"Soviet tractor factory"

Needs rebooting. No one department seems to have oversight. Open hostility and demarcation disputes between departments. Points of contact appear fearful of prioritising or even raising issues with operational staff.

Business managers feel empowered to make clinical judgments that are then scorned by visibly (scuse the pun) irritated and disaffected doctors.

similar fear of rocking boat by other professionals (GP

Optician PALS)

Distrust of sharing findings or entering into discussions with the patient symptomatic of fear of antagonising other departments.

It seems they are in control.

Eg They are too busy / have their own working methods / can't discuss that / take their time etc.

All the while, nothing gets done, the blindingly obvious (another pun) goes unresolved and cases stack up instead of being dealt with.

Almost as if they have been given a shiny new building and they're not going to spoil it by actually using it.