Inter Team Conflict

Inter Team Conflict in many respects is much simpler to deal with, although its existence can be catastrophic to performance, motivation, capacity and results. It arises essentially under two guises:

Internal Competition

Source 1 is inevitable in a cash-strapped environment where everyone has less resource than they would ideally like and in most cases less than they consider to be a bare minimum to provide an effective service. Under these conditions, someone will be seen as a resource winner and someone else a loser, with obvious perceptions of envy, right-wrong, unfairness etc developing between teams (often by team we mean department in this scenario).

Healthcare structure has developed in a somewhat piecemeal, silo manner with each specialty essentially becoming self contained in terms of its management structure and methods. Consequently, we find there is comparatively little central collaboration on what is the best overall plan for a provider and instead unhelpful and costly competition between departments. This is hugely dangerous in the modern environment where Trusts need to make objective and collective decisions about investment and resources, consequently activity managing expectations and interests so that it does not turn into competition.

Incompatible Practices

It is best illustrated with some examples. We will use the cancer surgery – pathology relationship as an illustration of what can happen over time.

Cancer surgery relies on pathology for identification & prioritisation of patients requiring surgery. Equally, pathology relies on cancer surgery as it is a patient passing through this department that gives rise to pathology funding through the payment-by-results mechanism. Both departments are under huge pressure – the former to achieve stringent treatment time targets and the latter to achieve absolute perfection in results with a myriad of competing departments wanting those results in short order. The relationship deteriorates as a result of the pressure combined with marked psychological differences between the typical person found in each specialty.

The surgeons, in their naturally assertive manner, demand results faster and faster to keep up with demand and targets. However, the more they push pathology, the more uncomfortable pathologists feel, worried about the possibility of mistakes arising out of ‘rushing’ something that needs care and attention to detail. These mismatched needs can easily escalate, either overtly or passively, resulting in:

The ultimate cost is in the results. This is a critical relationship that contributes directly to a Trust’s target attainment and financial stability through the PbR system.

Simple Steps

Inter team conflict is difficult to resolve over time although there are steps that can be taken to commence a process of improved collaboration and team-team effectiveness. These steps include:

Resolution and Long Term Prevention

The Medicology team will be able to advise you on the best overall approach. In the first instance, contact Andrew Vincent, Managing Director and Head of Team Performance Centre of Excellence on 07775 646947 or