Three Groups, No Authority

The situation

At Oracle I was running a programme for an NHS client to introduce a new digital tool for clinical teams. There were 3 groups of stakeholders who all had a real say in it. The clinical leads, who cared about patient safety and about not adding to their teams’ already heavy workload. The IT and information governance team, who cared about security and data protection. And the operational managers, who cared about cost and about hitting the targets they personally were being measured against.

None of them reported to me. I did not even work for their organisation. I had exactly as much formal authority over them as a stranger would.

The clash

About 2 months in, it became clear that they wanted fundamentally different things from the same product. The clinicians wanted it simple and optional to begin with. The operations managers wanted it mandatory from day one, because the entire benefits case depended on adoption. And information governance wanted to restrict what data the tool could show, which would have made it far less useful to both of the others. Each group had escalated to their own senior leader, so I was receiving 3 different sets of instructions at once.

What I did

I did not try to solve it in a big meeting, because I had learned that when people are dug in, a big meeting just gives them an audience to perform their positions for. Instead I met each group separately, and I did something slightly unusual. I asked each of them to tell me what they thought the other two groups wanted, and why.

What came out was that each group was carrying a caricature of the others. The clinicians thought operations only cared about numbers. Operations thought the clinicians were simply resisting change for its own sake. And both of them thought information governance was just being obstructive for the sake of it. None of these was true, but each one was blocking any possibility of agreement.

So in each of those conversations, I shared, carefully and fairly, what the other groups had actually told me. When the clinicians heard that operations were worried because their funding genuinely depended on showing adoption, they softened. When operations heard that the clinicians were worried about a specific, real patient-safety scenario, they became far more open to a phased approach. And when both of them heard from information governance about the specific data rule that was worrying them, which turned out to be a real legal constraint rather than caution, they stopped seeing it as obstruction.

Then I brought them together, but not to argue. I put up a single page showing what each group actually needed, as opposed to what they had each been demanding, alongside 3 possible designs. We went through them together.

The moment that tested me

The hardest moment came earlier in that process. The senior operations director told me, quite firmly, to just make the tool mandatory and let the clinicians adjust. I disagreed, and I told him so, privately. I explained that I thought a mandatory launch without genuine clinical support would lead to low-quality use and workarounds, which would quietly destroy the very benefits case he cared about most. And I told him clearly what I would need from him if he still wanted to go ahead anyway: a visible clinical sponsor. He did not enjoy hearing it, but he agreed to let me try the other approach for 2 weeks.

Outcome

In about 90 minutes together, they agreed a phased approach: optional for the first 8 weeks in 2 pilot wards, with a specific safety review built in, then mandatory, with the data restriction designed in from the start. Everyone gave something, and everyone got the thing they actually cared about most.

The lesson

Influence without authority is mostly about understanding. People dig in when they feel misunderstood.

If you can show each group that you genuinely understand their position, and then help them understand each other, the solution very often becomes obvious on its own. And when you do have to disagree with someone senior, you do it privately, with evidence, and you give them something to hold on to.