DO YOU CARE?

Care and Compassion Daljit Athwal, RGN, RSCN, RHV, MBA Programme Lead – CNO Strategy NHS England Leicestershire Lincolnshire Area 19 June 2013

Change, change and more change!!

CHI Healthcare Commission CQC

A reform is a correction of abuses; a revolution is a transfer of power.

Robert Bulwer-Lytton

Hospitals NHS Trusts Foundation Trusts Monitor National Trust Development Authority Regional Offices Health Authority Strategic Health Authority NHS England 2 Primary Care Groups Primary Care Trusts Clinical Commissioning Groups

Why does the NHS need compassion? Great-grandmother suffered as a result of a catalogue of failures during a four week period at the hospital, including not having enough fluids, which led to her death from dehydration.

Silent scandal on wards for the elderly: Three female hospital carers arrested and department shut after 'cruel abuse' of geriatric patients Mother's horror as nurse tapes dummy in mouth of her premature baby boy Unacceptable failures by hospitals to meet older people's nutritional and dignity needs have been uncovered by the Care Quality Commission Poor treatment of older people in the NHS is an attitude problem Rude, arrogant, lazy: Patients' verdict on NHS staff as two in three tell of poor care

Mid Staffordshire Public Inquiry

Mid Staffs was extreme – the dynamics are everywhere

“NHS Staff should not distance themselves from what happened in Stafford or reassure themselves that they would have done things differently, and that the same failings could not happen elsewhere” Don Berwick

Winterbourne View

The evidence around compassion

• Care and Compassion – Health Service Ombudsman 2011 • Undercover – North Manchester and Winterbourne • CQC – Dignity and Nutrition Inspections • Patients Association – Patient Stories Reports (2009-2012) • The Willis Commission Report – Quality with Compassion

Don Berwick – Normalisation of deviance

Normalisation of deviance

Philip Zimbardo (2007) – Lucifer Effect

'If you put good apples into a bad situation, you'll get bad apples.' • Mindlessly taking the first small step • Dehumanisation of self (anonymity) • Diffusion of personal responsibility • Blind obedience to authority • Uncritical conformity to group norms • Passive tolerance through inaction or indifference

To what extent do you recognise these in your own organisations?

The NHS touches our lives at times of basic human need, when care and compassion are what matter most

NHS Constitution

“If you want others to be happy, practice compassion. If you want to be happy, practice compassion.”

Dalai Lama

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Its called Compassion when …………..

co = together passion=Strong Feeling Buddhism “when we see someone in distress and feel their pain as if it was our own, and then strive to eliminate or lessen their pain, then this is compassion” • Deep awareness of the suffering of another coupled with the wish to relieve it • Empathy, as most people know, is the ability to put oneself in the other person's place. Although compassion and empathy are two separate things, having compassion for someone can lead to feeling empathy for another person.

Our opportunity…..improving experience

“People will forget what you said, people will forget what you did, but people will never forget how you made them

feel” - Maya Angelou (American author)

Building your resilience (Zimbardo)

• I made a mistake • I am mindful • I am responsible • I am Me, the best I can be • I respect Just Authority • I can oppose Unjust Authority/Systems • I want group acceptance BUT value my independence • I will be more Frame Vigilant • I will balance my Time Perspective

Compassion In Practice

Nursing, Midwifery and Care Staff vision • increase in respect for the profession • increase pride in role • improve quality of care and patient experience 3 year strategy

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Implementation Plans

• 1. Helping people to stay independent, maximise well being and improving health outcomes.

• 2. Working with people to provide a positive experience of care.

• 3. Delivering high quality care and measuring the impact.

• 4. Building and strengthening leadership.

• 5. Ensuring we have the right staff, with the right skills in the right place.

• 6. Supporting positive staff experience.

6Cs Live

"It is only when you are standing on the foundation of your values that you are able to maintain your truth, no matter what the surrounding circumstances."

Dadi Janki President of The Janki Foundation