Compassionate leadership – more important than ever in today’s NHS

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Part of Compassionate and inclusive leadership

Compassion has always been important in health and social care, but arguably never more so than now. Financial and operational pressures in the health and care system have resulted in performance targets becoming more difficult to achieve, constrained resources, and staff working longer and longer hours under increasing stress.

Consequently, alongside providing compassionate care for patients, it’s becoming more critical for staff to demonstrate real compassion towards each other in the workplace. This is borne out by NHS Improvement’s strategy, Developing people – improving care, which puts leadership and compassion top of its list of conditions needed to shape cultures that enable sustainable, high-quality care.

Our programme, Developing compassionate leadership through mindfulness, sets out to support health care leaders working in an increasingly pressured environment to develop compassion for themselves and others in a way that will really make a difference to health care outcomes.

One of the fundamental principles of the programme is that, in order to lead with compassion, a leader has to start with themselves. Self-compassion through mindfulness is used as a way to approach self-care, and studying emotional intelligence alongside this gives participants a better understanding of the neuroscience that sits behind it. By understanding the emotions of empathy, sympathy, compassion, happiness and stress, participants can consider the role and impact of compassion within and across teams, on their own leadership role, and across the complex systems they inhabit.

We know through talking to past participants that the programme has had an impact on how they manage the pressures they face in their day-to-day work. Participants talked about how they now felt better equipped to help themselves, their teams and their organisation; how they had changed their approach to challenging situations; how they interact with others and how they see themselves.

This feedback is supported by analysis of a research questionnaire and psychometric tests that participants completed before and after the programme.

Among the participants there was a significant decrease in perceived stress, and an increase in emotional wellbeing coupled with improvements in social and psychological wellbeing. A more mindful approach to working was also a notable highlight – with strong increases in participants’ ability to control their reactions and responses in the moment, and to act with awareness of emotions and situational factors. Perhaps most pleasing was the significant increase in the reported levels of self-compassion among the participants, because that is the core of being a compassionate leader – how can we demonstrate compassion to our colleagues and wider teams if we are unable to treat ourselves in the same way?

News reports about overflowing A&E departments, backlogs of ambulances outside hospital doors and a struggling health care system were brought sharply into focus by meeting and working with the amazing individuals whose daily work encompasses these pressures, and we hope that what they learnt on the programme will have a wider impact. The reality for the health and care sector today is that the pressures of maintaining high-quality care with increasingly constrained resources are not going away. So with bed occupancy in hospitals running at unsustainably high levels, and increasing pressure across the health system, there needs to be something that leaders can do to protect themselves and their teams. Evidence from high-performing health systems continues to show that compassionate, inclusive leadership behaviours and a focus on quality improvement rather than financial control creates cultures where the people are able to deliver sustainable, efficient and safe care.

In the words of a recent participant: ‘I am calmer and more grounded since attending the programme, and less likely to respond reflexively or emotively. I have reconnected with my self-compassion and the importance of my own wellbeing; this enables me as a leader to have the time to better connect with those around me in the way I talk, listen and behave.’


Mitzi Blennerhassett

medical writer/author/health activist,
Comment date
20 February 2017
Compassionate leadership would ensure patients are treated as people - they would be warned about possible and probable side effects not only during but after treatment. They would then not have to ask for help (to stop the agony) on Macmillan Cancer Support online groups. If there was compassionate leadership I would be able to access NHS treatment for NHS radiation-induced midline lymphoedema, especially since I had a successful course of MLD in 2005 - evidence of effectiveness, 3L fluid lost. Now I am left to manage myself - impossible - and deal with the depression brought on by being on the scrap heap - a CCG reject.

Sylvia Hall

Anglia Ruskin University
Comment date
21 February 2017
I would like to receive new letter.


Digital Communications Assistant,
The King's Fund
Comment date
22 February 2017
Hi Sylvia,

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Dr A J Gray

Consultant Psychiatrist,
2-g MH NHS Trust
Comment date
23 February 2017
We need both to improve health workers self care and self compassion, but at the same time to improve the services, decrease demand and increase available resources. Otherwise staff get blamed for not being compassionate and resilient enough when the problem is with the system.
More and more being demanded with less and less resource is a recipe for burnout no matter how self-compassionate the individual worker.

Greta alleyne

matron elderly care,
self employed
Comment date
13 March 2017
Useful resources good for teaching

Ethan Sykes

Comment date
21 March 2017
Leadership is a vital part of our success and professional life. So, we need to develop this attitude and skills to get quick success. Apart from that, leadership skills are very much essential in different sectors, therefore, people are looking for different types of leadership programs to develop their skills and attitude in that particular region. Thanks for highlighting such important topic.

Phil Dourado

Leadership Development,
Comment date
05 May 2017
Hmmm... This seems to be more about self care than leadership. Yes, we need to be able to look after ourselves to better look after others but I feel that helping practitioners feel less powerless in the face of the resource limitations and more able to deal with complex unpredictable situations where you are often making resource decisions between patients or pressured staff of equal 'deserving'-ness in the moment constantly and repeatedly without eroding our own sense of doing the best we can and without eroding our own morale and confidence that we can make a difference is what's needed in our development and ability to support and lead others by example. Then getting up and going back in next day or night to do it all over again. I feel to help us develop this capacity and stave off the feeling of burnout or helplessness and avoid the shutdown of perception that can occur we need examples of how to inspire ourselves and others in impossible (as in impossible to match our aspirations and ideals with the reality of the limitations of the resources) situations. Stockdale Paradox-type thinking, Gramsci's ideas about the triumph of the will over an apparently hopeless environment, compassion renewal theory etc. But mainly the idea of modelling and inspiring others in a tough leadership environment with real examples bolsters our inner strength the most and is critical to compassionate leadership development in my experience. And, as Dr Gray points out in another comment, the confidence to push back constantly against the system issues that stop us doing our jobs as we were trained to do them is needed, too - refusing to accept the unacceptable while working within it is part of the paradox of leadership. And mindfulness only goes so far in helping us develop that political with a small p and systems thinking ability to work within a system while working to change its inadequacies innovatively at a local level. Sorry, that turned into an impassioned rant :)

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