Understanding Conflict in the NHS

Conflict occurs in many forms and indeed many guises (or disguises). However, whatever form it takes it is not only disruptive but often downright destructive to performance, morale, stability and organisational effectiveness.

The precursors to conflict

Conflict tends to occur when there is either an actual or a perceived difference of needs, values, goals and interests. In truth, much conflict is a complex amalgam of each of these factors and it may manifest itself in a wide variety of ways.

Where conflict occurs

In a large, complex, multidisciplinary organisation such as the NHS, conflict may occur at a number of levels or in a number of situations including:

Corporate conflict

Corporate conflict tends to exist whenever individual or group interests appear to diverge within an organisation or where the organisational direction seems to be at odds with the values or goals that the workforce believes are closest to their true purpose. Within the NHS, intra-organisational conflict between managers and clinicians is well described and often much higher than is healthy, each party appearing to have an agenda which is incompatible with the others whilst both feel that theirs is the more righteous. In the past, organisations might have continued to survive in spite of this internal conflict, survival and growth in the new world will become increasingly difficult in those organisations where a clinical-managerial divide remains.

Personal conflict

When person-to-person conflict erupts it is easy to spot, highly destructive and attracts attention from many within the organisation. However, it is also vital to recognise the more pervasive, passive forms of conflict too, in which no active, obvious fighting occurs but in which there is an absence of positive collaboration e.g. passive resistance, disengagement and even ignoring behaviour. This doesn’t just occur at the person-to-person level and all too many Trusts find themselves in passive conflict with their clinical workforce. This is dangerous territory indeed in an increasingly competitive, results-driven environment where constructive, collaborative teamwork is a prerequisite.

Many drivers in the modern NHS

With increasing competition, massive reform, a drive to deliver services differently, new ways of commissioning, the impending NHS recession and a potential catastrophe in terms of NHS sustainability, conflict is becoming commonplace between individuals, departments, organisations, hierarchies and more. It is vital that conflict is dealt with appropriately and proactively in constructive ways, replacing conflict and competition with collaboration. Services that fail to ensure positive, proactive, collaborative engagement risk expending valuable time and resources wrestling internally, whilst the external vultures patiently circle.

This site is here to help you both prevent and resolve conflict within all types of organisations that make up our NHS. We hope it serves you well.