The Interim NHS People Plan was published by NHS Improvement, NHS England and Health Education England this June. It sets out a vision for how people working in the NHS will be supported to deliver care and identifies the actions required to achieve this (NHS Improvement, 2019). The plan includes a specific chapter on improving leadership culture and aims to role model the leadership behaviours of collaboration, inclusivity and compassion.
The plan further expands on the rationale for inclusive and compassionate leadership, to ensure that all staff are listened to, understood and supported, and that leaders at every level of the health system demonstrably reflect the talents and diversity of people working in health and care services and the communities they serve.
In theory, this all sounds like a sensible approach—but as leaders, where do we start? My Trust has just begun a 2-year programme that was developed by NHS Improvement, the Centre for Creative Leadership and The King's Fund (2019) to develop cultures that enable and sustain continuously improving, safe, high-quality, compassionate care. The programme is split into three phases:
The Trust board were fortunate to be joined by Professor Michael West, whose team co-designed the Culture and Leadership Programme. He also gave a lecture that was opened up to all of our staff.
I am always concerned that compassionate leadership runs the risk of sounding soft but, as outlined in the programme, the focus on culture and leadership can enable NHS organisations to address a number of areas that have been highlighted in some of the national reports. These are concerns relating to:
The opportunity for improvements in ‘improvements culture’ and leadership was the focus of Professor West's opening remarks in his discussion with my Trust board. He very clearly told us that compassionate leadership is not ‘fluffy’, it is about dealing with poor behaviours and moving out of organisations individuals who display poor behaviours, up to and including risking the Trust losing at employment tribunals. In addition, as discussed in a King's Fund document, West's work requires a number of myths to be addressed to ensure that people see the value of compassionate leadership (West and Bailey, 2019).
These myths are that compassionate leadership will mean:
Professor West discussed the current challenges facing the NHS with us—predominantly focused on the recruitment and retention of our workforce. Part of the reason behind this is the sustained work overload staff face, which has been increasing over time. This has led to high levels of staff stress (50% higher than in the working population as a whole), harming the physical and mental health of staff across the NHS.
Professor West's mantra is that:
‘Compassionate leadership in practice means leaders listening with fascination to those they lead, arriving at a shared (rather than imposed) understanding of the challenges they face, empathising with and caring for them, and then acting to help or support them. Such leadership will help us begin to address the problems the service faces because top down national solutions are not working. Meanwhile, patient care and staff health are being undermined.’
My take-home message as a leader is that our roles are to enable compassionate and inclusive leadership, which will in turn give freedom to teams to act in the interests of our patients. The research from West's team shows that this will in turn lead to sustainable clinical, operational and financial performance delivery.