27/02/2025
"Peace is not the absence of conflict, but the ability to handle conflict by peaceful means." – Ronald Reagan.
When we think of conflict in the NHS, many of us picture difficult team meetings, staff tensions, or passive-aggressive emails. But what if conflict wasn’t something to avoid, but rather a crucial ingredient for team success?
In Patrick Lencioni’s Five Dysfunctions of a Team, the second behaviour essential for a high-performing team is healthy conflict. Without it, teams become stagnant, avoid difficult conversations, and ultimately fail to reach their full potential.
Many healthcare teams struggle with conflict because they see it as negative. This leads to two common dysfunctions:
1️⃣ Artificial Harmony.
Team members avoid difficult discussions to “keep the peace,” leading to unresolved issues, disengagement, and poor patient outcomes.
2️⃣ Destructive Conflict. When issues do arise, they may escalate into personal disputes, affecting morale, team trust, and efficiency.
Both scenarios prevent teams from making the best clinical and operational decisions, leading to delays, frustration, and reduced quality of care.
Lencioni argues that the best teams don’t avoid conflict—they lean into it in a way that is open, respectful, and constructive. In the NHS, where patient safety, efficiency, and teamwork are paramount, healthy conflict can drive better decision-making, innovation, and staff wellbeing.
How NHS Leaders Can Foster a Culture of Healthy Conflict
✅ Build Trust First – Teams that trust each other can challenge ideas without fear of blame or judgment. Psychological safety is key.
✅ Normalise Debate – Frame conflict as a necessary and positive process for improving patient care and workplace efficiency.
✅ Challenge Ideas, Not People – Discussions should focus on clinical reasoning, strategies, and service improvements—not personal attacks.
✅ Facilitate Open Dialogue – Encourage all voices to be heard, ensuring that junior staff and quieter team members feel safe contributing.
✅ Resolve, Don’t Bury – Addressing tensions openly and constructively prevents issues from resurfacing later in a more damaging way.
Great NHS leaders don’t just manage conflict—they create environments where it drives improvement. When teams learn to engage in productive disagreements, they:
🔹 Make better clinical and operational decisions because diverse perspectives are considered.
🔹 Improve efficiency by tackling issues early rather than letting them fester.
🔹 Enhance staff morale and retention by fostering a culture of respect and open dialogue.
In healthcare, where high-pressure environments and multidisciplinary collaboration are the norm, the ability to embrace healthy conflict is essential for both team effectiveness and patient care. When we can turn disagreement into innovation, we build stronger, more resilient NHS teams.