NHS Employee Engagement and Compassionate Leadership

A lack of staff engagement has been cited as a reason for systemic failings in the UK’s National Health Service (NHS). Collective leadership, a style that ensures that all staff takes responsibility for ensuring high-quality care for patients, is being encouraged as a way to transform the culture, strengthen engagement and deliver better care.

So the news that levels of engagement, as recorded in the NHS Staff Survey, have increased since the previous year must surely be welcomed.

Unfortunately it’s not so simple, according to The King’s Fund’s Michael West, former Executive Dean of Aston Business School, in a recent article. Only Dr Pangloss would welcome a survey of perceived ‘employee engagement’ which reported only 58% of staff 'often or always looked forward in going to work', particularly in a profession that has always attracted dedicated and committed people.

“While the survey results can be presented from a ‘glass half full’ perspective, if we see the glass as half empty then the results are disturbing.” says West, pointing out that the survey results show:

• 41 per cent would not recommend their trust as a place to work
• 57 per cent say they are unable to meet the conflicting demands on them at work
• 13 per cent report being bullied by their managers
• 15 per cent have been assaulted at work in the previous year
• Only 39 per cent feel they are able to deliver the quality of care they wish to patients
• 31 per cent did not agree that they would feel happy with the quality of care in their organizations if a friend or relative needed treatment
• Only 42 per cent agreed that their roles actually make a difference to patients.
• Only 42 per cent feel their work is valued by their organizations

The reason the Staff Survey results show engagement to be up is possibly because, with the current pressures in the system, staff have to put in more effort, longer hours, and give greater emotional support and creativity than previously to deliver high-quality care.

“But ever-increasing levels of engagement without increased support are not sustainable.” says West .

Compassionate leadership is the key according to West. Compassion is a core value at the heart of the NHS and a value that motivates its staff at all levels. Yet the survey data suggests that the way the service is being led fails to enable NHS staff, people who have dedicated their working lives to delivering high-quality care, to live that value or to fulfil their personal missions.

NHS managers, says West need to develop models of compassionate leadership. “Compassion is paying attention and listening with fascination to the other person (patients for example); understanding their distress or difficulties; having an empathic response; and taking skillful or intelligent action to help. So we need leaders to lead with compassion, and this means paying attention to staff.”

The well documented pressures on the NHS regularly hit the headlines. Along with financial pressures, increasing demand, difficulty in recruiting doctors and nurses, there are serious ‘people’ pressures that result in high levels of stress. (As the survey reports, only 31 per cent agreed there were enough staff for them to be able to do their jobs properly; 60 per cent were working unpaid overtime; etc.) But this is all the more reason for adopting a compassionate style of leadership at every level of the system and for listening, understanding, empathising and taking intelligent action to help at every level.

“Ultimately high levels of staff stress begin to erode compassion and affect care quality, patient experience and patient outcomes." says West and "It is vital that all NHS leaders recognise the imperative of developing a style of compassionate leadership to sustain the core values of the NHS. The real cost will be too great if they do not.”

Further Information

Leadership Development at the King’s Fund

2015 NHS Staff Survey