At a time of complex change and transformation in health and social care, a powerful leadership and wellbeing intervention has promoted the journey towards self-compassion for senior leaders in the NHS. The programme, which explores the three key components of self-compassion based on the latest academic research, embeds principles and supports the development of a compassionate approach with colleagues, teams, organisational processes and organisational culture. Read an in-depth review of the NHS NWLA Compassionate Coaching offer.
The NHS North West Leadership Academy (NHS NWLA) has observed an increasing need for interventions which encourage colleagues across the region, to take stock of their own health and wellbeing as part of leadership development activity. The shifting sands of health and social care transformation across the North West are creating a demanding backdrop for colleagues who are experiencing volatile, uncertain, complex and ambiguous (VUCA) environments at work.
Recent research commissioned by the NHS Leadership Academy, carried out by the Institute for Employment Studies (not yet published), highlighted resilience as a priority development area for Director level colleagues. Sense-checking this in the North West, with a local survey and various conversations, we also found that resilience and wellbeing was a continual concern to senior colleagues both for themselves, and for their workforce.
The resulting eight week programme took place from September to December 2018. This case study focuses on the first two concurrent cohorts, of five participants, run during this time. It offered a unique opportunity for senior leaders (NHS Organisation Directors, Executive Leads and those working in system level roles in transformation footprints) to work with a chartered occupational psychologist to explore self-compassion through group coaching and webinar sessions.
The Compassionate Leadership Coaching Programme package consisted of the following components;
- Four one-hour group coaching sessions online
- Access to four facilitated training webinars exploring the three key components of self-compassion based on the latest academic research, alongside activities and worksheets
- Prior to undertaking the coaching programme, individuals completed a valid and reliable measure of self-compassion and mental well-being and an insightful questionnaire which was revisited at the end of the programme
- Post-programme online workshop, one month after completion of the programme to support participants to review their progress and build a ‘Community of Practice’.
This programme, is the second compassionate development intervention offer delivered by the NHS NWLA. Compassionate Coaching has been developed and updated from evidence and feedback, with the most notable change of being a cohort intervention as opposed to individual.
In total, ten participants were allocated a place on the programme following a competitive application process. Participants were all working in senior board/sub-board roles in either provider or commissioning organisations across the North West. Application forms were designed to ask applicants about their role and how this sort of programme would benefit them individually, and at a team and wider organisational level. Themes from submitted application forms suggested that applicants;
- Wanted to target their own self-compassion to increase resilience, and work more compassionately with others
- Recognised the increased pressures for themselves and wider peers and colleagues and felt that this intervention could provide space and time to reflect on this
- Had awareness of their own role in role-modelling compassion and wanted to actively apply their learning in their teams and organisations
All delegates participated in the programme, with 70% attending all sessions and completing all activities including the evaluation activity.
Theory of change
The Compassionate Leadership Coaching Programme is based on existing explanatory models of adaptive emotion regulation and resiliency. Gentry and Baranowsky (1998) suggested that interventions that target adaptive emotion regulation and patterns of thinking in response to stressors and foster new ways of relating to work may be central to building resiliency and reducing compassion fatigue (Rees et al., 2018).
Executive coaching is a targeted, purposeful intervention that helps executives develop and maintain positive change in their personal development and leadership behaviour (Grant, 2012a). A recent systematic review of coaching outcomes identifies many benefits for the coachee (Athanasopoulou and Dopson, 2018) including personal development including better personal management and skills as well as better leadership skills, quality of interactions and relationships and work performance.
Coaching as an approach to develop leadership skill and ability is well researched and regarded as a key intervention in the workplace. Through the use of instructional webinars, that presents both the theory and offer practice opportunities to develop self-compassion in the workplace and small group coaching sessions, the leaders are provided with an opportunity to reflect on their experience of developing self-compassion and how they are bringing this to their working practice.
Through undertaking this intervention the outcomes expected for individuals were as follows ;
- An increase in Self-Compassion Scale Scores and Warwick and Edinburgh Mental Well-being Scores
- Reported behavioural change in relation to general role at work and leadership role
- Reported impact on team, end users of service (patients) and organisation
Evidence was gathered via application forms, questionnaire and programme feedback. The activity and evaluation data suggests that overall, senior leaders have welcomed the opportunity to explore self-compassion and that there have been positive impacts at an individual and wider team level in terms of the implementation of activities that support and enhance self-compassion.
"I found the coaching sessions extremely helpful, with opportunity to learn from shared experiences and perspective of others, along with chance to talk through my own thoughts and application of the webinars"
In terms of the perceived impact on their leadership roles, participants reported being more conscious of their well-being, noticing that they were more compassionate to themselves, actively taking time for self-care such as meditation, walking and hydrating appropriately. Participants also reflected that they were kinder to themselves, less critical and more accepting of finding things difficult. Other comments reflected feeling more connected to colleagues, and there was a proactive approach to disseminating information to colleagues to support the development of self-compassion more widely across teams;
"I feel I am more aware of both self-compassion and demonstrating compassion to others"
"I have started to see an impact of the course on my work; especially being more kind to myself and how I deal with stressful situations"
Practically participants also noticed improvements in practical tasks such as goal setting, effectively prioritising and delegating to others. In some cases this was having a positive impact on individual team members;
"I am kinder to myself. Better at delegating work, it is not my role to do it all"
Overall, data would indicate that the programme has positively impacted all of these areas. In addition, on revisiting the individual participants needs and objectives in attending the programme, they reported wanting to increase self-compassion and work in a more compassionate way with others, as well as wanting to better role model these approaches. The data reflected here would demonstrate that from an individual perspective, these aims have been met with examples of active self-compassion to self and others, and recognition of the impact of role-modelling highlighted across data sets.
Recommendations & lessons learned
The evaluation indicates that approaches to enhancing leadership wellbeing are valued. Consideration should be given as to what further aspects of leadership wellbeing might benefit from an approach such as this. The current climate for colleagues across the public sector is increasingly pressurised, and opportunities for time out, self-reflection and peer support, with a focus on wellbeing should not be underestimated.
The impact of the programme for the senior leaders undertaking it was considered by participants to be particularly effective due to the bespoke delivery and the nature of the programme which was held completely virtually, through group skype sessions and training webinars. This allowed greater flexibility for attendees in undertaking the programme and allowed them to apply the learning in-between group sessions, at their own pace. The programme provided a balance between dedicated sessions and self-learning which was appreciated in the feedback. Although there were some reservations initially, in terms of the online approach, preparatory work and testing the online system before the coaching/webinars took place, helped to address any teething problems. Looking at ways to replicate this style of learning in future programmes to support greater attendance going forward could be a key aspect of engaging with a senior leadership audience.
"I have never been involved in online sessions before, but the software/meeting worked really well. Great for flexibility of location and for pace of study"
This programme has been found to powerfully promote the journey towards self-compassion of senior leaders in the NHS and increase the compassion they are able to give and receive from those around them in their working environment. Participants explored the key concepts of self-compassion, tackled the barriers that may interfere with compassion development, action planned for change and provided suggestions for ongoing practice and maintenance.
The programme, which explored the three key components of self-compassion based on the latest academic research allowed the individual to undertake practice sessions to embed the principles and supported them in how to develop a compassionate approach with their colleagues, teams, organisational processes and organisational culture.
Further delivery of the programme has been recommended to support the continued self-compassion development for NHS senior leaders across the system, particularly looking at role benefit and development and the impact for individuals and across the organisation / system.