Malcolm Lowe-Lauri, KPMG in the UK 

Having led some of the UK’s largest provider organizations, Malcolm has spearheaded new delivery models to achieve cross-organizational change.


I’m Malcolm Lowe-Lauri. I’m part of the Global Center of Excellence working between the UK and Australia. I’ve just done 17 years as a chief executive officer in the UK, mainly in teaching hospitals—not only, but mainly in teaching hospitals—and that’s part of a 32-year career in health service management. My most recent academic training is in organizational behavior, which gives me a real insight not just into the systems and processes of healthcare, but also things like organizational politics, organizational culture, things that go into governance that people don’t easily see, because you can’t say, “That’s a thing we can study, that’s a thing we know about”--although it’s the sort of thing that people talk about a lot of the time.

So, what do I see as the big questions? Well, if you sit from the perspective of being an acute hospital chief executive officer, you’re sitting in a form of organization which no longer applies to the key health questions and health requirements across not just the developed, but also the developing world. So how do we change this model which effectively is broken, and how do we make it relevant, for example, to the growth of an elderly population across the globe with an increasing range of long term conditions--typically more than one--and for whom articulating that is an acute episode in a hospital emergency room? It’s not the way of providing good care, it’s not the way of financing good care—and by the way, therefore it’s nobody’s good experience. So if we can get to grips with that in the next few years, contributing around the globe as part of the Center of Excellence, I’ll be very happy.

First of all, if you go back to this point that the hospital model is increasingly redundant—it’s broken—then what I’m able to bring is a couple of things. First of all, I think I can help with an offering which allows people to hang in, in terms of cost management and value management while they’re doing the transformation. What I notice in the UK—which we’re also beginning to pick signals up elsewhere in places such as Australia—is that that middle tier of the organization, the middle management piece, is where the organization’s under most strain; but often there’s least investment and capability—financial management capability--quality management and therefore, there is something that we can do. So, what I’ve been working on already in the UK is something I’m calling “know your business”, which helps middle managers understand how to manage proactively, how to get to the use of resources when those resources are being consumed, not two months later when there’s a discussion about them and the accountability effectively is gone for the delivery in that period. So, we’re working on this “know your business” product. I can bring that.

At the top end, I think there’s something I could bring about us getting into tier one, getting into the academic hospital environment, getting into academic health sciences given my history of creating academic health science centers and working on the development of the academic hospital and that will be important, because in the UK, we tend to be very good in the middle of the market—we’ve a very good middle market—but top end, we’re not quite there. With the Global Center of Excellence ability we’ve got, there are huge intellectual resources, massive fire power to bring on that kind of question—and I can help with that.

A highly accomplished change agent

Malcolm has been at the forefront of the NHS’s modernization efforts, having helped several UK healthcare authorities deliver change and improve performance, successfully working with multiple stakeholder groups.

Most recently Malcolm was CEO of University Hospitals Leicester NHS Trust, England’s third- largest university hospital trust with GBP700 million turnover and 11,000 employees, where he moved the organization forward following a failed asset renewal program.

In a 30 year career with the NHS, Malcolm’s early successes include rationalizing laboratory services, consolidating clinical and support services and meeting ambitious national waiting list targets at a number of London hospital authorities.

As CEO of Peterborough Hospitals NHS Trust, he nurtured a collaborative environment, building strong partnerships with health authorities, other trusts, local government and patients, and introducing greater clinical accountability.

Malcolm then became CEO of King’s College Hospital NHS Foundation Trust, steering the organization toward more effective service delivery and overhauling its governance.

A prominent national and international figure, he has chaired the UK CEO’s Research Forum and was a member of the NHS Future Forum, advising the UK Government on health legislation.

Malcolm has a BA from Oxford University, an MsC from the University of London and is an Honorary Fellow of King’s College London.

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