Abstract: The focus of this study was on managers' perceptions of the impact of Flexible Working Practices (FWP) in the healthcare setting and their role in its management. In the literature the benefits of FWP to the establishment and the individual were clear but the need to ensure that arrangements are applied equitably across the organisation has been expressed. It also demonstrated that new forms of FWP impact on staff availability to meet with today's increased demands for health service efficiency. This creates a difficult and challenging working environment for the physiotherapy manager. A qualitative research method was used in this study allowing a deeper exploration of managers' perceptions of FWP. Data collection was carried out using semi-structured schedule interviews with a sample of frontline managers employed within the HSE northwestern region. Analysis of quantitative data was undertaken using SPSS computer technology. Framework analysis was employed to interpret qualitative data and provide a meaningful format of evidence to answer the initial research questions. Following analysis, it was evident that managers' experience varied on customer service impact and they outlined some positive outcomes as a result of FWP. Findings on FWP benefits, impact, processes and management competencies for meeting implications in a health service context are also outlined.