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PurposeThe purpose of this paper is to examine how the more tacit dimension of knowledge is shared in projects in a construction contracting organisation and whether explicit organisational knowledge management initiatives can help resolve and better manage project‐based challenges.Design/methodology/approachThe paper is based on a single in‐depth case study and uses a combination of qualitative and quantitative research methods.FindingsThe findings demonstrate how the more tacit dimension of knowledge is fundamentally important to resolving project‐based challenges, such as adjusting the detail of or re‐sequencing tasks, that major contractors frequently face. Even though a number of organisational initiatives were in place, knowledge was most successfully mobilised due to project managers, who competently orchestrate a number of inter‐ and intra‐organisational relationships amongst a host of stakeholders who are relevant to the delivery of projects.Research limitations/implicationsThe research is limited to a single organisation. It is exploratory resulting in interpretive reflection upon the largely qualitative data, alongside simple statistical descriptions.Practical implicationsThe practical implications are that construction contractors and other similar players should better understand and consider the significance of agents who are central to the effective use and flow of knowledge.Originality/valueThe paper confirms the limited usefulness of knowledge management initiatives, and points to the pivotal role of the project manager as latent knowledge managers. The originality is the lack of awareness amongst senior management as to the critical role project managers undertake in marshalling tacit knowledge. This is reinforced by the project managers who themselves are only partly aware of the impact of their knowledge management role. Their emergent, almost instinctive, management of knowledge supports project performance and questions whether further management intervention would be useful for the practitioner and the delivery of client value.

Traditionally, there have been tensions between frontline healthcare professionals and managers, with well-known stereotypes of difficult consultants and pen-pushing managers. Many junior doctors have limited management experience and have often never even met a manager prior to taking on a consultant role.Based on a successful programme pioneered by Dr Robert Klaber (Imperial, London) we have set-up an innovative scheme for Birmingham Children's Hospital, pairing junior doctors and managers to learn and work together. Our aim was to cultivate positive attitudes and understanding between the two groups, break down inter-professional barriers, and to provide practical leadership experience and education.We recruited 60 managers and doctors to participate in shadowing, conversation, and quality improvement projects. Thought-provoking online materials, blogs, socials, and popular monthly workshops consisting of patient-focused debate and discussion around key leadership themes, have helped to support learning and cement shared values.Formal evaluation has demonstrated an improvement in how participants perceive their knowledge and ability based on key NHS Leadership Framework competencies. Participant feedback has been extremely positive, and everyone plans to continue to incorporate Paired Learning into their continuing professional development.We are now embedding Paired Learning in the on-going educational programme offered at Birmingham Children's Hospital, whilst looking at extending the scheme to include different professional groups and other trusts across the region and nationally. ProblemHistorically in the NHS, clinical professionals and managers have struggled to find ways to work effectively together, with some doctors not even meeting a manager prior to being a consultant.The NHS Leadership Framework is applicable to all healthcare professionals, and outlines how we can each incorporate leadership development throughout our careers. Hospital trusts and deaneries need to find ways to provide management and leadership training opportunities for junior doctors, nurses, allied healthcare professionals, and managers in locally based programmes.

The optimal strategy to manage hypoxaemic respiratory failure associated with COVID-19 remains uncertain. Potentially overwhelming demand on critical care resources requires strategies to reduce progression to invasive ventilation. Awake prone positioning has been proposed, 1 with evidence that it is associated with improved oxygenation in selected patients. 2-5 The aim of this study is to report our experience using APP and its impact on respiratory physiology in COVID-19.