A View from the Top

David Williams is the Chief Executive of St Monica Trust.

Reflections on the last decade

Over the last decade we’ve witnessed a dramatic increase in customer expectations and our customers are now far better informed about the care they would like delivered to them. We’ve also seen an increase in regulation over the sector and a decrease in funding into health and social care. There’s been a lot of talk about health and social care integration, but we have seen very little materialise in terms of services on the ground.

Projections for the next decade

Starting to produce products that are tailor-made to produce excellent outcomes in terms of wellbeing and celebrating the fact that older people are living longer, means that it’s going to be a very exciting decade.

However, we’re facing four significant challenges. We have a market which is affected by the increase in the number of older people within the UK population as a whole. We shall see an increase in competition among providers for a limited staffing group due to larger employment within the country. There will be an increase in the expectation around services older people want to receive and to encourage them to downsize from their homes to live in a retirement community. We’ve also got increased regulation.

To understand customer expectations and how we develop the services that people want, we need to go out and find out how those services need to be constructed. We also need to be fishing upstream and convince young people that health and social care is a good career to go into. This will involve actively going out into schools, embracing apprenticeship schemes and selling health and social care as a really fulfilling career.


What I’ve really enjoyed in my first few months with the Trust is meeting and talking directly with over 900 staff and 1,000 residents. Engaging in these conversations is vital in order to learn richness of the organisation and how we should be moving forward together.

It’s really important to me that a chief executive isn’t hidden away in an office. We need to be visible, walking around and feeling the culture that’s being developed. I want to create an environment where people feel they can contribute to strategy and to use that as a framework to develop the organisation into the future.


My greatest influence, in terms of how I consider the world, was working as nursing assistant in a psychiatric hospital after I graduated from university. The treatment of older people that I witnessed within that ward has had profound effect on my life. My experience in that ward was of a completely depersonalised service, where people were treated as objects rather than individuals. There was a factory-line mentality with the focus on what made things easier for staff. People’s own needs were being ignored. These are things that I have dedicated my life to changing and have driven me to work in a career that focuses on older people’s housing, health and social care needs.


It’s important to be open and honest in your dealings with people. Also, if you say you’re going do something, then you should deliver it. Always be prepared to accept criticism and acknowledge that you are not always going to be right. When you are wrong, accept it and then do something about it. Equally, it’s important to learn from your mistakes and not repeat them. In terms of being a chief executive, it’s important not to think that you own the business. The role of a chief executive should be as a trustee of that organisation. The time when think you own it is the time to leave.


You can always learn new things and try to take advantage of coaching and mentoring opportunities as they arise. Try to absorb as much information as you can as you progress, but don’t be afraid of discarding any information that doesn’t fit. Finally, surround yourself with good people.

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