How RCOT reshaped the top table

The Royal College of Occupational Therapists made a structural shift to made transformation a priority

The challenge

Digital transformation was necessary for the Royal College of Occupational Therapists. The strategic case was there. The need was clear. But like many professional membership organisations, the executive team's attention and experience was focused on current state operations.

Transformation was seen as important - but struggled to become a priority. It competed with everything else for executive bandwidth and visibility.

Without senior-level attention, transformation stalls. It becomes a project to manage rather than a strategic imperative to pursue. Good people carry it forward, but without executive backing, without their work being reflected in what leadership discusses and decides about, the organisation doesn't truly shift behind it.

The approach

CEO Steve Ford made a structural decision that signalled something fundamental about priorities. He replaced the Finance Director role from the executive team, with a newly created Director of Transformation and Technology role at that same table.

This wasn't about downgrading finance or disrespecting financial stewardship. It was a deliberate choice and message about what the organisation needed to focus on the most in that moment of time to achieve their mission. As Steve describes it: "Made the decision to demote the FD role from the top table and make a director of transformation and technology – because that's what needed the attention."

The decision was bold partly because it was unconventional. Most organisations protect the Finance Director's seat. Most assume finance must be at every strategic conversation. But Steve understood something crucial: structural decisions – who sits at the table, whose voice is heard first, whose priorities shape the agenda—shape what actually gets done.

The result

By putting transformation at the executive table, the organisation signalled that this wasn't a side project. It had executive visibility and voice. It shaped how resources were allocated, how priorities were debated, how success was measured. The transformation work moved from being something leadership monitored to something leadership actively steered.

Over time, this structural commitment enabled integrated transformation: a new CRM, website, communities platform, and CPD tracking system. But more importantly, it created the conditions where such transformation could actually happen—where it wasn't constantly deprioritised in favour of keeping the lights on.

Why it worked

This case study illustrates how structural decisions create trajectory change through resource reallocation. The key is, resourcing doesn't just mean money. They mean leadership time, attention, and authority.

Many organisations attempt transformation whilst leaving the old power structure intact. Finance stays dominant. Operations can feel like firefighting. Transformation sits as a separate layer hoping others will cooperate. At RCOT, Steve understood that trajectory change requires structural change, that you have to move resources from somewhere to signal what matters.

By removing the Finance Director and elevating Transformation, he did three critical things simultaneously. First, he freed up executive attention for a different conversation, one centred on how the organisation needed to change, not just how it would pay for the status quo. Second, he gave transformation a voice equal to other functions at the table, so when budgets were debated or priorities clashed, transformation wasn't automatically deprioritised. Third, he sent a message throughout the organisation: this matters. Not as a nice-to-have, but as a core strategic priority.

This is what trajectory change through resources looks like, not just moving money from one budget line to another, but reshaping the structures and governance that determine where leadership attention flows. Steve was willing to make an uncomfortable choice, to signal that something had to matter more than something else. That structural commitment is what enabled the subsequent transformation work to actually shift how the organisation operated. A powerful case study about trajectory and the importance of action off of the back of strategic decisions.

This case study was developed based on an interview by Julie Wilson-Dodd with Steve Ford, ex-CEO at RCOT. Claude.ai supported in the synthesis and writing of the case study.