How NHS managers are perceived by nurses

The introduction of business principles into the NHS to increase efficiency and value for money has involved bringing in managers who are not necessarily experienced in healthcare, but can offer the right business skills.

To learn more about frontline nurses' perception of senior managers and any areas of potential conflict.

Interviews with 31 frontline NHS nurses in a Scottish hospital between July and September 2010 to explore their perceptions of the managers' role.

Many participants had a poor understanding of senior managers' role. They believed the non-clinical background of some managers meant they cannot understand the pressures at the front line.

One way to increase staff engagement could be for managers to spend time at the front line experiencing what it is like to give patient care. This could increase their credibility to frontline staff as leaders.

Tensions can arise between managers and nurses because of perceived differences in priorities. Understanding the relationship between senior managers and frontline nursing staff, and involving nurses in decision making, can lead to shared goals.