IHM Calls For Action To Close Divide Between Managers And Clinicians

Tension between managers and clinicians in healthcare remains a significant area for concern and needs to be addressed in the interests of improving patient care, according to the Institute of Health Management (IHM).

A recent survey by the Institute revealed that nearly three-quarters of managers (74 per cent) think the relationship between the two groups of professionals could be defined as “a partnership with areas of tension” or “a relationship of tolerance with frequent tensions”.

Add to these figures the fact that a further 14 per cent believe the relationship has “persistent and unresolved tensions” and it becomes clear that it is time for action.

Weight is added to this conclusion by the revelation that few managers expect to see any improvement in the relationship. Again, nearly three-quarters (73%) thought the relationship would stay the same or get worse over the next five years.

In recent years, increasing importance has been placed on clinicians working in multidisciplinary teams across professional and organisational boundaries. Ways to address this divide need to be found, not least because evidence shows that medical engagement is linked with improved organisational outcomes (Hamilton et al., 2008).

An analysis of inquiries into major quality and patient safety failures in the acute sector also found common themes of poor communication and low levels of information sharing across professional groups (Hindle et al., 2005).


IHM believes that if clinicians and managers 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, a greater understanding of one another’s priorities will be reached.

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.”