I experienced more managers than people actually doing any of the work.
Cash strapped. They're struggling for money. Have resorted to contractors because the permanent staff left due to ill treatment of colleagues and worrying about job security.
Say they do Agile, but they don't. Typical story. They want to do Agile because it's the in thing, but the management don't want to actually embrace it. They don't want to pay for training, or for a qualified scrum master. They don't see the benefits of actually sticking to the framework, because they don't follow it.
Always late and chasing their tail when it comes to their clients work.
If the clients actually knew how poorly run the place was, they'd probably run and take their NHS money with them.
I witnessed a squabble amongst staff where the managing director couldn't control them, get a word in edgeways and he had no authority at all. He had to wait for them to finish squabbling with each other before continuing his speech.
The guy running the company had no respect or authority over the staff.