Research report
1 Dec 2016
Area of work:

There has been a longstanding policy agenda to improve services and reform clinical work by improving the working relationships between doctors and managers. Although areas of tension between the two groups have always been present, these relationships have been severely tested in the past three decades, which have seen multiple initiatives around quality and safety, successive reorganisations and major restructuring against a background of significant technological, clinical, social and demographic change.


This narrative literature review looks at empirical studies on perceptions of doctor–manager relationships at medical director and clinical director level in the UK published since a 2002 survey on this subject by the same authors. This literature review accompanies a research report on the findings from a 2015 survey of doctor–manager relationships at board and middle-management levels of NHS acute trusts, which seeks to understand their views on the current state of the relationship in the UK, the pressures it is coming under, how it has changed, and the outlook for the future.

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