- The interaction with the US side is not always easy: especially regulatory / QA, project management and business development have requests that, even if reasonable, are not always communicated clearly and timely. It's a joint responsibility from both UK and US site, not blaming any part, but something to improve.
- Senior management people sometimes change their mind too often (I guess it's quite common in companies, but it's none the less disruptive), product specifications are not always communicated very clearly and they keep changing in some cases, following external comments (advisory boards, conferences, clinicians, market research) rather than a pre-defined solid path.