Closing the gap between strategic intent and impact: a perspective for chiefs of staff in pharma and biotech

When a pharma or biotech leadership team develops and commits to a strategy, the stakes are high and the pressure to execute is real. But even the most committed leadership teams find that translating strategy into organisational reality is harder than expected – and the gap that opens up between the two can carry a substantial cost in lost momentum, misaligned effort and delayed impact.

Very often, this gap also lacks a natural owner in the business, and it falls to the Chief of Staff to close it – the person who works most closely with the leader, and who understands the distance between what’s decided and what’s actually happening better than anyone.

In an increasingly complex environment, where organisations are being asked to execute and transform simultaneously, the gap is widening.

Pharma and biotech leaders are navigating geopolitical uncertainty, pipeline volatility, major patent cliffs, M&A integration, and the pressure to rewire their organisations around AI. McKinsey’s 2024 life sciences research found that nearly half of senior leaders feel they need to completely abandon their traditional business model to enable innovation¹. When an organisation is being asked to execute a bold new strategy while fundamentally redesigning how it operates, the distance between strategic intent and organisational reality widens considerably.

The Economist Intelligence Unit surveyed 587 senior executives and found that 61% said their organisations struggle to bridge strategy and implementation. The causes weren’t poor strategy. They were poor communication, lack of leadership engagement, and the wrong performance measures². In many organisations, an additional layer of ambiguity compounds this – roles and responsibilities within the leadership team around strategy execution are often poorly defined, creating gaps in ownership that nobody formally fills. These challenges are human or organisational failures – which means they land squarely in the Chief of Staff’s world.

At Insocius, we’re seeing the gap between strategy and delivery concentrate in four areas at the moment, which chiefs of staff tell us they recognise.

1. A strategy that has been launched but hasn’t activated. The strategy that was genuinely owned in the room fails to translate into how people make decisions day-to-day. Without the right reinforcement, functional priorities reassert themselves, and teams don’t adopt the strategy in a way that has real impact. The Chief of Staff is left orchestrating an operating rhythm around a strategy that isn’t truly shared or embedded.
2. A transformation where the human side of change is under-resourced and underserved. McKinsey’s research found that 60% of highly successful transformations invested explicitly in changing mindsets – compared with only 12% of unsuccessful ones³. The Chief of Staff frequently owns the transformation agenda at the senior level. But the human side of change – shifting mindsets, embedding new behaviours, building cultural traction – is the hardest part to execute well, the least well-served by the support that is often available, and ultimately determines whether the transformation succeeds.
3. A leader who is new in role and needs to establish quickly. The new leader must cement their credibility, create relationships, establish a functioning team and operating rhythm – but they are navigating it largely alone. HBR research puts the probability of a new executive leaving within 18 months at around 50%, and consistently points to inadequate integration, not poor selection, as a primary cause⁴. The window to get this right is narrow. Most organisations under-invest in it, and the leader’s Chief of Staff often ends up with the responsibility for making it work, fixing issues or managing the challenges that arise.
4. A leadership team that is individually talented but not collectively effective. In pharma and biotech, careers are often built and reputations earned within functional areas – yet the matrix demands collaboration across them. That tension doesn’t disappear at the senior level – leadership teams are often assembled and simply expected to perform as one unit. Most organisations have no structured way to address the dynamic, and the Chief of Staff – tasked with making the leadership team function effectively – can see the dysfunction clearly but has limited levers to resolve it.

These are not problems that resolve themselves, and they are rarely solved by the same mechanisms that created them. They require external perspective, independence and the kind of seniority that can hold difficult conversations without political cost.

This is the work Insocius does – and why we work so closely with chiefs of staff.

We’re a specialist consultancy working exclusively with senior leaders in pharma and biotech to accelerate performance, drive change, and enhance leadership success. We focus on the human and organisational side of strategy and change – new leader effectiveness, leadership team performance, strategy activation, and enabling transformation that actually embeds. Chiefs of staff understand the context, the politics, and the gap between what’s said and what’s true better than anyone. When we work alongside them, we bring what’s hard to provide from the inside: external credibility, robust methodologies and lived experience honed across many similar situations, independence, and the seniority to have the conversations that matter – without the political risk of driving them internally.

We also work directly with leaders and chiefs of staff through executive coaching – offering a confidential space to navigate the complexity of senior leadership and the dynamics of the leader relationship. And where the challenge is team performance, we work with leadership teams on the dynamics, trust and ways of working that unlock collective effectiveness – structured, ongoing work that translates into how the team actually operates.

We believe that the organisations that will execute well over the next few years are the ones investing now in the human infrastructure of change – in leadership capability at the moment it counts, in teams that function as units, in strategies that travel through the organisation rather than lose traction under the pressure of day-to-day priorities: the challenges that chiefs of staff in pharma and biotech understand better than most.

If any of this reflects what you’re navigating – or what someone in your network is – we’d welcome a conversation.

1. McKinsey & Company, ‘Simplification for Success: Rewiring the Biopharma Operating Model’, McKinsey Life Sciences Practice, November 2024.
2. Economist Intelligence Unit, sponsored by the Project Management Institute, ‘Why Good Strategies Fail: Lessons for the C-Suite’, 2013.
3. McKinsey & Company, ‘The Science Behind Successful Organisational Transformations’, McKinsey Global Survey, December 2021.
4. Sabina Nawaz, ‘The Biggest Mistakes New Executives Make’, Harvard Business Review, 15 May 2017.