Clinicians regard NHS managers as committed and trying hard but 'poorly trained and not always of a high intellectual calibre', the Audit Commission has found.

Its report, Engaging Clinicians in Financial Management, says these negative stereotypes need to be overcome if clinicians and managers are to work together to cope with slower funding growth. It puts the onus on managers to do that.

Andy McKeon, managing director of health at the commission, said: 'It's quite difficult to get beyond "it's all about relationships and communications" when it comes to this issue but we have tried to get beyond bland statements by developing an assessment framework for judging where an organisation is.'

The commission's 23-point checklist for senior staff asks them to consider questions such as the proportion of consultants managers are on first name terms with, and why they have not introduced patient-level costing systems.