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9th April 2020

Compassionate Leadership in the NHS during COVID-19

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:

Compassionate Leadership in the NHS during COVID-19 1

(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.