More than 10 months after Gill Morgan quit as NHS Confederation chief executive, it has failed to appoint a successor.
Part of the problem is that Ms Morgan's widely admired talents appear to have paralysed the Confed's thinking. Staff and trustees repeatedly say "we'll never be able to replace her" - hardly a great vote of confidence in the NHS leaders the Confed is there to represent.
The organisation is also struggling to decide who is the tail and who is the dog when it comes to its networks and the central officers.
The Confed needs to stop dithering and spell out its direction before it starts shedding members.