Compassionate leadership for a sustainable workforce – your questions answered

Dr Rachna Chowla, King’s Health Partners Joint Director of Clinical Strategy, and Christin Marshall-Hall, Project Manager in King’s Health Partners Clinical Academic Group development team, caught up with Prof Michael West [pictured below], Senior Visiting Fellow, the King’s Fund and Professor of Organisational Psychology at Lancaster University, on the role of compassionate leadership in forging the way for a sustainable workforce.

On 9 September, Michael spoke at our Clinical Academic Innovation workshop on workforce innovation and sustainability. You can watch his full presentation on our Learning Hub.

Following the workshop, Rachna and Christin had the pleasure of catching up with him again to answer some of your questions on the theme of compassion.

Rachna: why is compassion in healthcare important?  

Michael: The NHS was founded in 1948 as an expression of a core national value of compassion, and compassion is also fundamental to the work orientation of those who deliver health care. Virtually all NHS staff have dedicated a major part of their lives to caring for others in their communities, with compassion being their core work value. When they work in organisations that mirror that core value, their motivation, wellbeing and creativity are sustained and nurtured. Care that is compassionate rather than uncaring or disempowering, has a positive effect on patient satisfaction and health outcomes - “Compassionate care is what patients want and need” (National Advisory Group on the Safety of Patients in England 2013).

A recent review on compassion in healthcare and scientific evidence on the ways it makes a difference to patients, illustrates its enormous value to a healthcare system. These include:

• patients randomly assigned to compassionate palliative care survived 30% longer
• compassion leads to better control of disease progression
• compassionate interventions are associated with shorter stays in hospitals and lower costs
• compassion leads to improved levels of depression, anxiety, distress and wellbeing in patients and staff.

The challenge for us as professionals is how we can create a culture in which staff will be supported and motivated to be compassionate, not only in their interactions with patients, but also in their interactions with their colleagues. And most importantly, compassion starts with self-compassion. The extent to which we can be compassionate towards others depends on how compassionate we are towards ourselves, and our working lives must enable this to be so.

Christin: one of the attendees at the workshop asked – ‘are we able to develop compassion, or is it an inborn characteristic?’

Michael: we are hard-wired to be compassionate. Compassion helps us as individuals to contain the feelings that reverberate within us when others are experiencing suffering. It cushions us against stress and burnout.

Within organisations, there’s research evidence, such as Compassionomics: The Revolutionary Scientific Evidence That Caring Makes a Difference, that shows we’re able to successfully develop compassion. We know from research on leadership in teams that creating conditions in which team members feel included, safe to learn, contribute and challenge the status quo, is key for organisational effectiveness.

Good leaders ensure there is a shared vision among their teams, frequent opportunities for shared reflection, and an appreciation of diversity and difference. Modelling empathy too and practicing putting yourself in another person’s shoes is also vital.  

Rachna: we had a number of questions on how do we deal with “difficult” people?

Michael: this is a good question that comes up a lot. In my view, it’s not a question of “difficult people”, rather, the difficult contexts people find themselves in is that makes their behaviour difficult. So behaviour is usually a reflection of the situation people find themselves in.

We deal with “difficult” people by understanding how to give them proper feedback about their behaviour. Giving honest feedback about their behaviour, in a compassionate way, allows for people to reflect on their behaviour and address those aspects perceived as difficult. Poor behaviours can pose greater risks to patient safety. These risks could be as detrimental as poor infection control practices in wards, which is why addressing people’s behaviours is essential.

Christin: In the face of service demand, how do we ring fence time and space for leaders and staff to regularly connect, reflect, process, share? In addition, how can we foster a space for self-compassion and thus capacity for other-compassion (colleague and patient)?

Michael: you must do it. Creating the space for leaders and staff to regularly connect, reflect, process and share is vital. There are some great examples of good practice in the General Medical Council report that I was commissioned to work on with Dame Denise Coia. For example, an NHS organisation that was overwhelmed with work, set up two team meetings a week to make time to discuss cases and issues, together as a team. This helped boost confidence and a sense of working inclusively, and their data suggests the approach has significantly reduced referral rates.

When you create that space, you become more productive. There are so many examples of people making the time, and it working. It’s your responsibility as professionals to make that time - for the wellbeing of patients and your own wellbeing.

What matters is that we are using that time to discuss objectives, strategies and processes, including work overload and being too busy. During the pandemic we’ve learnt it’s important for teams to reflect, or to have some time to catch-up about their weekends, have some humour – all of that stuff is really important for building a sense of connection within our teams and organisations.

Christin: How do we shape the wider system to promote and reward compassionate leadership?

Michael: we have to build in compassionate leadership and compassion into all of the processes that we have, for example appraisals, performance management, selection, recruitment, promotion - there are places across the country that are doing this in health and social care. It’s about transforming the processes in the organisation so that they align with that core value of compassion. It’s also about making sure that leaders are getting feedback on how they lead, and how inclusive they are as leaders.

National bodies also have a role to play in influencing culture beyond their organisational boundaries – it’s important they lead by example on compassionate leadership – positively benefiting the whole healthcare system. There are movements in that direction, but we need to keep the pressure on those national organisations, so that they are modelling institutional compassion.

Rachna: How do we balance between patients’ needs and being compassionate towards staff?  

Michael: It starts with self-compassion. The more compassionate we are with ourselves, the more compassionate we are with others, so rather than a balancing, it is a way of being. Compassion has to be our core value, and the core value or culture of our organisations and the way we live. Culture is like an ocean, it is created by every interaction we have, with everyone, every day, and this includes how we are with ourselves. By being compassionate towards ourselves, we’re able to be more compassionate with our colleagues and with our patients, so that it becomes a way of being in all our relationships. If we’re not compassionate to ourselves, then we won’t have the resilience and compassion to be consistently compassionate towards others.

Christin: one final question – how can we influence other senior leaders in our organisations to be more compassionate?

Michael: it begins with us, and how we behave. Compassion is contagious – emotionally contagious! We can influence in that way – that’s something we all have control over. If we build effectively functioning teams, what they will do as good practice is to provide regular feedback on their behaviours, including the team leader. We have to make sure that we are providing feedback to all leaders of the organisation on a regular basis about how people see them in terms of compassionate inclusion. If compassion is our core model, then we should be selecting and supporting leaders throughout the organisation to be compassionate. That’s how we transform culture.

On the theme of compassion, we’re delighted to share our new Director of Partnerships and Programmes, Joe Casey, has been nominated for this year’s Kindness and Leadership, 50 Leading Lights UK Awards. Joe continues to be an exceptional leader, able to build good relationships with people from diverse organisations, backgrounds and levels. Exemplifying the values that are at the heart of King’s Health Partners, Joe connects with clinicians, academics, policy makers and multiple sectors by finding a shared purpose and helping others to succeed. He empowers colleagues from all levels by recognising the unique insights and contributions that diverse people bring and harnesses those for the greater purpose. On World Kindness Day, November 13, the 50 Leading Lights will be announced.

To hear about their exciting work on novel technologies, diagnostics and therapeutics King’s Health Partners would like to invite you to the next episode in their Clinical Academic Innovation Workshop Series on 11 November. Register online.

Liked this article? Watch the King’s Health Partners Annual Conference 2020 on demand for more workshops on workforce innovation and sustainability.