Most executive search briefs are already obsolete by the time the successful candidate walks through the door. That sounds unlikely until you consider how long it takes to appoint a senior executive. 

Six to nine months can pass between defining the role and welcoming someone into it. In a scaling MedTech company, six months is often enough for the organisation to become something materially different from the one described in the original brief.

Looking back, the appointment still appears to have been the right one. The executive was capable, the references were strong and the interviews were thorough. Yet, eighteen months later, something no longer feels quite aligned. The individual hasn’t failed but the organisation has simply moved faster than the assumptions that shaped the role.

That is a pattern worth paying attention to, because it is becoming increasingly common across the life sciences sector.

The Academy of Medical Sciences published its first annual assessment of UK medical science this month, and the headline figures are genuinely impressive. 

Inward investment into the sector rose 164 per cent in a single year, reaching £2.1 billion and lifting the UK from eighth to fourth among comparator nations. The life sciences industry now generates close to £147 billion in turnover and employs almost 360,000 people. Nearly half of the research submitted to the last national assessment was judged world-leading. 

By any conventional measure, British life sciences is scaling. Yet the same assessment is candid about something else: the country is not converting that research strength, or that capital, into commensurate improvements in health outcomes. The foundations, in the Academy’s own language, are showing signs of strain even as the headline numbers rise.

It would be easy to read that as a policy story, or a funding story, or a story about the NHS’s capacity to absorb innovation. It is, in part, all three. But underneath it sits a pattern that any Chair or CEO in MedTech or HealthTech will recognise immediately, because it plays out at company level exactly as it plays out at national level.

More capital did not automatically produce better outcomes. More investment did not automatically produce better commercialisation. More people, more funding rounds and more resources changed the scale of the system, but not the constraint that ultimately determined its success. The problem was never one of resources in the first place.

Boards tend to assume that growth is additive. More revenue requires more salespeople. More complexity requires more layers of management. A Series C requires a “more senior” CFO than the Series A did. It is an intuitive model, and it is wrong at precisely the moments it matters most.

What actually happens in a scaling MedTech or HealthTech business is that the organisation periodically outgrows the assumptions embedded in its leadership team. The leaders themselves have not become less capable. The company they were appointed to run simply stopped existing somewhere in the previous eighteen months, replaced by a business with different demands, different constraints and a different future. 

A commercial function built for early adopters now has to sell into procurement committees. A regulatory strategy built for CE marking now has to navigate two jurisdictions at once. A founder-led culture that moved fast on instinct now needs governance it was never designed to carry.

Simply adding capability does not solve this. You can hire brilliantly for the company you have and still be wrong for the company you are about to become, because the two are not the same organisation, even if they share a name, a board and a P&L.

The first mistake is rarely made during the search itself. More often, it is made before the search even begins. It happens before the search begins. The board defines the role through the lens of yesterday’s organisation, drawing on the responsibilities of the departing executive, the gaps in today’s leadership team and the priorities captured in last year’s strategy.

It is a reasonable instinct. It is also answering the wrong question, because the vacancy being defined belongs to an organisation that will not exist by the time the appointment lands.

Every executive appointment is a bet on the future version of your company, not the organisation that exists today. Not the version described in the current org chart. Not the version reflected in this year’s board pack. The version that will exist in two or three years, shaped by decisions about geography, regulatory pathway, capital structure and commercial model that, in many cases, have not yet been finalised at the moment the search brief is written.

Seen in that light, the appointment is less about filling a vacancy and more about shaping the organisation’s future. It is an architectural decision, made under uncertainty, whose consequences often take years to reveal themselves.

A Chair who appoints against today’s organisation is, in effect, designing for a building that is about to be demolished. A Chair who appoints against the organisation’s likely future is designing for the one that will actually need to be occupied.

Venture and private equity investors understand a version of this instinctively when they underwrite a thesis rather than a set of current-year financials. 

The best of them are not backing what a company is; they are backing what it becomes under a specific set of conditions. Leadership appointments deserve the same discipline and rarely receive it, because the pressure to fill a seat quickly is almost always stronger than the pressure to define, with precision, which future organisation that seat actually needs to serve.

The UK’s life sciences sector is not short of capital, talent or ambition. Its own annual scorecard makes that clear. The more difficult discipline is looking beyond today’s organisation and asking what tomorrow’s organisation will require. 

Only then can boards make leadership decisions that are aligned with the future they are trying to create, whether they are appointing a first VP of Regulatory or deciding how billions of pounds should shape the future of the sector.

So the question worth sitting with is not whether your organisation is investing enough in leadership. It almost certainly is.

Many of my strongest client relationships started the same way: a thoughtful exchange of messages, a short video call, then coffee and cake. Everything else followed from there. If this article resonates, I’d be delighted to start the conversation in exactly the same way.

After all, the best leadership decisions rarely begin with a search. They begin with a conversation.

In the coming weeks I’ll be exploring the questions this article raises, from leadership architecture and succession to why organisations outgrow roles long before they outgrow people.

#MedTech #HealthTech #Scaling #BoardLeadership #LifeSciences

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About the author

Harun Rabbani is the Founder of Precilium, where he advises Chairs, CEOs and investors of scaling MedTech and HealthTech companies on leadership architecture before critical executive appointments are made. Drawing on three decades in medical technology, executive search and international leadership, he helps boards align leadership decisions with the organisation they are becoming, not just the one they are today.

Most of his strongest client relationships begin with a thoughtful exchange of messages, a short video call and, if the conversation continues, coffee and cake.

Next in the series

Next: Why Organisations Outgrow Leadership Roles Before They Outgrow Leaders

Why do highly capable executives suddenly seem to lose their edge, even when they haven’t changed? In the next article, I’ll explore why leadership misalignment is often a symptom of organisational evolution rather than individual performance, and what boards can do before they conclude they have the wrong person.