ltd, and previously an advisor to the Financial Reporting Council, a co-founder of the Risk Coalition, Visiting Professor of Bristol Business School, Board course provided with Henley Business School and mentor of numerous highly committed board members. www.linkedin.com/in/bryanfoss

Terry Hook is business and operations director of the Sleep & Health Clinic www.sleepandhealth.org

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