Leaders and managers have a significant impact in shaping organisational culture. Leadership style has been shown to influence a range of important outcomes in health and social care settings. These include; patient care and satisfaction, staff wellbeing, staff turnover and absenteeism.  

The following articles provide information and resources for leaders and managers in health and social care settings. 

Compassionate workplaces require leaders who are able to demonstrate compassionate behaviours such as listening and responding to staff needs. 

Compassionate leadership training can help support leaders to hold conversations with staff and build a culture where compassion and care are valued. The right support from managers can help staff feel a greater sense of belonging and allows their personal welfare to be valued and recognised.  

Research demonstrates the positive impact compassionate workplaces have on staff morale, retention and sickness levels. 


Behaviours of compassionate leaders

The four key behaviours that the King’s Fund model of compassionate leadership seek to strengthen are:  

  • Attending – pay attention to staff by ‘listening with fascination’ and without judgement.  
  • Understanding – arrive at an understanding of the challenges staff face through a dialogue with them.  
  • Empathising – empathising with staff and the stresses and pressures they may be facing.
  • Taking action – taking decisive action to enable staff to do the job that they want to do. 

"Research reveals that leadership is the most significant influence on culture. Every interaction by every leader, every day, shapes the culture of the organisation. We must develop and continually reinforce the right leadership values and behaviours – such as developing and empowering people, encouraging shared learning and continuous improvement." - Professor Michael West, 'If it's about NHS culture, it's about leadership'

"A compassionate leader encourages employees to talk about their problems and to provide support for one another." - Roffey Park, 'What is Compassionate Leadership?'

Watch: in this video below Michael West shares his thoughts on compassionate and inclusive leadership for a recent event The challenge of culture change: sharing system-wide learning to deliver the NHS long-term plan. 

  • NHS England have compiled a range of resources on compassionate leadership. These may be useful if looking at how to introduce more compassionate leadership into your organisation as a whole.  
  • Blog: The Kings Fund - "If it's about NHS culture, it's about leadership" - Professor Michael West describes the impact of individual leaders on the culture of an organisation, and the early development of the NHS Culture and Leadership Programme. 
  • Roffey Park – ‘What is compassionate leadership?’ this paper outlines 5 compassionate behaviours and provides a short quiz to consider how compassionate you are as a leader. It also outlines the research base for compassionate leadership in the workplace. 

The NHS London Leadership Academy are a pan-London NHS leadership development organisation, working to support leaders across London. They create time and space for leaders to learn together, creating connections across London and building networks, to enable them to deliver the best care possible to patients and service users across all workstreams, including systems, primary care, leadership, and coaching and mentoring.

Executive Suite

exec suite.PNGThe Executive Suite provides a range of opportunities for senior leaders to both access support and development for themselves and, to aid them in also supporting the development of their staff.

The suite is open for those working in executive roles, including CEOs and AOs designed to support a resilient leader, continue to thrive in your role, and set cultures that value the importance of health and wellbeing.

Explore the Executive Suite here.

 
#ProjectM

#projectm.PNGA place and space for team leaders and managers to connect, share and learn together. Includes a wider offer to managers and leaders throughout the system, delivered primarily through Twitter as a means of creating the space for people to make connections.

Find out more about #ProjectM here.

NHS England outlined in the NHS People Plan 2020/21 that all managers should hold wellbeing conversations with their staff, and that every member of the NHS should develop a personalised plan.

Wellbeing conversations are a key part of the NHS framework because they are designed to help nurture the recovery of staff and help managers to guide staff to additional support and to reduce the long-term impact of their distress.

“Health and wellbeing conversations are intended to be regular, supportive one-to-one coaching-style conversations that focus on NHS people’s wellbeing. The conversations aim to consider the whole wellbeing of an individual, to identify any areas of their life where further support may be required.”  - Our NHS People, What is a Wellbeing Conversation?

Watch wellbeing conversation videos

A short 3 minute video from NHS Employers to support and guide line managers through wellbeing conversations and a short staff experience video on how wellbeing conversations helped them personally and why they are important.   

We know that the wellbeing of our NHS people can be affected by all kinds of factors at work.  Workload, capacity, relationships with colleagues and the physical working environment can all have an impact.  Likewise, factors outside work, including lack of sleep, financial worries, health conditions, caring responsibilities and other personal circumstances, can have an impact – especially if they have changed recently. 

The NHS People Plan encourages all NHS organisations to create cultures where our NHS people have regular wellbeing conversations with their line manager or a trusted colleague.  These wellbeing conversations could be held as standalone conversations with a colleague, or incorporated into existing conversations, such as regular 1:1s or during check-ins.  You could also touch base during team meetings or shift handovers to see if anyone would benefit from a follow up conversation.

In most cases, a health and wellbeing conversation will be held by a line manager or supervisor, but in some instances colleagues may feel more comfortable talking to another trusted colleague about their wellbeing.

We would also encourage that, across an organisation, teams actively support one another by regularly checking in.

Tip: For some, holding a wellbeing conversation may feel daunting at first. It is important to remember that you are not being asked to provide clinical advice – your role is to hold the conversation, actively listen to your colleague, be compassionate and signpost to further support.

Whether it’s taking place virtually or in person, it’s important to hold a  wellbeing conversation in a safe, confidential space.

Before you start the conversation, take a moment to reflect on any cultural considerations that may be relevant.  For example, if you are aware that your colleague has recently experienced a bereavement, consider the different bereavement practices that they may follow depending on their religion or beliefs.  Be aware of any religious festivals or events that are taking place that may have an impact on your colleagues wellbeing, such as fasting during Ramadan.

A great way to start the conversation is by simply asking ‘how are you?’ and allowing your colleague time to reflect and respond.  Actively listen to their response and allow the conversation to flow.  Where needed, follow up with further open questions such as “how are you, really?”, “is there anything that is currently having an impact on your health and wellbeing?” or “how can I best support you?”.

Tip: Some colleagues may not feel comfortable talking about their personal health, and it is important that as a line manager, you reassure them that this is ok.  Perhaps make a suggestion that the conversation will be followed up at a later date.

Staff experiences

Watch a short staff experience video on how wellbeing conversations helped them personally and why they are important.   

What is trauma? 

Trauma can be defined as a response to a distressing or disturbing event or set of events. Trauma can result from a variety of sources, including adverse childhood experiences, relational difficulties, race-related experiences, violence, terrorism or accidents/disasters. Research suggests there are a variety of common experiences after exposure to trauma. 

Psychological responses can include, but are not limited to, intrusive thoughts or flashbacks, feelings of guilt, anger, stress, sadness or numbness. Physical responses may include difficulties with sleep, hyper-arousal (an increased state of alertness), increased heart rate or fatigue.  

Some examples of traumatic events which may occur within health and social care settings include:

  • witnessing or experiencing an assault or verbal abuse
  • terrorist attacks
  • or events which cause high patient mortality (for example due to the Covid-19 pandemic). 

Some staff, such as first responders and social workers may be more likely to experience trauma at work, although traumatic incidences can affect any team.  


Vicarious trauma (also referred to as secondary trauma) is where a person does not experience trauma first hand but is exposed to traumatic material indirectly through hearing, seeing or reading about another person’s experiences. Staff who are engaged in supporting people who have experienced trauma may experience secondary traumatic stress as a result.  

The National Fund for Workforce Solutions suggest that identifying trauma and its impact within a workplace is not always simple. They propose that many employees may not want their employer to know they are struggling. When staff members are experiencing negative impacts of trauma it may not be obvious and may present as absenteeism, presenteeism or high staff turnover within services.  

Managers should be aware of the service and/or local policies and procedures to follow in response to traumatic or risk related incidents. The Centre for Health Care Strategies advocate for the development of organisations which are both physically and psychologically safe for staff. Line Managers can support staff by facilitating access to psychological first aid and wellbeing conversations. 

Managers should also make staff aware of services which are available to them such as Keeping Well NWL, Employee Assistance Programmes and Occupational Health.  

There has been a movement towards trauma-informed approaches within many health and social care settings. For example, the NHS long-term plan commits to developing trauma-informed approaches for organisations supporting adults with mental health difficulties and young people in contact with the criminal justice system.  The US governments trauma and justice strategic initiative (SAMHSA) suggest that the goal of trauma-informed approaches (also known as trauma informed practice or care) is to ensure that all staff are aware of the wide impact of trauma. Trauma-informed approaches aim to promote care which fosters recovery from trauma and prevents the re-traumatisation of clients and staff.   

SAMHSA suggest that staff should experience their workplace as “safe, inviting, and not a risk to their physical or psychological safety”. They have developed a framework of trauma-informed practice which involves four key assumptions that organisations should embed into practice: 

  • Realising the widespread impact of trauma and pathways for recovery.  

  • Recognising the signs and symptoms of trauma in staff and clients. 

  • Responding by integrating knowledge about trauma into policy, procedures and practices.  

  • Resisting re-traumatisation of clients and staff by facilitating supportive and proactive services. 

Preliminary research has begun to examine the impact of trauma-informed responses to support staff well-being during the COVID-19 pandemic: 


Have you thought about creating wellbeing roles within your team?

There are many to consider, including wellbeing guardians, wellbeing champions and Mental Health First Aiders. All roles are different, although the terms are sometimes used interchangeably, and the definitions we are using are below:  

Wellbeing guardians 
  • A Wellbeing Guardian is a senior member of staff who takes forward the wellbeing agenda within their organisation. 

  • They typically take an assurance role at Board level, in which they look at the organisation’s activities through a health and wellbeing lens.  

  • NHS England recommend that the role is best suited to a Non-Executive Director. They should be able to check and challenge the executive team, but do not need to have specialist wellbeing knowledge.  

“As a Wellbeing Guardian, you have the opportunity to make a real difference in your organisation, placing staff health and wellbeing at the heart what we do. You will be in an ideal position to support, influence and seek assurance from your senior leaders, creating a culture of wellbeing where the organisation cares for its people, who care for others.”  - NHS England

Wellbeing champions
  • Organising informal catch ups within the team 
  • Encouraging participation in current wellbeing activities within the team  
  • Encouraging the team to input their ideas for promoting wellbeing 
  • Raising issues with senior staff on behalf of the wider team 
  • Liaising with senior staff to introduce training for teams that require additional support 
  • Creating a team display board to celebrate successes and to share ideas 
  • Communicating with colleagues within team to find out their different interests and pastimes  
  • Organising social activities outside of work, i.e. team away days 
  • Encouraging a culture of kindness, appreciation and compassion 
Mental Health First Aiders
  • Mental Health First Aiders are members of staff who receive training to identify anyone who is developing a mental health problem, experiencing a worsening of a mental health problem, or in a mental health crisis.  

  • Their training teaches an in-depth understanding of mental health, enhanced interpersonal skills such as non-judgemental listening and the knowledge to help guide others to further support.  

Would you like further information on wellbeing roles in a work environment? Click here for more.

Resources throughout the Keeping Well Academy will be helpful to a wellbeing guardian who would like to study more about how wellbeing is shaped by the workplace, and what organisations can do to improve wellbeing.  

NHS England provide information to welcome new Wellbeing Guardians and offer resources to support the role. They cover the following areas mixing video and written content:

Have a read of the NHS Wellbeing Guardian guide for further information about the role and expectations.

Covid-19 support

Whether you are an employee or manager, you might find yourself recovering from Covid-19 or supporting someone who is.

NHS England and NHS Improvement has curated resources to aid 1:1 conversations around staff vaccine hesitancy. For further information on how to have a 1:1 conversation to support vaccine uptake, please see the Guidance to support COVID-19 vaccine uptake in frontline staff.

Visit the NHS England website for further toolkits and resources that include:

  • Breastfeeding, fertility and pregnancy
  • Ethnic minority communities
  • General resources for specific target groups
Watch needle phobia video

Ciara, Keeping Well CBT Therapist where she talks about the effects of needle phobia, how to use a common coping technique and where health and social care staff can find support. 

The Keeping Well service are also available for consultation to support teams, contact us to find out more.