Talking leadership: Fiona Greenfield on developing compassionate leadership through mindfulness

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Since its launch in 2014, The King’s Fund’s Developing compassionate leadership through mindfulness programme has attracted a mix of clinical and non-clinical managers across health and social care. The programme was launched following publication of The King’s Fund and Center for Creative Leadership’s Developing collective leadership for health care report, which showed how organisations can develop cultures that enable staff to take collective responsibility for delivering high-quality compassionate care. We spoke to Fiona Greenfield, an experienced nurse who recently took part in the programme.

What sort of situations do you face at work where you need to respond and lead compassionately?

I have worked in the NHS for more than 30 years in various senior nursing positions from ward sister in coronary care to advanced nurse practitioner in the emergency department. My current role involves me in investigating possible cancers and treating patients with respiratory problems. In one day, I can yoyo between writing a business case for a new role and sitting in front of a patient to tell them they have mesothelioma. Talking to patients in such situations requires very mindful use of words to convey the right balance of information and hope. While I may have other pressing business agendas, I need to put these temporarily aside so that my whole focus is on the patient.

What are your thoughts on compassion as a manager?

I have always known that looking after the team is the most important thing to do in order to deliver really outstanding services. I believe that managing a team requires honest, meaningful conversations – taking account of people’s different agendas as well as their personalities and abilities. My experience has shown me that the best teams are those that are most diverse and that like working with each other. Creating strong teams sometimes requires skilled facilitation – it doesn’t always just happen naturally. Encouraging an understanding of each other’s perspectives can help and to achieve this we really have to listen to each other and have equal participation. This requires a clear understanding of the team’s emotional intelligence.

Why did you decide to come on the programme?

I applied out of a curiosity about how compassion and leadership could combine in my day-to-day work. Compassion is there every day in my heart and head as I deliver patient care but I had not previously considered how it related to me as a leader.

Which aspects of the programme did you find most useful?

I was a bit shocked to be starting with me as the focus of improvement; this felt almost selfish, but it was absolutely what I needed. Recently I have been challenged by a career decision and I have been struck by my inability to choose. The course has reconnected me with self-compassion and the importance of looking after my own wellbeing. This has created the space I needed to consider important career changes.

The programme also encouraged us to learn in small peer groups. The people in my group have been a constant source of encouragement and inspiration, and their diversity of experience and backgrounds has been a rich resource. The programme was adapted to our needs as we progressed, which made it more personal.

Since the programme, have you noticed a change in how you respond to challenging situations?

A close friend and colleague told me that she had noticed that I seemed calmer and more grounded since attending the programme and less likely to respond reflexively or emotively. I do feel different. I feel that I can see issues more clearly. I now have more time because I understand how to work more effectively and this encourages prioritising. I use my ‘extra’ time to connect with those around me. These are small changes but they are so important when we are all so busy. I know that what I’ve learned has changed how I talk, and how I act, for the better.

What would you say to others thinking of coming on to the programme?

If you are open to change, new ways of thinking and working, and hope to become more effective as a leader then sign up. Health care delivery can be emotionally and intellectually demanding and I believe that being the best you can be at work is essential for delivering the best care.


Simon McGee

Owner and Director,
Home Instead Senior Care, Chichester
Comment date
25 January 2017
I completely agree that compassionate leadership is essential to creating a culture that is caring and effective.
However, it is almost impossible to retrofit culture to an organisation or institution, and has to be the hardest aspect of any organisation to change. That is why it is so hard to replicate. It needs to be built bottom up based on core values, principles and attitudes AND the right operational environment. If there are structural flaws in any of these then the whole house falls down.
This transcends industries and correlates directly with measures of job satisfaction and employee retention.

Pearl Baker

Independent Mental Health Advocate & Advisor/Carer/DWP Appointee/Deputy to COP,
Comment date
25 January 2017
As a Carer i have received NO HELP SUPPORT from any GP or Local Authority, despite the Care Act. The DWP have removed most of my son's Welfare Benefits, they returned to live in the family home, due to Mental Illness. I am the DWP Appointee for my son, and he is in receipt of ESA, and no longer required to complete the 'horrendous' 45 page questionnaire. The 30 minute interview resulted in ATOS stating that he can do everything himself? It is NOT about what you can do it is about the Support you require to live in the Community (albeit) with the Family.

I am annoyed that i have to remind those PAID to implement the Care Act, including Carers Rights fail to take on board that without us many more would be on the STREETS' Homeless,which is increasing.

Mental Illness has nothing to do with intelligence!

Fiona Greenfield

Comment date
05 February 2017
Hi Simon,
Firstly thank you for taking the time to comment. Like you I am absolutely convinced that compassionate leadership is essential and especially for caring professions. I would agree that changing the culture of an organisation is no easy job- yet cultures do change.
Personally I believe in bottom up and top down measures- if these align they have potential for real change. We each have a sphere of influence that we can work within and we can each only try our very best to make this happen.

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