How a CIO Can Navigate Conflicting Demands in Large-Scale Programmes

Have you ever been in a meeting where the clinical lead asks for one thing, operations asks for another, and finance and security seem to be speaking an entirely different language?

Yep, that’s pretty much the NHS enterprise reality. One CIO I spoke to recently summed it up like this: “It’s like playing chess where every piece believes it’s the king.” Confusing, high-pressure, and never quite linear.

What makes it trickier is that all stakeholders have valid perspectives, even if they don’t line up neatly. The CIO’s job isn’t to pick a favourite, it’s to bring clarity and alignment so programmes actually move forward.

Map the Voices

Start by putting all stakeholders and their priorities on paper. Listing them is one thing, but understanding motivations gives you real insight.

Here’s a quick mini-template you can try:

Stakeholder	Priority / Demand	Influence	Potential Conflict	Shared Outcome	Notes
Clinical Lead	Faster system access	High	Finance may push back on cost	Patient safety and care	Focus on operational efficiency
Operations	Efficiency & process compliance	Medium	Security may require extra steps	Smooth workflow	Identify quick wins
Finance	Budget adherence	High	Clinical delays may frustrate	Cost-effective delivery	Link spend to outcomes
Security	Compliance & risk reduction	Medium	Operations speed may be slowed	Secure, auditable systems	Focus on integration

Even just filling out a few rows will turn chaos into a clear landscape you can navigate. For real-world examples of this in action, see SPG Intelligence Scale case studies.

Focus on Shared Outcomes

Instead of chasing consensus or trying to please everyone, anchor decisions around shared outcomes.

For example, instead of saying:

“Let’s speed up this system,”

Try:
“If we improve turnaround time, clinical teams see fewer delays, operations gain efficiency, finance sees cost relief, and security stays compliant.”

Suddenly you’re speaking everyone’s language, not just theirs. For further insight on outcome-driven approaches, check SPG Intelligence Scale solution.

Communicate Humans-First

Dashboards and reports are useful, but nothing beats plain human communication. Keep it simple:

• Short, regular catch-ups

• Plain language summaries

• Highlight small wins to build trust and reduce friction

When people feel heard and progress is visible, they are far more likely to collaborate than compete. Resources like the NHS Leadership Forum can help support communication frameworks.

Plan for the Unexpected

Even with good alignment, NHS programmes are complex and dynamic. Priorities shift, new pressures arise, and surprises are inevitable.

Good CIOs:

• Maintain a live risk and dependency tracker

• Clarify ownership for key tasks

• Set up simple routines to handle surprises early

Planning for the unexpected reduces firefighting and keeps programmes moving forward with confidence. For guidance on risk management and governance, see NHS Digital Transformation guidance.

Takeaways for CIOs

Conflicting demands are part of the job, but they don’t have to be a nightmare. Focus on:

• Mapping voices and motivations

• Anchoring decisions around shared outcomes

• Communicating like a human, not a machine

• Planning for the unexpected

Using this approach, your programmes don’t just survive, they progress confidently. You spend less time managing conflict and more time turning plans into results.

Need some help? Take a look at our Scale Solution.