Client Overview
This global leader in medicines had recently become an independent business, requiring a renewed focus on growth, agility and innovation, and a much higher level of external scrutiny on performance. We were invited to work with the leadership team for North America. They were a critical part of the new organisation’s global strategy, representing a significant share of revenue and a key driver of future revenues.
Challenge
Following the spin-off, the US leadership team faced a pivotal question: how should they organise to deliver on their ambition? The business needed to balance two distinct portfolios, each with different commercial models, capabilities and market dynamics. There were also legacy structures, cultural habits and decision-making patterns that no longer served them well. The leadership team recognised that designing the future organisation would require more than just structural changes. It would mean making choices about accountability, ways of working, and how to lead in a more entrepreneurial and performance-focused environment.
Approach
Sophy and Mark partnered with the US leadership team over four months to co-create a new organisational design. The team began their work with a series of in-depth interviews across the leadership and broader organisation. These conversations surfaced a wide range of perspectives on strategy, capabilities, culture, and the obstacles that were hindering progress. The insights gained from these discussions shaped a set of design principles that became the foundation for their work. Through a series of workshops and virtual sessions, the team explored different structural options, ranging from fully decentralised to fully centralised models. Using frameworks such as the Language of Unit Roles and the RAPID decision rights model, they tested trade-offs and iterated toward a hybrid design that best aligned with their strategic goals.
In the final phase, the team developed detailed designs for each area, identified critical roles, and discussed how to make the new organisation work at the interfaces, particularly around decision-making, data, and customer experience. Conditions for success were agreed upon, including capability building in key areas, clarity on role levels, and a focus on leadership behaviours. Throughout the process, the work was highly collaborative, with the leadership team investing time in meaningful conversations—not just about structure, but about how they wanted to lead and work together.
Outcome
The work resulted in a clear and shared high-level design for the future organisation, one that better aligned with strategic priorities and clarified accountability across key areas. The team made thoughtful decisions about how to group activities, where decision rights sat and how to support more agile and data-informed ways of working.
More importantly, through this work the tone and quality of leadership conversations shifted. By working through trade-offs together, the team built stronger alignment and trust. They surfaced and addressed long-standing tensions, clarified expectations, and created the conditions for more effective collaboration across business units and functions.
