Really interesting blog from @SaxtonJoe @nfpSynergy about how charities approach devolution and set up (or don't) for Scotland, Wales and NI. Important for any charity leader to read, but I do have some thoughts... https://twitter.com/nfpSynergy/status/1377546393993285632

Firstly, the blog focuses more on structures than I'd like and not enough on organisational culture. As I heard at a seminar several years ago on managing change, "culture eats structures for breakfast"

How do you ensure having a Scotland/Cymru/NI arm of your charity and/or a Head of [nation] is more than just a tick box exercise? I see plenty of charities that have this set up who don't necessarily have much increased impact as a result

The risk is that by having that structure, it almost absolves any staff based in England/London/HQ of needing to have any responsibility for impact in devolved nations. That then creates a huge disparity in what resource is really available overall

CRUK has staff based in Scotland, Wales and NI (including me!) but they all link back into the centre. I'm not saying it's always perfect but it does make it easier to link up with the fantastic people, expertise and talent and direct some of this beyond England

The main thing then is ensuring that people based in Scotland, Wales and NI are brought into conversations at the right time. They should be a consideration at the outset and never as a last minute thought. My most frequent question at work is, "what about the devolved nations?"

Joe rightly points out that for a medical research charity, funding should be focused on quality, not geographies. But there's a lot more that CRUK does, including influencing change, fundraising, providing information, the list goes on. This stuff should be four nation in focus.

I've yet to come across a charity that has truly cracked the devolution question. That's because it's not easy - devolution is messy and it can be a minefield to navigate, especially for a health charity. There are a few simple things we can all do that will help though:

1. Stop talking about "the Government". There is no one government any more. There's 4 in the UK (or 3 and 1 NI Executive). It's really offputting to hear it when you don't live in England. It also lets devolved governments off the hook when they might be equally responsible.

2. Similarly, there is no single NHS, so don't refer to it in those terms. For one thing, NI doesn't have an NHS, it's the HSC. As for the rest, the NHS in England is VERY different to the health systems in Wales, Scotland and NI.

3. Get the language right. The UK, Great Britain, British Isles, and England are not interchangeable terms. They all mean different geographies so be more specific about where your message is relevant.

4. Understand each nation properly. Don't use England as the model for how other countries operate. All four have their own distinct culture and politics. Getting it wrong can look amateur. For Wales, that includes language - everyone speaking English too is not a valid response!

5. Ask the devolved nation question early on. Not every piece of work will be appropriate for every nation or the environment won't be ripe for success. But at least opportunities won't be missed.

This stuff is important because the devolved nations often see higher levels of deprivation, poorer health outcomes and worse health behaviours. If you were going for a needs-first approach, you'd start there.

On the flipside, the opportunities are greater. It's easier to work with devolved governments and health bodies. And if your objective is national level change, Scotland, Wales and NI are smaller and more contained than big and chaotic England.

Finally, some might say England is most important on numbers alone. But you're missing the bigger picture. For charities, the UK should be treated as one big theory of change. Success in one nation can be used to bring about change in another. People we support are relying on it.