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Recognising, understanding and managing high conflict behaviours in healthcare
  1. James Kelly,
  2. Yasir Al-Rawi
  1. Elderly Care Department, Royal Hampshire County Hospital, Winchester, UK
  1. Correspondence to James Anthony Kelly, Consultant in Elderly Care and Stroke, Royal Hampshire County Hospital, Winchester, UK; James.kelly{at}

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Conflict in healthcare is commonplace, may be increasing, and is hardly surprising given the combination of a high stress environment and multiple stakeholder involvement.1

The national health service (NHS) identifies three major forms of conflict: task conflict relates to differences in opinions and viewpoints. Typically associated with change and short-lived, it may be functional, involving a healthy challenge of the status quo and driving improvement. Process conflict involves disagreement over the logistics of achieving an outcome or change, which can also be functional. Finally, relationship conflict, where there is a perceived interpersonal incompatibility, either between staff or between staff and a patient or relative.2 Such conflict is dysfunctional, often relates more to personalities than problems and accounts for the majority of negative and destructive conflict. When severe, multiple adverse outcomes may occur, including decreased job satisfaction and productivity, absenteeism and medical errors1 2 and occasionally it may be extreme enough to garner media attention.3 Where unusually difficult or protracted, especially where there is consensus that the conflict is unjustified or disproportionate, a high …

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  • Contributors JAK conceived this article which was then researched and written in collaboration between JAK & YA-R who contributed equally.

  • Funding There was no funding source and the authors have no competing interests.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.