What Are the 5 Causes of Conflict in the Healthcare Setting?

Poor communication, power differentials, heavy workloads, stress and fatigue, and organisational pressure are the five most consistently cited causes of conflict in healthcare settings, drawing on NHS workforce training material (Health Education England, citing Obholzer & Roberts' research on stress in the human services).

Poor communication - Misunderstandings between colleagues, or between staff and patients, are one of the most common roots of tension: unclear instructions, information not passed on, or a message landing very differently than intended.

Power differentials - Hierarchy within healthcare teams, and the power imbalance patients often feel in a clinical setting, both create friction. A patient who feels unheard or powerless is more likely to escalate; the same dynamic plays out between junior and senior staff.

Heavy workloads - Understaffing and time pressure leave less room for the kind of communication that prevents conflict in the first place, and shorten everyone's patience.

Stress and fatigue - Affects staff and patients simultaneously - a stressed clinician and a frightened, exhausted patient are both more likely to react badly to a minor friction point.

Organisational pressure - System-level issues - waiting times, resource constraints, competing demands on staff time - create the conditions conflict thrives in, even when no individual has done anything wrong.

Worth noting: this list originates from NHS staff-relations training, so it's framed around colleague-to-colleague conflict as much as patient-facing conflict. In practice, the same five pressures drive both - which is exactly why de-escalation training for NHS staff needs to address the systemic conditions, not just the moment a situation turns confrontational.

Our Conflict Management & Personal Safety training is built around exactly this reality - recognising these pressures before they tip into conflict, whatever direction it comes from.