Autumn Newsletter - Page 3

The science of Compassion8
Kindness and compassion, Steve Trenchard
The time for ensuring that NHS-funded organisations
have compassionate care cultures has arrived. The
National Leadership Framework (Developing People –
Improving Care, Dec 2016) acknowledges that
compassionate and inclusive leadership:

creates an environment where there is no bullying;
increases the chances of learning and quality
improvement becoming the norm;
helps staff feel valued, engaged and enabled to show
compassion themselves; and
ensures that staff feel able to speak up when
something is wrong and they are empowered to
continuously improve.
Our understanding of leadership and culture and the
development of the Compassion8 approach has its roots
in the science of compassion (Gilbert, 2017), based on
the evolutionary model which recognises that the
complexity of human behaviours is explicitly linked to our
developmental past. Getting the right leadership
behaviours within your organisation and across the
system is imperative and is the clear driver behind the
new NHSI + King’s Fund approach. In addition to this,
new system leaders will need an understanding of the
fundamental processes of successful change and
innovation, and will need emotional intelligence,
engagement and coproduction skills. Curiosity,
understanding, sharing and responding are all central to
the Compassion8 approach:
Compassion in the face of adversity
Recently, at the Conservative Party Conference Jeremy
Hunt stated that “unless we support staff to learn from
mistakes we just condemn ourselves to repeat them –
and that means dismantling the NHS blame culture and
replacing it with a learning culture.” Whilst Jeremy Hunt
was talking mainly about patient safety incidents there are
similar messages to apply to management, leadership
and culture.
When serious incidents happen, internal processes must
be followed to ensure good governance is followed and
learning occurs. However, for a small number of incidents
there may be unforeseen consequences that follow. For
example, the involvement of the local or national press,
the impact of email and social media, means that more
people can more quickly become aware of the event(s) as
they unfold.
Understanding the psychological impact of the human
response is an important tool in the kit of any senior
compassionate leader. And ensuring a compassionate
response can ultimately help people to avoid anxiety,
depression and time off work.
Being involved in serious incidents is not dissimilar to
experiencing a trauma. The normal and immediate
response to stressful events is the physical bodily
reaction to threat (such as raised heartbeat, palpitations,
sweating, feeling flushed) which can in turn trigger
unhelpful negative thoughts and self-criticism. The
experience of self-criticism and shame is well understood
in therapeutic terms, but less well applied to people in
leadership, management and professional roles. An
effective approach to working with ‘shame’ has been
developed in Compassion Focused Therapy (CFT) by
Professor Paul Gilbert.
Shame in the workplace
If the NHS is to become more compassionate, and better
equipped to learn from incidents or when blame is a
factor, then the whole of the NHS needs to become more
psychologically aware of the impact of shame on a
persons’ health and wellbeing whether a staff nurse of a
senior leader. Indeed, it is likely that the senior leader is
the person held to account in a very public way and
shamed with media headlines whilst the staff nurse or
doctor faces patients, families and colleagues each day.

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