Compassionate leadership

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:

  • attending
  • understanding
  • empathising
  • helping

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?

Leadership Management
Influencing Authority
Can be an informal role A defined role
Independent Work and task focused
People Focused Policies and procedures
Values based Budgets
Inspiring Power and control
Innovative Capacity and demand
Questioning Give directions
Proactive Reactive
Risk and change Maintains the status quo
Have followers Have subordinates

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:

  • attending
  • understanding
  • empathising
  • helping

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].