The Frankenstein Document Problem
Why NHS strategies look professionally written but fail to drive change
The Frankenstein Document Problem
NHS strategy documents often look professionally written. They have executive summaries, clear objectives, and polished language. But despite their professional appearance, they fail to drive change. This is the Frankenstein Document problem: strategies that are stitched together from multiple sources, edited by committee, and disconnected from the people who need to implement them.
What Makes a Frankenstein Document?
A Frankenstein Document is a strategy that has been assembled from multiple contributors, each adding their piece, but without genuine integration or coherence. Like Frankenstein's monster, it looks complete on the surface, but lacks the life force, the genuine buy-in and understanding, needed to make it work.
The Assembly Process:
- Initial Draft: Written by one person or small team
- First Review: Edited by senior leadership
- Stakeholder Input: Comments and suggestions added
- Second Review: More edits, trying to incorporate feedback
- Final Polish: Professional formatting and language
- Result: A document that looks good but no one truly owns
The Problem:
- Multiple authors, no single voice
- Competing priorities stitched together
- Language that sounds professional but lacks meaning
- Disconnected from implementation reality
Why Frankenstein Documents Fail
Frankenstein Documents fail for three critical reasons:
1. Lack of Genuine Ownership
When a document is assembled by committee, no one truly owns it. Each contributor added their piece, but no one feels responsible for the whole. When implementation begins, everyone points to someone else's section as the problem.
The Result: Implementation stalls because no one is driving it forward with genuine commitment.
2. Disconnected from Reality
Frankenstein Documents are often written in isolation from the people who will implement them. The language is abstract, the goals are aspirational, but the connection to day-to-day work is missing.
The Result: Frontline staff can't see how the strategy relates to their work, so they ignore it.
3. Competing Priorities Stitched Together
When multiple stakeholders contribute, they often have competing priorities. The document tries to accommodate everyone, resulting in a strategy that says everything and nothing.
The Result: The strategy lacks focus and clear direction, making it impossible to prioritise actions.
The Cost of Frankenstein Documents
The cost of Frankenstein Documents goes beyond the time spent writing them. The real cost is in:
Wasted Strategy Development Time:
- 6-12 months of back-and-forth
- Multiple rounds of review and revision
- Executive time consumed in endless meetings
- £80,000 in wasted time for a typical NHS Trust
Failed Implementation:
- Strategies that sit on shelves
- Initiatives that never get started
- Resources allocated but not used effectively
- Frustration and cynicism among staff
Organisational Damage:
- Loss of trust in strategy processes
- Cynicism about "another strategy document"
- Resistance to future strategic initiatives
- 70% disconnection among stakeholders
How Frankenstein Documents Are Created
Frankenstein Documents are created through the traditional batch-and-queue approach to strategy development:
The Traditional Process:
- Write: One person or team writes initial draft
- Review: Senior leadership reviews and edits
- Consult: Stakeholders provide feedback
- Revise: Document revised to incorporate feedback
- Re-review: Another round of review
- Finalise: Professional formatting and approval
The Problem: Each step adds another layer, another voice, another edit. By the end, the document is a patchwork of contributions, not a coherent strategy.
The Alternative: Co-Created Strategies
The alternative to Frankenstein Documents is co-created strategies, where all stakeholders participate in creating the strategy together, in real-time.
Co-Creation Process:
- Problem Framing: All stakeholders together understand the challenge
- Systems Mapping: Together map the system and identify leverage points
- Solution Design: Together design solutions that fit the context
- Strategy Development: Together create the strategy document
- Implementation Planning: Together plan how to implement
The Result: A strategy that everyone owns because everyone created it.
How Dynamic Genie Solves This
Dynamic Genie transforms strategy development from batch-and-queue assembly to real-time co-creation. Instead of writing, reviewing, and revising over months, all stakeholders work together in a single intensive day to create the strategy.
The Dynamic Genie Approach:
- Pre-Session Intelligence: Understand friction points before the session
- Structured Co-Creation: All stakeholders together in real-time
- AI-Powered Facilitation: Tools that help capture and synthesise ideas
- Immediate Output: Complete strategy document by end of day
The Result: Strategies that are genuinely co-created, owned by everyone who participated, and ready for implementation.
Breaking the Pattern
Breaking the Frankenstein Document pattern requires changing how we approach strategy development:
From: Writing strategies in isolation, then consulting stakeholders To: Co-creating strategies with stakeholders from the start
From: Multiple rounds of review and revision To: Real-time collaboration and immediate output
From: Professional documents that look good but don't drive change To: Co-created strategies that everyone owns and implements
Conclusion
Frankenstein Documents are a symptom of the Overheating Spiral in NHS strategy development. They look professional but fail to drive change because they lack genuine ownership and connection to reality.
The solution is co-creation: bringing stakeholders together to create strategies in real-time, ensuring everyone owns the result and understands how to implement it.
If you're struggling with Frankenstein Documents in your organisation, Dynamic Genie can help you break the pattern and create strategies that actually drive change.
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