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Look here for the 6C's (p.13)

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10·All NHS organisations should seek to harness the leadership potential of patients and members of the public as they fulfiltheir respective responsibilities whether as providers.

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There are a whole raft of other leadership types such as Inclusive leadership (similar to compassionate), Situational Leadership, Patient Centred Leadership, Charismatic Leadership, Transactional leadership, Transformational leadership, Situational leadership.
And within these types there are often a range of styles which may include a democratic, autocratic and Laissez-Faire style. Research these over the course of your programme.

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The NHS Long term plan (2019) highlights the importance of visible senior clinical leadership in enabling and assuring the delivery of high quality care

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5. Provide leadership to make sure people’s wellbeing is protected and to improve their experiences of the health and care system

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nb: if leadership frameworks ppt too large a fIle, just download in your browser. thanks

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Building and Strengthening Leadership (2014)

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Building and Strengthening Leadership (2014)

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Look on page 14 for a list of qualities of a Compassionate leader. Are these applicable to learning outcome 1?

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NHS England (2015) Improving Experience of Care through people who use Services: How patient and carer leaders can make a difference

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NHS England (2015) Improving Experience of Care through people who use Services: How patient and carer leaders can make a difference

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The concept of patient leadership is emerging as one important new way of working collaboratively with patients and carers. ‘One new concept – patients as leaders – is beginning to gain popularity’ (Kings Fund 2013 ).

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Want to know whether you have what it takes to lead others? Excellent leaders bring out the best in the people around them. The following assessment will evaluate your Leadership Skills and Style - whether you possess the personality traits and skills that characterize good leaders.

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Got transformational or transactional leader qualities? Test your leadership skills & leadership style with Leadership Style Test, a great tool for leadership training & leadership skills development.

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NHS Improvement (2019) Clinical leadership –a framework for actionA guide for senior leaders on developing professional diversity at board level

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NHS Improvement (2019) Clinical leadership –a framework for actionA guide for senior leaders on developing professional diversity at board level

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‘Clinical’ can be defined as traditional NHS clinical professions or widely defined as anyone trained to deliver frontline care. clinical professions in health are: • Allied health professionals (AHPs), Doctors • Healthcare scientists  • Midwives • Nurses • Pharmacists • Psychologists • Social workers..
All members of the health care team are identified as potential leaders.

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Royal College of Nursing Principles (2010)

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Royal College of Nursing Principles (2010)

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Principle H

Nurses and nursing staff lead by example, develop themselves and other staff, and influence the way care is given in a manner that is open and responds to individual needs.

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Principles of nursing practice | Royal College of Nursing

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The eight Principles are used to describe what everyone, from nursing staff to patients, can expect from nursing.

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Student nurses cannot be leaders? Think again (2019)

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Student nurses cannot be leaders? Think again (2019)

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Written by a year 3 Student Nurse

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Third year adult nursing student Claire Carmichael, who aspires to work in general practice, wrestles with what leadership means to her.

'Hello, my name is Claire Carmichael and I am a student nurse leader and future newly qualified nurse leader.'

Like most students and nurses, I find these words hard to say out loud and squirm when I do. I never thought of myself as a leader and often misinterpreted the word leader for something or someone else.

Before starting my nursing degree in January 2017, my views were very different about leadership. I thought leadership was for people with millions of followers or someone at the top of a hierarchy - like Matt Hancock, for example. Until now, I did not realise student nurses could be called leaders too. I am five weeks away from qualifying and I have had messages from other students along with qualified nurses calling me these very words, which still makes me uncomfortable.

However, I have come to realise that any single person can be a leader. Because in my eyes, to be a good leader you have to inspire others to be their best self. As a leader, you create other leaders. As a leader, you motivate and encourage others to do more, be better and be the best version they can be.

I also believe that good leadership goes hand in hand with being a good role model and think most people have these qualities without even realising it.

So, if you are someone who has advised a patient on their health and they have followed your advice, you're a leader. Because you have motivated and encouraged that patient to become their best self for the benefit of their health and well-being.

If you are a mother or father who has encouraged your child to do learn and grow - such as through reading, writing and doing their homework - you are a leader. Because you're setting them up for a fantastic future ahead of them.

If you are that person who sees your colleagues stressed, down, needing advice and have motivated them to keep going, you are indeed a leader.

If you are that student who sees someone else struggling and gives them that encouragement to keep going, you are a leader. Or you go out to placement and see something isn't quite working right so you provide a simple solution and now it's being used in practice - that's right, you are a leader in my eyes! Because I believe that the small things amount to big things.

So, here are a few of my tips for good leadership:

* Have empathy

* Integrity

* Good communication skills

* Empowerment

* Encourage, motivate and inspire someone to do something amazing

* Build others up

* Share your own good work and positive messages to inspire others

* Work from the bottom upwards so you can understand the different bands in nursing

* Share other peoples' good work

* Be a good role model

This is my own opinion and experiences of leadership; other opinions may vary from person to person. We are all individual and unique human beings and what works for one might not always work for another. So, find your inner leader.
Claire Carmichael is a third year student nurse at Birmingham City University and student information officer at the Royal College of Nursing, as well as an ambassador for general practice nursing and the Academy of Fabulous NHS Stuff.

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Student nurses cannot be leaders? Think again

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Third year adult nursing student Claire Carmichael, who aspires to work in general practice, wrestles with what leadership means to her. 'Hello, my name is Claire Carmichael and I am a student nurse leader and future newly qualified nurse leader.' Like most students and nurses, I find these words hard to say out loud and squirm when I do.

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Becoming a Caring & Compassionate Practitioner in Health and Social Care (2017)

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Becoming a Caring & Compassionate Practitioner in Health and Social Care (2017)

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A piece written by Clouston et al (2017) about becoming a compassionate leader.

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This page has two core elements. The first part will explore what leadership is in health and social care and why it is important. The second part will look at ways in which you can develop your self-awareness as a compassionate leader in practice.
By the end of this page you will be able to:

Identify why leadership is important in health and social care and define compassionate leadership

Understand why thinking about how leaders behave and make decisions is important

Reflect on areas where compassionate leadership may make a difference

Consider how you may be able to influence others to create a culture of compassionate leadership

Leadership in health & social care
Many high-profile failures have been reported in health and social care identifying how patient and/or client care has been lacking (Francis 2013, Andrews 2014, Laming 2009). A common factor in all of these and other reports, was the failure of leadership and the impact of cultures within organizations on staff and patient/client care.

Making difficult decisions, ensuring standards of care are high and encouraging a culture of positive regard, compassion and openness are some of the required aspects of being an effective leader. Identifying an awareness of what effective leadership looks like in practice can help self-development by encouraging enthusiasm for innovation.

It is often difficult for students and practitioners to identify themselves as leaders and consider what the difference is between leading and managing care. In all caring professions however, standards and ethics state that we are all responsible for our patient or client care and the quality and competence of our professional practice; as such we are all leaders within that context. So, let's explore what leadership is in order to understand this further.
Defining leadership
Leadership has been a part of military and political disciplines through the centuries, so why has it become such a prominent issue within health and social care now? The common issues of dealing with and managing large organizations effectively, communicating with people collectively and inclusively, driving high quality and safe care and recognising failure and mistakes needs good leadership. As health and social care settings require all these elements, so effective leadership is needed. Leadership, as a concept, an action or practice is, however, known to be difficult to define. As Northouse (2016 p2) states, "as soon as we try to define leadership, we immediately discover that leadership has many different meanings". This variety of definitions and perspectives includes identifying leadership as a personality type, a power-based type, e.g. knowingly using the position or role held to make decisions of reward or punishment (Western 2019). Bass (1990) discusses leadership in terms of achieving goals, while Northouse (2016), Stogdill (1974) and Kotter (1990) consider processes of influencing, of making decisions, of being in authority or managing change.

Consider all these; which do you think is true in your experience of health and or social care?

Whilst all the above may be relevant to health and social care settings and being a practitioner, we should also consider how values based and compassionate leadership styles may fit with our professions. The Kings Fund (2017) consider this type of leadership as the basis of creating and enabling innovating, caring and compassionate cultures within our health and social care organizations. A compassionate leadership style supports the altruistic motivation of health and social care professionals, developing a culture of openness, non-blaming, support and encouraging innovation. Compassionate leadership also takes a collective approach, so every staff member takes responsibility for high quality, safe and effective care. Evidence suggests more traditional hierarchical leadership styles are not effective in health and social care, so a compassionate and collective approach could support the development of a safe and innovative caring environment (Kings Fund 2014). According to Atkins and Parker (2012) and The King's Fund, (2017) a compassionate leader should have the qualities to be able to be:

Organizational culture grows from its founding values, its experiences, history and norms, as well as the behaviours and tone set by its leaders. For our professions to thrive and our patients and clients to be receive high quality care, we need to encourage compassionate leadership in our own practice and expect these values from our leaders.
Leading or managing?
At times, the terms leadership and management are used without a clear definition between the two. We may, for example, consider that we manage the daily care we give to our patients/clients, so where does leadership come in? Are there times when these overlap in practice?

Before looking at the table below, write down your ideas of the differences between leadership and management. Now compare your ideas to the table. Do your views reflect the descriptions below? If not, where does the difference lie?
Becoming a compassionate leader
Being a self-aware practitioner and considering the emotions of others while responding appropriately requires attentiveness, truthfulness and curiosity. Emotional Intelligence is also required for compassionate leadership. Consider the pages on Emotional Intelligence here and here; consider how this will help you reflect on the styles and attributes of leadership in others and yourself.

Much has been written on theories and styles of leadership. Briefly, here are some of the most common referred to. Perhaps you can identify some of these traits in leaders you have worked with in clinical practice:

Charismatic

Situational (where a style is applied according to the assessed need)

Transactional (based on exchanges between leaders and followers where praise and criticism is involved, with little responsibility held by the followers)

Transformational (motivational and inspiring for change) (Stanley 2019)

Transcendental (leads by example, can communicate a vision, has integrity and will put collaborators before self (Cardona 2000); this links well to the qualities required for compassionate leadership.

So how do you develop your individual leadership style and philosophy? Considering the ethical and professional values of our professions in health and social care, we can call on three intrinsic areas which shape our practice and transfer these to our approach to developing individual leadership styles to influence a compassionate culture. These are our personal and professional values, experience and evidence base.

As reflective practitioners, we reflect within our practice and Schon (1987) distinguishes between reflecting before, in and on practice. The opportunity to reflect from all three lenses provides the professional opportunities to relate evidence, experience and values of their practice and with the insight of [emotional intelligence], develop and master an approach to leadership. Earlier we considered the requirements for compassionate leadership as:

By keeping all these elements in our practice and developing skills and confidence in making decisions, being innovative, supporting colleagues and expecting best practice for our patients and clients, so we begin to develop compassionate leadership. The figure below represents these integrated elements of compassionate leadership.

The integrated elements of compassionate leadership

Elements of compassionate leadership
Now that you understand the elements of compassionate leadership, what can you do to build on this and work on developing your compassionate leadership style?

Read your professional standards and take note of where leadership sits in its requirements.

Consider all the people you have worked with who you think demonstrate effective leadership and how they apply this.

Think of the challenges that you may face in developing a compassionate leadership style and how they link to the other pages.

Consider the reports mentioned above, how might you influence for a positive culture by applying elements of compassionate leadership?

Suggested activities
Who do you consider to be an effective leader from this group of world leaders? Why do you think they are effective and why do you consider others to be ineffective?

Nelson Mandela, Donald Trump, Barak Obama, Julius Caesar, Abraham Lincoln, Angela Merkel, Vladimir Putin, Indira Gandhi, Mahatma Gandhi, Kim Jong Un, Pope Francis.

Click here to read Michael West: Collaboration Compassionate Leadership, The King's Fund Leadership Summit, May 2017. Spend 5-10 minutes writing down your initial thoughts and how you can apply 'Compassionate Leadership' into your practice.

Click here to read a really interesting blog by Kilroy who uses the proverbial four monkeys. to review the issues raised in the Francis report 92013) about leadership in healthcare.
References
Andrews J (2014) Trusted to Care. Available at; https://gov.wales/sites/default/files/publications/2019-04/trusted-to-care.pdf

Atkins P, Parker S (2012) Understanding Individual Compassion in Organizations: The Role of Appraisals and Psychological Flexibility. The Academy of Management Review 37(4):524-546

Cardona P. 2000. Transcendental leadership. Leadership & Organization Development Journal 21(4):201-207. DOI: 10.1108/01437730010335445

National Advisory group on the Safety of Patients in England (2013) A promise to Learn a commitment to act. Available at; https://assets.publishing.service.gov.uk/government/

Francis R (2013) The Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry: Executive Summary. The Stationery Office, London

Laming (2009) TheProtection of Children in England. London Stationary Office

Kings Fund (2017) Caring to Change: How Compassionate Leadership can Stimulate Innovation in Healthcare. Available at; https://www.kingsfund.org.uk/publications/caring-change

Kings Fund (2014) Delivering a Collective Leadership Strategy for Healthcare. Available at https://www.kingsfund.org.uk/sites/default/files/2017-05/delivering-collective-leadership-ccl-may.pdf

Kotter J P (1990) A Force for Change: How leadership differs from management. New York. Free Press.

Northouse, P. G. (2016). Leadership: Theory and practice (7th ed.). Thousand Oaks, CA: Sage.

Schon D (1987) Educating the reflective practitioner. San Francisco. Jossey Bass Pub.

Stanley D (2019) Values-Based Leadership in Healthcare. Congruent leadership Explored. Los Angeles. Sage Pub.

Stogdill R.M (1974) Handbook of Leadership: A survey of the literature. Free Press. New York. Western S (2019) Leadership. A Critical Text. Los Angeles. Sage Pub.

To cite this page please use James A. 2019. Compassionate Leadership in Clouston et al., Becoming a caring & compassionate practitioner. Available on line https://caringpractitioner.co.uk/index.php/compassionate-leadership/ [add date when you accessed].

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This page has two core elements. The first part will explore what leadership is in health and social care and why it is important. The second part will look at ways in which you can develop your self-awareness as a compassionate leader in practice.

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Future Patient – musings on patient-led healthcare (2017)

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Future Patient – musings on patient-led healthcare (2017)

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What is a Patient Leader?

For me, a patient leader is ‘someone who is affected by life-changing illness, injury or disability who influences change through working in partnership’. The shorthand: ‘people who’ve been through stuff, who want to change stuff’.

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Future Patient - musings on patient-led healthcare

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The NHS loves to unleash (sic) its buzz words, euphemisms and catchy soundbites. I'm not sure which is more depressing. Watching their footprints (sic) come. Or go.

But the phrase 'patient leader' seems to be sticking. What does it mean?

To be honest, when it came into my head a few years back, I laughed - Put two contested terms together. Light fuse. Stand well back and watch the fun. Patient Leader - marmite. Love it? Hate it? At least we are talking still about it. I have seen people slip back into their chairs at its mention, others puffed with a new found pride at finding a stronger status - 'yes, that's me'.

It was also the culmination of other questions I had: what do we call idiots like me who, instead of just wanting to heal in peace, return to the NHS in a different guise? The troublemakers, the grateful. Those who bring back jewels of wisdom from caves of suffering and want to help or heal the system.

A growing and growling gang. We need to belong, find our individual and collective identity, support each other to be effective change-makers (or health-makers, as Karen Maskell has so beautifully put it), whinge and gossip over cake. Heal together. Was there a name for our tribe? So rich, so diverse yet driven by common cause.

I don't like the traditional connotation of the word 'patient'. But by linking it to the term 'leader', it turns heads and meaning on its head - a reclamation, a bit like the gay movement reclaiming 'queer'.

Meanwhile, I watch the failure of the engagement industry - reliant on child-parent feedback mechanisms and adolescent-parent institutional arrangements that pit representatives against professionals (or co-opt them) in tedious sub-sub-committees. And yields... not much to be honest.

Everywhere I look, power is neutralised and buffered. We are patted on the head, told to play with broken toys rather than join in with the big boys. The passion and wisdom gained through suffering and resilience is not valued. This is a caricature, but I believe it largely represents recent reality.

And now the questions - How can a patient be a leader? Who do they 'represent'? How do you get to be one? Who decides? Isn't 'people' a better term? And many more. They are good questions. But we don't have agency in the system or collective 'comms strategy' to articulate what we mean. We lack the power and rely on guerrilla techniques such as blogs! And these questions are also symptoms of institutional elites feeling threatened and wanting to undermine the inevitable shifts in power (IMO).
What is a Patient Leader?
For me, a patient leader is 'someone who is affected by life-changing illness, injury or disability who influences change through working in partnership'. The shorthand: 'people who've been through stuff, who want to change stuff'. Thus for me:

1. Patient = (a) someone who has been affected by a life-changing illness, injury or disability (or long-term condition) PLUS (b) someone who is, or has used, service regularly. I wish we had a different term - one that stressed both these aspects in a strong way. Call us user/consumer/client etc and it still emphasises 'use' of services. Call us citizens/lay and that ignores what we have been through. I wish there was a colour for us - the ecologists got lucky with green. We are, of course, people and human beings. But we also bring a different angle to a citizen tax-payer who does not know what it is like to be years in the caves of suffering. And yes, my definition includes 'carers' (i.e. those 'affected' by).

2. Leader = for me, a leader is someone who manifests what it means to be a true leader in their way of being and doing. I lean on models of collaborative leadership highlighted in all good leadership programmes for clinicians and managers - this includes someone who has a vision, leads change, inspires others, etc etc. In other words, it's the 'ship' in leadership that steers the way (pun intended).

This thinking has been helped by many people, including Jocelyn Cornwell, Harry Cayton, Mark Doughty (who co-founded the Centre for Patient Leadership) and Steve Laitner. And of course, the gang.

True 'patient leaders' display kindness, humility, are able to listen properly and work together. And they are often very strategic. Many with health conditions can do that, precisely because they value it so much when it comes to how they are cared for and supported. And they can see clearly what is right and wrong in the system.

But take a good look at yourself - can you truly work in partnership? Do you want to? Can you work with your own anger, and not be led into provoking it and maintaining the binary us and them? Can you bring your difference - be the grit in the oyster - and also assert a common thread of humanity? Are you part of the solution? Do you want to be, even when it is really really hard... ?
What about roles?
I have always been interested in power and justice. There's not much point in training patient leaders unless there are meaningful opportunities for them in decision-making roles, rather than 'being involved' in a project or committee. Unless we have 'Patient Directors' 'patient CEOs' etc, then we can't change the way the NHS works. I doubt feminists would accept being focus group fodder within a service aiming to be 'women-centred'.

There are so many ways to be a 'patient leader'. You can be an entrepreneur like Michael Seres, Denise Stephens or David Festenstein. You can be a community development activist or digital specialist like Roz Davies. You can work at national and/or local level as an improvement specialist, like Ceinwen Giles, Alison Cameron or Sibylle Erdman. You can help train and educate, or be into self-management implementation, like Anya deIongh or Lynne Craven. Or become Patient Editors (like the late great Rosamund Snow). Or any combo of the previous.

Can a clinician, administrator or manager be a 'patient leader'? Maybe it depends what hat you are wearing at any particular time. As long as we recognise that we need both 'outsiders' and 'insiders' in the room when making decisions. What I will say is that, in my experience, when you are 'inside', there is a risk you can become narrow in your views - this is happening to me, sometimes realising that I can focus more on what is possible for the system to deliver than 'what matters'. Or what I think is possible. Maybe because that is more comfortable.

Thus, in my current organisation, my role as patient director is more about creating opportunities for other patient leaders to congregate and meet with staff, than for me to be a 'patient leader'. Or maybe that's a role for any 'patient leader' - bring in others. And that's one aim of this blog.

And if you still don't like the phrase, don't use it. No-one is forcing it on anyone else. More importantly, we are not going away, whatever we are called.

-

If you liked this blog, please take a look at the many others at http://www.futurepatientblog.com

And follow me on Twitter @DavidGilbert43

I also offer mentorship for 'Patient and Carer Leaders' and those working in the field of patient and public engagement. Get in touch?

© 2017 David Gilbert

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Why we need Patient Leaders The NHS loves to unleash (sic) its buzz words, euphemisms and catchy soundbites. I'm not sure which is more depressing. Watching their footprints (sic) come. Or go. But the phrase 'patient leader' seems to be sticking. What does it mean? To be honest, when it came into my head a...

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Daly, J, Jackson, D, Mannix, J, Davidson, PM & Hutchinson, M 2014, 'The importance of clinical leadership in the hospital setting', Journal of Healthcare Leadership, vol. 6, pp. 75-83. 

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Daly, J, Jackson, D, Mannix, J, Davidson, PM & Hutchinson, M 2014, 'The importance of clinical leadership in the hospital setting', Journal of Healthcare Leadership, vol. 6, pp. 75-83. 

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In this article some of the attributes of clinical leadership include being skill, value and vision driven, having advocacy skills, have an ability to affect change, facilitators of healthier workplaces, credibility, have clinical competence and a positive attitude towards their profession

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Platform 5: Leading and managing nursing care and working in team
5.1 understand the principles of effective leadership, management, group and organisational dynamics and culture and apply these to team working and decision-making

5.6 exhibit leadership potential by demonstrating an ability to guide, support and motivate individuals and interact confidently with other members of the care team

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Royal College of Nursing: Leadership skills: How to demonstrate leadership skills within your career

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Royal College of Nursing: Leadership skills: How to demonstrate leadership skills within your career

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What is a leader?

Upon hearing the word "leader," you might automatically think of someone who manages a team, or someone who makes big decisions.

Although the term can have different meanings for different people, the Chartered Institute of Professional Development (CIPD) defines it as "the capacity to influence people, by means of personal attributes and/or behaviours, to achieve a common goal."

Leadership in healthcare

Research and reviews have revealed the importance of good leadership in healthcare, linking it to patient mortality, quality of patient care and satisfaction, and improved staff wellbeing/morale.

Using the idea that all employees can be leaders at some level, healthcare organisations have been aiming to improve and invest in strong, effective leadership within the services they provide.

Leaders at all levels

All employees can show good leadership in their own way, from directors to middle managers or from first-line supervisors to front-line staff.

You could be a leader for example by raising concerns about staffing levels, by acting as a role model, or by suggesting ideas on how to improve patient care.

Demonstrating leadership skills during recruitment

When recruiting, many healthcare employers will want to see evidence and examples of your leadership skills within your CV, job application, assessments and/or interview.

Alternatively you may be applying for a post where leadership plays a key or important part. In this case employers will be interested in your leadership skills, but also about your leadership vision, leadership ethos/philosophy/style, or leadership strategy. They may be interested to see not only how you lead, but also how you will develop leadership skills in others.

Possible interview questions around leadership skills could include:

Tell us about a time where you took the lead on an idea, task, or project.

Describe a time where you had to bring someone around to an idea you had.

How do you act like a role model?

Tell us about a time where you advocated for a patient.

Describe a time when you had to take charge of a situation.

What does good leadership mean to you? / What type of leader are you?

How would you foster a culture of leadership within your team?

Give examples of how you "lead with care."

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RCN Careers Resources: Leadership skills | Royal College of Nursing

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Healthcare organisations are shifting a relentless focus onto improving and investing in strong and effective leadership within the services they provide.

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Covid-19: why compassionate leadership matters in a crisis

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The Covid-19 situation is full of uncertainties. Leaders are struggling to find the right solutions as the context changes almost hour by hour. Now more than ever, leaders need to draw upon all available resources, most particularly their people, utilising the collective intelligence of experience and knowledge while adapting and revising solutions as the situation unfolds.

NHS staff are highly skilled and motivated. They have great wisdom, experience and profound values of compassion. They can all be leaders if the right conditions exist for them to be able to do what they know to be the right thing. Unleashing their collective wisdom requires compassionate leadership. That means paying attention to all staff, truly listening to them and being present with them. It means truly understanding the challenges they face, rather than seeking to impose understanding. Empathising with them, feeling their fears, stresses, uncertainties, anxieties and exhaustion, provides the motivation to always ask the question 'how can I help you?', the most important task of leadership. Compassion should also be guided by appreciating and meeting the core 'ABC' of human needs at work.

A: autonomy and control

People instinctively want to have control and not feel coerced or directed, particularly when under huge pressures in a crisis. Staff must have voice and influence over decisions that affect their delivery of care and their own workplace environments. They need to be trusted to make the best decision they can. Taking away autonomy in a high- demand situation creates stress. Ensuring autonomy and control means listening to staff every day and taking account of their knowledge, skills and experience to make crucial decisions.

Control also means being able to take regular breaks from the inevitably high workload to ensure staff do not make mistakes, get sick or patient care suffers. Staff need access to food and drink to meet their basic biological needs and they need time to care for their health and wellbeing.

The key role of leaders is to provide the resources and clear away obstacles to fulfilling these needs on the path to successful management of the pandemic. Leaders also need to be honest when resources are in limited supply and involve staff openly and honestly in both assessing the impact and risks involved and in making difficult decisions.

B: belonging

Belonging is fundamental to human wellbeing and the need to belong is greater during a crisis. Everyone can feel frightened and overwhelmed in the situation we now face. We cope by feeling supported, loved, cared for and building a sense of belonging as part of a larger, caring whole. And our immediate work group, team, department is critical. Not only must leaders ensure a positive, caring and supportive climate but also encourage and enable sustained multidisciplinary team-working where everyone is clear about each other's roles.

This means everyone being a member of a 'home team' (preferably multidisciplinary) that provides support, enables a shared focus on the task and provides the medium for collective learning and innovation. Such team-working leads to better care, better staff wellbeing and more innovation. And working flexibly, supportively and collectively across boundaries is the way forward in this crisis and for the future. This can only be successful in the context of a compassionate and collective organisational culture.

C: competence

All staff desperately want to deliver high-quality care during this pandemic. Leaders will need to enable and support staff to work effectively during what will be a very testing and prolonged period. Work overload is only sustainable for so long - a saturated sponge cannot take in more water. Leaders must ensure that workloads are manageable if the NHS is to respond to this crisis effectively over the months ahead and not lose staff in the process to a preventable work-related illness, breakdown or a sense of helplessness.

Time is very pressured, but staff need to meet with their fellow team members regularly to review, to share learning, to develop innovative responses to the crisis and to simply recover together. Time spent in meeting like this is associated with a 35 per cent improvement in productivity and innovation and similarly large increases in wellbeing. Building short team reviews (even of just a few minutes) in to daily work will establish a rhythm to facilitate greater learning and support to all staff. Regular supportive supervision for all teams and individuals is needed so that their work can be sustained. And it is vital to constantly seek out and share learning from organisations and health care systems around the world about how to deal with the pandemic.

These are the hands, and this is the moment. By working compassionately, courageously and honestly, leaders can support and care for their staff so that they can save thousands of lives across our communities.

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Covid-19: why compassionate leadership matters in a crisis

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Suzie Bailey and Michael West examine why compassionate leadership matters now, in a time of global crisis, more than ever before and how leaders can best support those health workers and carers risking their own health and wellbeing in the fight against Covid-19 (coronavirus).

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The Patient Revolution: What's it like to be a Patient Leader? (2019)

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The Patient Revolution: What's it like to be a Patient Leader? (2019)

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6 minutes

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The Patient Revolution: What's it like to be a Patient Leader?

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Recommendation 195: Ward nurse managers should operate in a supervisory capacity, and not be office-bound or expected to double up, except in emergencies as part of the nursing provision on the ward. They should know about the care plans relating to every patient on his or her ward. They should make themselves visible to patients and staff alike, and be available to discuss concerns with all, including relatives. Critically, they should work alongside staff as a role model and mentor, developing clinical competencies and leadership skills within the team. As a corollary, they would monitor performance and deliver training and/or feedback as appropriate, including a robust annual appraisa

Recommendation 197: Training and continuing professional development for nurses should include leadership training at every level from student to director. A resource for nurse leadership training should be made available for all NHS healthcare provider organisations

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Quinn B (2020) Using Benner’s model of clinical competency to promote nursing leadership.Nursing Management. 

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Quinn B (2020) Using Benner’s model of clinical competency to promote nursing leadership.Nursing Management. 

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Patricia Benner theory (1982) is really important when examining competence and leadership and she developed 5 stages which are Novice-Advanced Beginner-Competent-Proficient-Expert

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Compassionate Leadership in the NHS during COVID-19

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Compassionate Leadership in the NHS during COVID-19

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Published 9th April, 2020.

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During times of global crisis, such as the unprecedented COVID-19 outbreak and the extensive challenges this has brought, it is particularly important to ensure that there is a culture of support in the NHS. Compassion and care must be a certainty for employees at a time of great uncertainty. Compassionate care is shown to be beneficial for patient health outcomes including reduced mortality and malpractice complaints and increased satisfaction with care (Decety & Fotopoulou, 2015). However, it is equally important that we show compassion to our colleagues, as they are the ones who will need to manage an increasing burden of responsibility and so they too will need to feel supported. Understandably, this may seem like an unrealistic demand during a highly pressurised "command and control" situation, yet it is now more essential than ever.

Compassionate leadership involves responding to your colleagues with kindness and acknowledging their concerns or worries. Even the smallest acts of compassion, including mindful listening and acknowledgement of the challenges they face, can have a positive impact (Montague et al., 2013). Additionally, showing compassion to a colleague not only benefits them but also benefits anyone who witnesses this compassion. This knock-on effect can have a really positive effect on the organisational culture, helping to create a caring and supportive environment (Frost et al., 2000; Goetz et al., 2010; Lilius et al., 2011).

There are four core components of compassionate leadership:

(Atkins & Parker, 2012)

Attending - "I pay attention to others and how they are feeling"

Attending to how your colleagues are feeling is particularly important at a time of crisis. A compassionate leader will ensure that they listen to the challenges, difficulties and problems their colleagues are facing, even if time is limited. To do this effectively, you must first pay attention and actively listen with an open mind in order to learn and gain new insight into how they are feeling (West et al., 2017). Whilst doing so, you must ensure that you withhold judgement and aim to develop an empathetic connection with your colleague (Hoppe, 2007). Next, it is important that you then clarify, summarise and reflect on what you have heard in order to show that you listened and understood what was said. Finally, a compassionate leader may then share their own thoughts or concerns about the situation. Although there are a few elements to this step, the process of attending is relatively quick. Even if you can only spare a matter of minutes to check-in on a colleague, it will still show that you are looking out for them. A compassionate leader is someone who promotes psychological safety; colleagues can safely speak up about problems or uncertainties without fear of being ignored or reprimanded. Compassionate leaders are also individuals who really know their colleagues and therefore would notice any changes in their behaviour and would check-in with them if they did.

Understanding - "I understand why an individual may be feeling distressed"

In order to show compassion, a leader must work with their colleagues to understand their feelings and emotions. If your colleagues are able to explore their emotions and the challenges that they are facing with someone, then they are more likely to make sense out of the situation and start thinking of effective ways to resolve them (West et al., 2017). Additionally, helping your colleagues to understand their feelings will help you to appraise the situation and understand why they may be feeling that way. Coaching techniques are also beneficial to help colleagues to develop increased self-awareness and self-efficacy which is especially important at a time where there will be feelings of disempowerment and fear (Ting & Scisco, 2012; Strauss et al., 2009). These can include:

GROW Model:

G oal: The individual's goal which they want to accomplish. It should be defined as clearly as possible.

R eality: That's the status quo, where the individual is right now. They describe their current situation and how away they are from their goal.

O bstacles and Options: What are the obstacles (roadblocks) that keep the individual from achieving the goal? Once identified, help them find ways to overcome them (the options).

W ay forward: Convert the options into action steps to accomplish the goal.

Positive coaching:

You ask your colleague a miracle question i.e. what would it be like if they had achieved what they are concerned about. This technique encourages the use of positive imagination to visualise what is truly desired. Ask your colleagues the following questions:

On this perfect day...

How do you feel after waking up?

What are you doing?

How do you feel as the day goes on?

Now work backwards to see the steps that they will have to have taken to achieve this.

Empathising - "I empathise with others who are in distress"

As leaders are typically in a similar environment to the colleagues they manage, they may often be feeling similar emotions to their colleagues or have felt the same emotions in the past which can helpful for empathy and to engage in an effective discussion about it which can be helpful. These experiences of similar emotions can help provide the leader with the motivation to support their colleagues and ease their discomfort (West et al., 2017). Additionally, feeling understood and valued by a leader is associated with increased engagement at work which is beneficial (West & Richter, 2007; Dutton et al., 2014; Fryer, 2013; Lilius et al., 2011). During this public health crisis, leaders need to reassure colleagues that everyone is in this together. Feelings of fear and anxiety are normal responses to the external demands and these emotions are likely to be felt by everyone at this current time. Ensure that you communicate this to your colleagues so they know that they are not alone and the current pressures on the system will be affecting everyone.

Helping - "I take thoughtful, intelligent and appropriate action to help relieve an individual's suffering"

Compassionate leaders are individuals who are willing to offer help to their colleagues. This goes beyond the management role that they take with their colleagues as part of their job description. You must be driven to take thoughtful and caring action to benefit others (West et al., 2017). It does not necessarily mean that you must fix the problems for those you lead but instead, you may help your colleagues to find appropriate solutions. For example, you could help support them with their tasks by providing appropriate resources, giving them more time or helping colleagues evaluate their best options and strategies moving forward. Albeit in the current situation, the latter is likely to be most suitable. Ultimately, a compassionate leader will become a role model and create a higher standard of compassion and care which other people are then likely to observe and imitate.
Compassionate Leadership in Health and Social Care
Each of the four steps are really important to increase the prevalence of compassionate leadership within the NHS. It is times like these when it is really important to come together and support one another. Although compassionate leadership is primarily focused on caring for colleagues which you directly lead, it is still relevant and important to show compassion towards other leaders and individuals. If everyone shows compassionate leadership in a team this will increase camaraderie and feelings of support which is really important, particularly at times of high stress and uncertainty. Ultimately, a compassionate approach to supporting colleagues may be vital in order for them to remain brave in the face of the challenges that lay ahead.

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Compassionate Leadership in the NHS during COVID-19 - Impact

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During times of global crisis, such as the unprecedented COVID-19 outbreak and the extensive challenges this has brought, it is particularly important to ensure that there is a culture of support in the NHS. Compassion and care must be a certainty for employees at a time of great uncertainty.

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Keogh (2013) Review into the quality of care and treatment provided by 14 hospital trusts in England: overview report

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Keogh (2013) Review into the quality of care and treatment provided by 14 hospital trusts in England: overview report

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Clinical leadership (both medical and nursing) needs to be strengthened and embedded throughout the organisation structure.

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Students Learning to lead in Health and Care: Healthcare systems need good leadership to deliver continuous improvements to the health and care of patients and populations. The academy is leading a national drive to embed leadership development in all healthcare professionals’ undergraduate and pre-registration programmes.  See 4 minute video below that explains the role of leadership and the student of all undergraduate programmes.  There is a Health Education England (2018) document and brief recorded Powerpoint (also on BB or download in another window as indicated)  to explain HEE (2018) and NHS Academy  (2013) leadership models

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What Compassionate Leadership Means to Me

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What Compassionate Leadership Means to Me

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Isle of Wight NHS (6 mins)

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What Compassionate Leadership Means to Me

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4.52. We will also do more to nurture the next generation of leaders by more systematically identifying, developing and supporting those with the capability and ambition to reach the most senior levels of the service (p.89)

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Health Education England (2018) Maximising Leadership Learning in the Pre-Registration Healthcare Curricula

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Health Education England (2018) Maximising Leadership Learning in the Pre-Registration Healthcare Curricula

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This document developed 3 stages of developing as a leader in pre-registration: Focus on Self, Working with Others and Improving Healthcare

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Look on Blackboard if too large to download