Scenario A

After years of research and clinical trials, a drug has finally been approved for your condition and is now going through NICE’s Health Technology Assessment in the hopes of having the drug reimbursed in the UK. Your patient group has been giving evidence and has finally received an outcome. NICE will reimburse the drug, but only for a very small subset of patients. How do you deal with this decision and communicate back to your rare disease community?

Suggested response

In this difficult and disappointing situation the community would be looking to the leader to decide what would happen next. A good first step could be to gauge the community reaction to the news and to console any individuals who were feeling disappointed or let down. This would involve a good level of social awareness and emotional intelligence. A good course of action could then be to communicate with your community, team and trustees about the best course of action to take. If they are happy to let the drug be reimbursed to just a small subset then this could be a positive thing. This situation involves being very intuitive to the needs of the community on the whole, perhaps as a leader you could put forward an alternative plan of action and suggest that those who took part could be first for the next partnership or project. This situation would also involve a level of diplomacy and relationship management with NICE to inform them that you are disappointed with the outcome and would like to rectify it. This would also demonstrate a proactive attitude to your community.

Scenario B

Your patient group has three full-time staff members. Out of the blue, one of your long-serving staff members resigns, which will impact future projects and staff-morale. How do you deal with this situation, in particular encouraging and empowering your remaining team members?

Suggested response

This scenario may be completely new and unprecedented which may make it harder to deal with. Firstly it may be important to ensure that the staff members departure is dealt with as positively and professionally as possible to ensure no hard feelings were felt and that the work they had been doing had been handed over appropriately and recorded properly. Next it could be key to focus on the morale of the remaining staff and the atmosphere of the workplace. Utilising your emotional intelligence is important and it would be key to ask the remaining staff members how they are coping with the changes and if they need anything to cope better with it. By having open and honest conversations with the remaining employees this may help them to feel encouraged to share any anxieties and feel more in control of their reactions to the changes. As you are in a leadership position it would be your responsibility to assure them and to take control of the next steps, either by modifying the roles and responsibilities of the existing staff to take on the extra workload or by setting out to hire someone new. The remaining employees may feel empowered if you give them a role in the process to show a unified stance on the new situation.

Scenario C

You have been approached by a Tobacco company, offering you a transformative amount of funding for your organisation. How would you approach this interaction and the ethical considerations around accepting this funding?

Suggested response

In this situation keeping ethics and the purpose of your organisation clear in your mind would be important. Although a large sum of money could transform your organisation may be important to consider whether where the money has come from is in line with yours and your community’s moral standing and whether your reputation would be tainted by taking money from a tobacco organisation. It may be worth asking your trustees what their perspective on the situation is. If declining the offer, it would be important to manage the relationship with the tobacco company appropriately by being polite and professional.

Scenario D

One of your staff members has been acting strangely for the past two weeks. Whilst usually quite a bubbly, polite and positive person, they have recently been quite withdrawn, quiet and, at times, irritable with other staff members. This escalates during a team meeting when they have an outburst directed at another employee. What do you do?

Suggested response

This situation requires a careful amount of balance in how it is dealt with. As the leader it would be your role to choose if and how to reprimand the employee for their unprofessional behaviour. It could be insensitive to heavily reprimand them and make them feel embarrassed and guilty. Rather, a socially aware leader would recognise this behaviour as abnormal and try and discover the root cause of the outburst. A person with good emotional intelligence would recognise this as indicative of wider issues. A leader should take steps to try and help the person by further developing an open and empathetic atmosphere. This could be done by asking the person if they need anything to help them cope better or maybe need a break from work to deal with personal issues.

Scenario E

You have been assessing your organisation’s yearly targets and discover you have not hit your fundraising target. You need to address this with your trustees, how do you go about doing so?

Suggested response

Transparency is key in this situation and your role would be to provide a clear and simple summary of the situation to the trustees. Initially it may be useful to establish the facts such as how much you raised, what the major sources were, the successes, and the failed bids. You should also ensure that you review both the reasoning behind the target, and the needs of the organisation at the present time. Was the target a fair one and based on good information? Does the organisation need to meet the target to meet its obligations, and what is the timeline for any financial difficulty arising from this?At this stage you will probably have an understanding of the situation, and how it compares to where you expected to be, and what the organisation’s needs are. Next it would make sense to identify any areas where you feel there may have been failures or shortcomings on the fundraising process. You need to be very clear and honest about this – in general it is good to have collective responsibility and accountability within the organisation, and this is a good default position to help everyone feel that they have a stake in the organisation and can impact its direction. It also avoids a culture of blame. There are, however, scenarios where a failure in fundraising performance could be due to specific strategic decisions, service providers, or a key team member. While no one thing should ever be blamed for negative financial performance, it is crucial that a leader can objectively identify serious problems and raise them with the board – you have responsibility primarily for the survival and success of the organisation.

Finally, you need to present your recommendations for action to the board. How are problems fixed, what action needs to be taken to mitigate against any financial challenges? How will you motivate your team for a significant fundraising push to meet the short fall? What can be learnt for future planning and target setting? Present a clear and simple set of recommendations to the board from your perspective. If possible, this should be addressed in a timely manner at a full board meeting. In the meeting, work through the facts and address any questions the board may have. Then present your assessment of any issues, and propose your solutions to them. Seek advice and assistance from the board to refine that plan and implement it. Make it clear that some form of plan needs to be agreed as part of that meeting.

Scenario F

You have completed a project that didn’t go quite to plan due to some problems in communication between different stakeholders, meaning some key tasks didn’t get completed. A company who helped fund the project is not happy with the result and wants to meet with you, how do you handle this situation?

Suggested response

Firstly, be clear that you understand the terms of your funding agreement, and what you are committed to do as an organisation. Work out what outcomes the funder has a right to request are delivered, and which outcomes are rather those that are dependent entirely on the engagement, interest, or for the benefit of third-party organisations. Funders, in general, should not be determining your charitable aims. When you have a clear sense of these boundaries, arrange a meeting with the funder as soon as possible, ideally in a face to face setting. Ensure that the person who had responsibility for project delivery attends that meeting with you, as they will have the best knowledge and understanding of the project itself. In preparing for the meeting, gather together materials to show the work you have done, and the outcomes, and your attempts to effectively deliver all of the agreed package. Ensure any team members who attend the meeting with you know their role – if you bring a project lead with you, make it clear why. They are there to ensure that you can give the best and most accurate information on the project. They are not there to be held up as the person responsible for the issues. As the team leader you will, and should, take these difficult questions and defend and justify the work of your team members. In the meeting try your best to be open and honest about your work, and the outcomes. Have some suggestions for ways that any problems the funder has can be addressed but be prepared to defend your work and the position of your organisation in a firm and fair manner at need. Aim for a collaborative tone, and work to highlight the good that their funding and support has done and find new ways to help them meet the aims that weren’t possible this time. Make them feel part of the good work your organisation does.