The filling in the sandwich: HRM and middle managers in the health sector

The central role of line managers in implementing human resource management, is widely acknowledged. There has, however, been scant research into how far that group affect, or are affected by, such practices. Through a case study in two Trust hospitals, this article demonstrates that middle line managers, positioned between the service’s decision‐making bodies and its employees, are bearing many of the consequences of the change process. The effects of growing workloads, combined with altered expectations of their increasingly visible roles, have enhanced the tensions and role conflict inherent to their position. This creates “role dissonance” for managers who must balance the various aspects of their work from a weak power base, and act as a buffer between their staff and their seniors. Their perception is that they are under‐resourced and lack the time needed to manage their staff effectively.