Ashfield Hospital Records Migration - a communication plan that only broadcasts
Ashfield Hospital Trust is nine months into an 18-month, £2.1m migration of 340,000 patient records. The communication plan consists of a monthly email newsletter from the project manager to "all staff" and a fortnightly progress report to the steering group. Two weeks ago the 14 clinical safety leads - the group that signs off clinical risk assessments - learned about a planned change to prescription workflows from the newsletter. Their lead has written to the medical director calling the project "unsafe and uncommunicated". The project manager has just discovered that the Care Quality Commission requires 30 days' notice before go-live, and go-live is in six weeks. Separately, a small group of records clerks who will do the bulk of the data cleaning have never been consulted about the schedule.
1. Map the key stakeholders on a power/interest grid. Classify the three groups named in the scenario and recommend an engagement approach for each.
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Grid logic. Power = ability to stop, delay or reshape the project (sign-off authority, funding, regulatory sanction, control of the resource). Interest = how much the outcome affects them day to day. Position determines how you engage, not how loudly you communicate.
Clinical safety leads - high power, high interest. They hold clinical sign-off, so they can block go-live, and the change affects their daily work. Should be in the manage closely / collaborate quadrant: face-to-face involvement in design reviews, a standing safety working group, sight of proposed workflow changes before decisions are taken, not after. They are currently being treated as low-interest recipients of a newsletter - the single biggest error in this plan.
Care Quality Commission - high power, low interest. It does not care about the project internally, but it can prohibit go-live. Requires keep satisfied: formal, scheduled, compliance-quality communication with a named contact and a diary-driven notification milestone. A 30-day statutory notice is a hard dependency, not a comms nicety.
Records clerks - low power, high interest. They do the data cleaning, so their goodwill determines schedule realism, but they cannot authorise anything. Requires keep informed plus genuine consultation on the schedule: a short workshop to test the data-cleaning estimate and agree shift cover.
Test to apply: if a stakeholder can say "no" to go-live, a broadcast channel is inadequate regardless of its frequency.
2. Diagnose the weaknesses in the current communication plan and set out what a revised plan must contain.
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Diagnosis. The plan is one-dimensional: it varies frequency but not channel, content or direction. A monthly newsletter to "all staff" treats 340,000 patient records and clinical sign-off as a broadcast topic. There is no feedback loop, no analysis of what each audience needs to know, no account of statutory obligations, and no record of who owns each message. The CQC notification requirement was never captured, which means the plan was built without checking external obligations - a planning failure, not just a comms one.
A revised plan must specify, per stakeholder or group:
- Who - named owner of the relationship, not just the project manager.
- What - the specific information they need, framed around their concerns (for clinicians: patient safety and workflow; for the CQC: compliance evidence).
- When and how often - tied to project milestones, with the CQC's 30-day notification treated as a hard milestone in the schedule.
- Channel - working group, one-to-one, formal letter, dashboard; several channels for high-power groups.
- Feedback mechanism - how their input is captured and what happens to it, plus a route to escalate dissent.
- Escalation route - who is informed if a group raises a red flag, and within what timescale.
Also: add a stakeholder analysis review at each stage gate, because influence shifts - the safety leads were low-profile until they objected.
3. Recommend how to recover the relationship with the clinical safety leads, and how to handle the CQC deadline.
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Recovering the safety leads - sequence matters.
- Acknowledge, don't defend. The sponsor and project manager should meet the lead in person within days. The complaint is factually correct: they learned of a workflow change from a newsletter. Opening with a procedural defence will harden the position.
- Give them the decision rights they already have. Re-establish the clinical risk sign-off as a formal, scheduled gate before go-live, with terms of reference and a documented membership of 14. Their objection is really about being bypassed; restoring the authority resolves most of it.
- Re-present the workflow change properly - the clinical rationale, the risk assessment, the fallback if it fails - and give them a defined window to respond. Be prepared for the change to be modified; that is a legitimate outcome, not a loss of control.
- Escalate visibly. Copy the medical director on the outcome so the sponsor's support is on record, and so any residual objection is being managed at the right level rather than in correspondence.
The CQC deadline. Six weeks to go-live versus 30 days' notice leaves roughly two weeks of slack - tight but achievable if notification is issued now. Actions: confirm the exact requirement with the CQC in writing, issue notice immediately (it does not depend on the workflow change being settled, but the content must describe what will be live), and log the notification as a milestone with the sponsor named as accountable. If notice cannot be issued in time, the go-live date moves - a regulatory breach is not a defensible trade for a schedule slip.