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The primary objective of this article is to explore what senior managers think they should be doing to improve communication in their organization, what they actually do in communication terms, and the high work load which senior managers undertake.

This understanding is advanced by using the results of a communication audit which was conducted in a major European health‐care organization (HCO) undergoing significant internal re‐organization. A communication audit can be defined as: “a comprehensive and thorough study of communication philosophy, concepts, structure, flow and practice within an organisation”. It assists managers by “providing an objective picture of what is happening compared with what senior executives think (or have been told) is happening”.

First, senior managers who over‐work are even less likely to have the time for reflection, followed by behaviour change. Second, the absence of adequate upward communication may blind managers to the full nature of their problems, which in turn guides the search for solutions.

Clearly there is a need to examine other types of organizations to establish the universality of the communication issues and problems that were found in a large HCO in Europe, using both quantitative and qualitative methodologies.

The data suggest that attempting to cover up communication weaknesses by managers working even longer hours only has the effect of further disempowering people, and so accentuating rather than alleviating the underlying difficulty.

The article has value to fellow academics and managers in practice and contributes to the debate on upward communication and the workload of managers.

Argues in favour of utilizing qualitative methods to assess the effectiveness of internal communications in the National Health Service (NHS), as a supplement to the more standard quantitative measures normally employed. Presents a case study from an NHS Trust, demonstrating the type of data which is generated. Compares these data to findings derived by quantitative methods. Argues that the qualitative findings both confirm and supplement those derived by quantitative methods, and that both can identify the types of major problems prevalent within the NHS at present. Suggests that the further study of these issues should become an important part of efforts to create national standards for communication effectiveness in the future.

Education managers from various education settings were asked to record the three most typical work‐related incidents of communication within a specified time‐frame. They were also asked to identify the strengths and weaknesses of communication practices at work. The resultant data provide insight into the existing communication climate within education organisations, and the problems which need to be overcome. Specifically, the main findings were of persistent communication problems between managers and staff, the organisation of meetings, the transmission of information and the use of appropriate communication channels. The data suggest that there is a need for improved communication to facilitate the more effective management of education organisations, and to improve relationships between education managers and their staff. Greater communication skills training for managers is therefore recommended. This paper also considers areas where further research is indicated.

Reports on investigation to ascertain from education managers their perceptions of the range of situations and difficulties they found most important in their work. Education managers were surveyed, using an expert systems approach, to identify those situations they face which generate most communication problems, the types of people involved in these interactions and the skills which would be of the most benefit in the effective management of communication relationships. Considers the implications for organizational research and management training.

Highlights the importance of communication as a management activity. In particular, examines ways in which internal and external communication strategies can be integrated. To this end, proposes a communication strategy sequence which provides a robust methodology for gathering data and informing decision making regarding communication needs. Details the four key steps in the sequence and provides examples from work done in Northern Ireland. Discusses the principles and practices of data collection and emphasizes the importance of securing the commitment of senior managers. Examines the costs and benefits of introducing comprehensive communication programmes and points out organizational advantages.

Communication is becoming increasingly identified as a significant factor influencing the ability of the NHS to achieve high‐quality outcomes. Typically, organizations have tended to conceptualize communication as a process dealing with external relationships. Emphasizes the importance of both internal and external communications, and argues that the NHS now needs to integrate both these dimensions of the communication function. Proposes a strategic framework which suggests how this can be accomplished. Proposes and discusses a communications‐centred model of the management process in the light of this approach. This model integrates perspectives which have hitherto dichotomized management as either a science or an art. It also locates communication at the heart of effective management. Finally, suggests the NHS is uniquely well placed to provide data on the impact and costs of total communication programmes.