Indeed. As an outsider, it looks as if it needs a review of its entire operation.
Ideally, it would consult with members but also invite input from the wider ME/CFS community. Some of them might even join if they felt they could support the strategy and had more confidence in the trustees.
I doubt it'll happen, though. The MEA's looked awfully like a clique for most of the time I've been aware of it.
There are two streams of conversation to be had here really. The second (next post) interacts because the 'what happens next' can be what stops 'sort the first'.
The first
seems a no-brainer (apart from the next catch) but something that would be now worrying if it was postponed etc. (because of issues like PROMS) And includes fixing some of the more unusual things that have been flagged that matter - I didn't realise that the checks/balances purpose of governance was being undermined by the trustees being the ones who actually write each of the strategies and plans, whilst also being the ones who advise and scrutinise them if that is actually correct ?
And its impact on job-size if so vs chances of recruiting good candidates (if the norm is a committment half the size as trustee for other charities). Plus of course the added, but ever more relevant, issue of this being an energy-limiting condition where experience with different severities also matters.
If you think of the direct relationship between that increased severity ('being qualified' by having that experience if you think in job terms) and reduced envelope or 'time to offer' if a carer (but not necessarily ability) then I suspect we have issues with ways of working almost implicitly making the most qualified the least able to access the role, for reasons that not only are not needed/priorities but aren't 'norms' necessarily.
Perhaps we should expect a modern ME charity would find a better way to balance having that disease-specific experience/qualification and professional skillset/understanding than expecting it all to be in one person.
The mention of the editorial control/ sign-off process is interesting as an example. Simplifying it to how things can work eg for a magazine, then each page will have a list/hierarchy of stakeholders (hierarchy as different people might suggest contradicting edits and there needs to be final says on each aspect), the whole magazine might have a specific tone and sign-off for that, and indeed their might also be the same by 'section' (what is and isn't included in that).
What qualified pwme/carers who might have experience in different severities/backgrounds would be able to flag vs for example someone who was hired for their expertise in fundraising or accounting or PR will be different. But there should also be overall 'messaging' or principles that those who are responsible for marketing, brand, PR would be ever-conscious of.
Who gets to decide these is part of strategy too. Which is currently scrutinised (and written?) by trustees. So no, just ticking the box saying 'patient insight' will cover it, isn't the same. It probably needs something a bit more substantial to get the right type of input properly built in. Sadly I don't have the answers off the top of my head, as it looks like it needs quite a bit of thinking through!