Communication can be disjointed with lots of team leaders involved in each practice. Training is not set up for people new to clinical systems. Roles are advertised for experienced persons and so training will be inadequate if you are new to Systmone/EMIS so I think many reviews are rather unfair that mention this! With team members working abroad, longer break times are not always organised to UK frameworks and sometimes it is difficult to be able to take a full breaks and to feel like you can be away from calls for 20mins at a time. Getting set up on systems with log ins etc takes a long time and so starting new sites can mean last minute changes and different work arounds happening with different staff, which can make it difficult to know expectation during inter team communications. All of this can add to existing pressure naturally occurring in this line of work.