Clinicians and managers must build better working relationships, but to do this their priorities must first be reconciled, write Pauline Owen and Colin Gautrey

Anyone who is serious about responding to the call for improved relationships between managers and clinicians must understand a key factor in relationships - the way you influence and in turn are influenced by other people.

This insight can provide practical ideas on how to build stronger and more productive relationships that offer the prospect of building a world class NHS capable of delivering and improving services despite the current economical turmoil.

The desire to influence other people is a part of being human. The way you influence - your style - has been established over the years by your experiences, learning and professional protocols supporting your role.

Subconsciously you will have found out what works for you. Psychology suggests that when it comes to being influenced, you will be more amenable when the other person is using the style you prefer.

So if you want to be more influential, you need to learn how to flex your style to match that of others you work with. This requires you to take a good hard look at how you operate and what you are seeking to achieve. There are many aspects to consider, one key element of which is establishing your preferred style and then learning how to become more flexible.

Experience of working with and in different groups within the NHS will have reinforced your professional values and norms. Recent changes and tensions in the NHS have reduced the opportunities for managers and clinicians to learn from each other. But it hasn’t always been like this.

When primary care groups were developed, we saw a great deal of enthusiasm across the traditional professional groups, bringing clinical standards and judgements closer to the heart of NHS management. We must reflect that era. With this knowledge, skill and flexibility we are all in a better place to reach common agreement on the challenges that face the NHS.

Dimensions of influence

Colin Gautrey and his colleagues have developed four dimensions of influencing style that must be considered when assessing the way you interact with others. By working out exactly where you are on these dimensions, you can start to think differently about how you interact with others as you seek to persuade and influence them.

The key dimensions are:

  • Tact and diplomacy The extent to which an individual is responsive to others and able to modify their behaviour.
  • Determination and dominance The extent to which an individual is prepared to assert their own views and to drive their agenda forward.
  • Gravitas and emotional management The extent to which an individual can remain calm under pressure and intelligently use emotive communication to influence.
  • Sociability and networking The extent to which an individual builds up a good network of useful relationships and is socially confident, active and visible within their field.

The most effective influencers, with the highest perceived integrity, have managed to develop a healthy balance between these four dimensions. The behaviour that sits behind each of these appears to be natural, and they are able to flex their style to suit the situation and the people they deal with.

To rise to the challenge you need to realise how your styles differ and then find flexible ways you can adapt your behaviour to match the preferences of your colleagues. If you want to become more influential and build stronger working relationships try the following:

For each dimension, estimate where you may score - low, medium or high. To moderate your highs and lows, who do you know is a good role model for each dimension? What do they do that you could emulate?

For key colleagues, can you estimate where they may be on each dimension? What can you do to flex your behaviour to move closer to their preferred style? If you were more influential in your relationships, what could you achieve on behalf of local NHS services?

There are many factors that may make it difficult for change to occur, but we also know that awareness is a key part of the solution. So at least we can encourage managers and clinicians to review their professional development plans, reconsider it in the light of these dimensions and learn to become more influential.