Compassionate leadership in health and social care

If you were to ask any member of the public what they want from health and social care, it’s likely that compassion from the staff who provide care would be high on their wish list. But in order to establish compassionate cultures that manifest on the front line, we need to begin with compassionate leadership.

Compassion has many definitions, but this one from eminent Tibetan scholar Thupten Jinpa is simple and easy to understand: ‘Compassion is a mental state endowed with a sense of concern for the suffering of others and aspiration to see that suffering relieved’. So it moves us on from empathy and sympathy by having three components: the cognitive ‘I understand you’, the affective ‘I feel for you’ and most importantly the motivational ‘I want to help you’. It is this third component that creates ambition for greater good, and the humility to act from a sense of other rather than for oneself.

Work by Michael West and colleagues has shown irrefutable evidence that caring, compassionate leadership is the key determinant of positive and compassionate cultures of care. But in today’s NHS, leaders are overwhelmed with demands, chaotic diaries, and relentless meetings allegedly necessary to increase productivity. So-called ‘smart technology’ inundates them with constant alerts, occupying their attention from the moment they wake. The risk is that this relentless flood of over-stimulation results in scattered attention, lack of focus and an inability to be present in the moment – ultimately leading to reactionary decisions and a desire for their teams to do more, better and faster. In turn, this can leave staff feeling unvalued, unheard and increasingly disengaged. It’s no wonder that we see reports of staff feeling ‘broken’ across the health and social care sector, and of CEOs with an average lifespan of less than two years.

That’s why it’s so important that compassion starts with oneself. Compassionate leaders look after themselves and model this self-care to others. They realise it is ok to be human, to make mistakes and learn from them – and they give themselves and others permission to do this. In a high-pressure environment with constantly competing priorities compassion can sometimes be forgotten, but these leaders have to have the courage to work against the norms and challenge the wider culture that pervades a publically scrutinised and regulated system. And organisations that not only enable their leaders to adopt this behaviour, but that actively encourage them to do so, are those that will reap the benefits in the long-term.

In working towards this leadership style and culture, many leaders are increasingly looking for ways of being consciously present or mindful, and are trying to avoid the pitfalls of over-analysing what has been or what might yet happen, over and above what can be usefully learned and applied to the present. While many leadership programmes still focus on cognitive processes and linear concrete approaches with an emphasis on tools to help deliver strategy, our new compassionate leadership programme invites leaders to engage with mindful meditation and be conscious of their experiences, thought processes and emotions so they are able to respond to individuals and situations in a non-judgemental way. This is absolutely critical when working in the complex health and social care system, especially with the current backdrop of conflict and uncertainty. Compassion and kindness are not the same as likeability; rather they imply an interpersonal closeness that comes with responsibility, vulnerability and an absence of self-interest. Our work on leadership and culture shows more than adequate evidence that leaders at every level who practice compassion, and where kindness is valued at work, then create a culture that people want to be part of and an environment that fosters innovation and productivity.

Taking time to connect with staff and patients as fellow human beings is all too often squeezed out, and as Dr Kate Granger reminded us – kindness and compassion are priceless and free to dispense. A humbling reminder of what all leaders can create.

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#548146 David Oliver
visiting fellow
Kings fund

Thanks for this Sarah
Much good sense and so so relevant to current travails in the NHS not least around workforce recruitment and retention, demand pressures and junior doctors stand off. By coincidence, in my weekly BMJ "Acute Perspective" Column I just wrote this on why being a doctor can be like Groundhog Day and how we might mitigate

David Oliver

#548174 Sarah Massie
Senior consultant
The King's Fund

Thanks David, I had the junior doctors in mind as one example as I wrote this

#549442 Ian Randall

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