Causes, Symptoms, Treatment 


Frequent service reorganisation
Too many management restructurings 
Unresolved tension between efficiency goals and performance targets
Confusion over priorities
Unresolved conflict with partners
Rapid turnover of chief executives (on average 2 to 3 years in severe cases  can be 18 months)
Low staff morale
High levels of cynicism throughout organisation
Image problem
Negative inspection reports 
Strident senior management language 
Debt/money problems
Blame culture
Replace chief executive 
Replace chair and some board members
Merger with another Trust(s)
Restructure and reorganise 
Invest in bigger communication team 
Set new targets
Issue new (additional ) priorities 
Invest in fast track leadership development
( There are no proven cures but many retain faith in the above giving case examples of short term relief. There are management consultants who believe the only effective treatment is a prolonged period of stability, financial security and a focus on safety and quality ).
Blair McPherson