Survey addresses increasing tension between management and clinical staff

A RECENT survey confirms that tension remains a major factor in relationships between healthcare managers and clinical staff.

The Institute of Health Management (IHM) which conducted the survey among healthcare managers found that 74 per cent think their relationship with clinical staff could be defined as "a partnership with areas of tension" or "a relationship of tolerance with frequent tensions".

A further 14 per cent believe the relationship has "persistent and unresolved tensions" and few managers expect to see any improvement in the relationship, with 73 per cent believing the relationship would stay the same or get worse over the next five years.

IHM points out that increasing importance is placed on clinicians working in multidisciplinary teams across professional and organisational boundaries. Analysis of inquiries into major quality and patient safety failures in the acute sector has found common themes of poor communication and low levels of information sharing across professional groups.

It believes that clinicians and managers should explore each other’s roles and responsibilities through paired learning and shadowing initiatives (such as those piloted at Imperial College Healthcare NHS Trust during 2010-11) in order to reach a greater understanding of respective priorities. IHM also promotes joint management training programmes and events to support these initiatives, and encourages the creation of working environments that build trust and interdependence between clinicians and managers.

Commenting on the Institute’s call to action, Shirley Cramer, CEO of IHM and the RSPH, said: "Tension between clinicians and managers is a long-standing issue, fed in part by the difficulties each professional group can experience in understanding one another’s priorities. The end goal is the same - improving patient care - but the ways to achieve this are approached from different angles.

"The endless cycle of reform in the NHS has not been helpful and it is good to see that the main political parties appear to have accepted that further structural change would be undesirable. Reform, whether or not welcome, can add to existing strains within all working relationships and it is time to take a closer look at how these can be addressed. An improved relationship between clinician and managers has to be in the best interests of patients."