What governance maturity actually looks like at pre-Series A

In June, I announced that I had become Chair of Biomarx, a MedTech company developing rapid, automated and affordable liquid-biopsy diagnostics. I promised to write more about what governance maturity looks like at this stage. This is the first of those letters.

A board is not there to be informed

One of the most common mistakes I see before Series A is treating the board as an audience. The founders prepare a presentation. The board listens, asks a handful of questions and receives an update. Two hours later, everyone leaves better informed.

It may feel productive. It is often close to useless.

A board that merely receives information is an expensive audience.

At this stage, its real purpose is to help the company make a small number of consequential decisions that the founders should not have to make alone. Every founder is working with partial information, personal investment in the outcome and limited distance from the day-to-day consequences. A good board contributes what the founder cannot easily create alone:

• Distance.

• Different blind spots.

• Relevant pattern recognition.

• And permission to say the uncomfortable things out loud.

The 38-slide board pack

I have been in meetings where the Board pack ran to 38 slides. Every metric the team thought might matter, alongside every dashboard the analytics system could generate and every workstream update. Everything was presented with equal weight because decisions had not been prioritised from critical to noise.

That is not really a board-pack problem. Nor is it uncommon.

A pack becomes bloated when the founder is uncertain of how to maxmise the Board's potential.

The question that changes the meeting

The solution starts with one question:

What are the decisions we cannot make alone this quarter, and where do we need the board’s judgement before the meeting ends?

Once that question genuinely shapes the agenda, the pack often falls to ten or twelve slides almost by itself. But, more importantly, the conversation changes.

The founder stops presenting a completed narrative and starts bringing an open question.

Board members stop nodding through a status report and begin doing what they are actually there to do: thinking alongside the founder about something material and unresolved.

My test for a useful board meeting is simple:

Did the CEO leave thinking differently about something important?

The minutes, formal approvals, investor reporting and governance administration all matter. But they are not the primary value of the meeting. They are the supporting discipline around better decisions.

What a working pre-Series A board pack contains

The strongest packs I see are organised around four categories of decision.

Capital strategy

How much runway is genuinely left?

What milestones must the company reach before the next raise?

What would make the next funding proposition credible, rather than merely hopeful?

Executive hiring

Is the team that brought the company here equipped to take it through the next stage?

Where is the founder still compensating for a capability gap?

Which hire would materially change execution?

Commercial focus

Which one or two routes to market deserve depth?

What should the company stop pursuing?

Where is apparent opportunity creating strategic distraction?

Strategic risk

What could realistically derail the company over the next 12 months?

Which risks are being actively managed, and which are being politely implied but never named?

Around those decisions sits the information the board needs to contribute meaningfully:

• An executive summary

• Financial position and runway

• Commercial pipeline

• Product and clinical progress

• People and organisational risk

• The decisions required

• A decision tracker from the previous meeting

That final item is frequently missing.

A decision tracker should show what the board agreed, who owns the action, what has happened since and whether the original assumption still holds. Without it, board meetings can become a sequence of intelligent conversations with no cumulative effect. A strong board should compound. Each meeting should begin where the previous one ended.

The annual rhythm matters too

The quality of the pack is only part of the design. The annual board rhythm matters just as much. With four formal meetings a year, each should carry a clear strategic emphasis:

• Capital

• Commercial

• Operational

• Long-term strategy

This does not mean other topics disappear. It means the board deliberately engages with the full shape of the company over the year, rather than repeatedly defaulting to whichever issue is loudest that quarter.

Without that discipline, urgent topics crowd out important ones. The board becomes reactive. And the company can reach its next funding round having discussed activity extensively, but strategy only occasionally.

Why this is particularly difficult for scientist-led teams

I wrote recently about the difference between scientific and commercial decision-making for funded scientist-founders. Governance is often where that gap becomes most visible. The instinct that makes someone a rigorous scientist is valuable:

• Gather more evidence.

• Test the assumption.

• Resist premature conclusions.

But in a board environment, that instinct can become reluctance to declare a decision made until the evidence feels unimpeachable. In an early-stage company, that threshold may never arrive.

A well-functioning board should not ask a scientist-founder to abandon rigour. It should give rigour a proper place.

• Evidence is gathered before the meeting.

• Assumptions are challenged in the room.

• A decision is then made with the best information available.

The chair’s role is to recognise when “we need more information” remains a legitimate requirement and when it has become a way of postponing a difficult choice. That distinction has to be acknowledged kindly, but directly. Because delayed decisions are still decisions. They simply happen by default.

This is operational work, not governance theatre

The period between the first institutional cheque and Series A diligence is when board habits begin to compound. A useful board develops institutional memory. It improves the quality of strategic thinking. It helps the founder distinguish signal from noise and it creates accountability without removing autonomy.

An ineffective board may still meet regularly, approve the minutes and receive polished updates. But when diligence begins, the company discovers that the board has been present without being particularly useful. Good governance at this stage is not about creating the appearance of maturity. It is about building the decision-making capability the next stage will demand.

What investors infer from the board

Governance also matters commercially.

During Series A diligence, investors are not expecting a pre-Series A company to operate like a listed business. They are, however, looking for evidence of founder judgement under pressure. How a founder has used their first board tells an investor something about how they are likely to use other scarce resources: capital, senior talent, expertise and time.

A founder who can name three decisions their board materially improved over the previous year communicates something a pitch deck cannot.

• They show that they can absorb challenge without losing conviction.

• That they know the difference between advice and accountability.

• That they can be influenced by good counsel without outsourcing the decision.

• That is a more valuable leadership signal than perfect governance administration.

Building your first board

Do not begin with a board-pack template.

Begin with the decisions.

What are the three or four decisions you genuinely should not make alone this year?

Then design the board around them.

Choose people with the judgement, experience and independence to improve those decisions. Create a meeting rhythm that gives important questions enough space. Build packs that support discussion rather than burying it. Track what was agreed and what happened next. The objective is not to look governance-ready for a future investor. It is to become a company that makes better decisions before that investor arrives.

For funded science and HealthTech founders, Well Purposed works alongside leadership teams and boards at this exact stage, helping translate scientific progress into commercial focus, governance maturity and credible scale.

Reply to this email or contact me directly if your board is meeting regularly but you are not yet convinced it is changing the quality of the decisions being made.

With purpose,

Sara