Middle managers feel anxious at work and are unclear what their employers expect of them, a joint HSJ/NHS Confederation survey has revealed.

In a poll of 557 middle managers, a third said they were not clear what was expected of them and a quarter said they were ‘usually’ stressed or anxious at work.

Just one respondent never felt stressed or anxious at work, compared with 58 per cent who felt that way ‘sometimes’ and 6 per cent who ‘always’ did so.

A long-hours culture appears to prevail, with 60 per cent claiming to often work more than their contracted hours and nearly a third saying they do so ‘sometimes’. Only 1.5 per cent said this never happened.

Jon Restell, chief executive of the Managers in Partnership union, said: ‘One of the killer facts in the HSJ/Confed survey is the big number of extra hours worked by middle managers, often for no extra pay. MiP will be telling the NHS pay review body about this when we give evidence early next year.

‘External factors such as government targets and reorganisation are part of the story here. But it would be worth investigating the role of workplace culture.’

Almost half of those who often worked longer hours did up to five hours extra a week, while 38 per cent worked five to 10 extra hours and 13 per cent added more than 10 hours to their contracted time.

Those in mental health trusts work the longest hours, according to the survey, with 68 per cent saying they often worked more than their contracted hours, compared with 53 per cent of GPs.

Primary care trust middle managers were significantly more likely to say that they were unclear what their organisation expected of them (43 per cent) compared with those in acute trusts (29 per cent), and mental health and GPs (both 25 per cent).

Uncertainty following restructures was common, although one complained of ‘overlapping roles within management and commissioning teams’.

Many said expectations of them mainly revolved around making financial cuts, summarised by one manager as ‘savings, savings, savings, then service’.

Despite all this, most replied positively to the question ‘do you enjoy your job?’ - only 10 per cent said no. GPs were the most likely to strongly agree with the question (31 per cent), followed by managers in acute trusts (17.1 per cent), mental health (16.9 per cent), then PCTs (10 per cent).

For more analysis of the survey, click here