News: Government and Ombudsman must improve handling of NHS complaints

The Government needs to take action to improve the NHS complaints system, properly investigate cases of historic injustice and modernise the legislation for England’s Ombudsmans’ services, the Public Administration and Constitutional Affairs Committee (PACAC) says.

The Parliamentary and Health Services Ombudsman is the final tier of complaint for people unhappy with their experience of the NHS in England and Government departments. Last year it received 31,444 new complaints, 88% about the NHS.

Slow progress

PACAC’s report on the PHSO’s work in 2016-17 agrees with the PHSO’s new Chief Executive that the time it has taken to investigate complaints is, “simply unacceptable”. The Committee is also calling on the PHSO to improve how it supports often very distressed complainants, and to get better at showing how its investigations help improve NHS’ services for future patients.

However, many of the challenges the PHSO faces are made harder by the Government’s slow progress on reforms to the complaints system. PACAC therefore calls on the Government to accelerate the legislation to modernise the Ombudsman and on the Department of Health to improve local NHS complaints handling and to properly resolve the historic cases where families feel they are still being denied justice.

Chair’s comments

Chair of the Committee Bernard Jenkin said:

“Although it has much more to do we are cautiously confident that the PHSO under the new Ombudsman Rob Behrens is now on the right track. We welcome the personal commitment he has shown to rebuilding trust in the PHSO and improving the service it provides to the public.

As a Committee we have heard from families left distressed and traumatised by making a complaint to the NHS and the PHSO. Too many people still have to complain to the Ombudsman because public services don’t deal with their complaint properly in the first place.

The Ombudsman and his staff do a difficult job. The Government can help them by introducing the reforms it has already promised. Ministers told our committee two years ago that improving NHS complaints was “unfinished business”. It is now time for action, and for the Government to introduce the long awaited legislation they have already published.”

For more information on work that C&C Empathy Training for on complaints, improving the experience of those raising complaints and extracting the relevant emotional information, click here

Email   OR call on 07541 798 949

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Interview with an emergency doctor about his search to find his empathy again – a humbling read

Dr Brian Goldman, an emergency room physician, at Toronto’s Mount Sinai Hospital, always felt himself to be a thoughtful doctor, that was until, 30 years into his career. Goldman, accused by the loved one of an elderly patient, of being unkind, found himself in the position of wondering if this was the case? He subsequently did some very honest thinking, analysing of his behaviour and perceived attitude; had he really lost his ability to have or at least demonstrate empathy?

This led Goldman on a 2-year global journey and subsequent book The Power of Kindness: Why Empathy Is Essential in Everyday Life. The below interview by The Star shows some of the deeply human experiences that have empowered Goldman to not only ti use his clinical skills in his work but utilise that human connection, of which empathy plays a powerful role in.

Much study is done on burn-out, with often conclusions stating that the more empathic the health professional is, the quicker they burn out. What often is overlooked though, is the empowering benefits us human beings get from connecting with others. Whether this is in a clinical role or everyday personal life. The problem arises with no support is there for us, when long working hours deplete our energy levels and resilience, when a lack of empathy shown back to us from those in leadership roles is evident, and when  systems and sometimes even patients and loved ones, yes, fail to show us empathy and kindness, then of course, any human being, including any nurse or doctor, can get burn out.

When I train in empathy, one of the things I draw attention to is the need for it to be two way. Whatever our job role, or gender, age or race, we all have the need for empathy and kindness, compassion and care (self-care too!). Burn out occurs from giving too much and not getting enough back, allowing for an imbalance and depletion in our empathy levels. Let’s be honest, we can even get burn out with our own children (particularly teenagers) when we are giving so much and they fail to empathise with us! And we love them!! Dr Goldman, however, listened to someone’s assessment of him and asked himself some honest questions and as a consequence has empowered himself professionally and personally in doing so.

Having lost my child in a hospital and challenged the lack of empathy shown towards me in the aftermath, (forming part of the training I now do with healthcare professionals and complaints teams now), if I was one of the relatives that spoke so honestly to Dr Goldman, on reading the below article I would feel not only empathy for him and kindness but uplifted also. A humbling read.

Original article: 

brian_goldman_cred_christopher_wahl_The emergency room physician, Dr Brian Goldman,  knew he was a thoughtful doctor and a caring husband and father. But he wondered whether his 30 years of treating patients in a busy downtown hospital had worn away his empathy.

Those brooding thoughts turned into a two-year search for kindness that took him across Canada and around the world. On his travels, Goldman, who is also the host of CBC Radio’s White Coat, Black Art, interviewed top neuroscientists, hung out in laboratories and underwent psychological testing to determine his own capacity for kindness.

But even more important to his pursuit, he says, were the extraordinarily kind people he met along the way.

Goldman has turned his journey into a book that describes these encounters and details his own reflections on what it means to be kind.

In , readers get to meet, among others, a woman from Sao Paulo, Brazil, who reunites a homeless poet — a man she calls her soulmate — with his family, the bar owners in New York City who have created a safe space for 9/11 first responders and Mark Wafer, who owns six Tim Hortons restaurants in Scarborough and who has made it a priority to hire people with disabilities.

You tell us at the beginning of the book that you worry you have lost your kindness, that the empathy you remember having as a kid is no longer with you. Is there one particular moment that sticks with you from your career as a physician or from your family life that made you think that you had lost your kindness?

Yes, indeed. It happened when I saw an elderly woman in the emergency department who was in the advanced stage of a degenerative disease. The family had brought her to the emergency department because, though they had been doing their level best to care for her at home, they felt they could no longer do so. She had no acute medical issues that required immediate admission to hospital — she wasn’t dehydrated, she didn’t have pneumonia, she didn’t have a fever — but they were at the end of their rope. They wanted her to be admitted. In fact, I did that. But I wasn’t kind about the way I did it. There was something begrudging in my attitude. At one point, one of the family members asked if I had done the referral and I snapped at this person. A few months later, the woman had passed away and the husband wrote me a letter, inviting me to meet with the family. He told me flat-out in the letter that he thought I was unkind, and the reason he wrote the letter was because he thought I was salvageable, that there was a human being under that moment of unkindness. Eventually, I met most of the immediate family and we all had a good cry in that meeting. It was that encounter, more than any other, that set me on this road and made me want to look inside myself — and also around the world to try to figure out what kindness looks like.

Kindness is the most important thing we learn in kindergarten. As we get older, it seems to matter less and less in our institutions. Why is that?

That’s a tough question. There are many reasons. Christian Keysers (co-director of the Social Brain Lab at the Netherlands Institute for Neuroscience in Amsterdam) told me that we are all hard-wired for empathy, but we also have this giant frontal lobe (in our brain) in charge of executive function. Keysers said to me that empathy is a choice — not including psychopaths and Machiavellians and narcissists — but for all the rest of us, empathy is choice. And for the rest of our lives we will have these competing interests in our daily priorities. So, you’re running to catch the bus for an important job interview and you see a child who has fallen off her tricycle. At that moment, you have to weigh your important job interview against this child who needs you. We are constantly weighing what it is to be kind in the moment. I think the reason why it gets more difficult to be kind is because we have so many competing interests that it taxes our ability to do the right thing at the right time.

You work in medicine, so data and double-blind studies are kind of your thing. But for this book, for the most part, you chose to write about individual people. Why did you focus on stories, rather than studies?

To me, kindness isn’t found in studies. It’s found in the one-on-one relationships between partners, between a therapist and a client, between a mother and a newborn baby, between two friends in a coffee bar who are matching each other’s hand gestures and speech patterns. I included some studies, where they were pertinent, because there is fascinating research into empathy and kindness. But I knew that if I wanted to become a kinder person, I needed to learn from the examples of other people who are kind, by finding out their stories. And I also know that in the emergency department, when I’m seeing patients, it’s not studies that count, it’s me and how I interact with the patients that count.

On your journey, you met many extraordinarily kind people. Is there one person who sticks with you, one person who you think of more than others, even now that your book is complete?

I think most often of Naomi Feil, the woman who pointed out to me, for the first time in my career as a health professional, that people at the end-stage of dementia who say things repeatedly and seem agitated are doing and saying those things for a reason. And, if you give them an opportunity to express what they are feeling, and not try to pull them back into the here-and-now, you can help them by validating their feelings, so they can release those feelings and be less agitated. No one taught me that.

That would be a useful lesson for a physician, but also as a human. Have you had an opportunity to use that lesson since meeting Naomi?

Yes. Since then I’ve had loved ones with dementia, including my father-in-law. Whenever I would see him, I made a point of never testing his memory to see if he seemed disoriented. I wanted him to know that I loved him for who he is and not for what he remembers. And I’ve used that kind of approach, thanks to Naomi Feil, in the emergency department as well.

What steps are you taking to bring back your kindness?

First, I breathe. I breathe into a count of six. I hold my breath to a count of six. And I exhale to a count of six. I’m breathing, I’m feeling air entering my lungs, it helps to centre me. Second, I clear the clutter in my heart and in my head. I try to let it float by like a balloon or a float in a parade. Any intruding thoughts — a bad memory, a conversation that didn’t go well, somebody who doesn’t have nice thoughts about me — I don’t judge them, I just let them float by until they’re gone. I try teleporting myself to the ceiling. I try mentally floating over to a spot above the person that I’m trying to be kind to and I float down right beside them. I imagine I’m with them. How are they feeling? How is life going? What’s bugging them? And finally, I remember to smile. Not smirk — smile.

What is the one thing we can all do today to make the world more kind?

The sweetest kindness in the world is the unexpected kindness. It often comes from people who you believe to be your enemy. You can’t control how they think about you. But you can certainly change things. And the way to change things is be unexpectedly kind to them.

This conversation has been edited for length and clarity.


5 tips to embed empathy into an organisation and health/social care and medico-legal specialist empathy training

5 tips to embed empathy into an organisation from a study by Business Solver, a USA based organisation. 

Click on this link for health/social care and medico-legal specialist empathy training, or see details below.

Mind the Gap Recognize the challenges facing job roles and levels, and how the gap between what employers think about workplace engagement versus what employees actually think could be causing problems.

Embrace Differences Across Your Organization Create more empathy in the workplace by embracing different backgrounds, genders, age groups, and working styles — the result can be a stronger patchwork of engagement.

Build Empathy Muscles — and Leadership Mindset Learn how to put empathy in practice through words, actions, and business policies/offerings. Even more importantly, learn how to practice it in day-to-day activities and interactions. Gain a clear understanding of where your organization currently stands in terms of empathy (seeking out professional assistance here may be a good idea to get an objective opinion), and then develop a plan to execute empathy training.

Walk the Walk…Over to Your Co-worker’s Desk Understand the ways to exhibit empathy — through 1:1 interactions and personalized communications, and practice what you preach through daily interactions with others.

Keep Your Eye on the Prize The ultimate goal of an empathetic workplace is a more engaged employee and, therefore, a stronger bottom line. It’s not an approach or process that happens overnight, but it has the power to transform a business

The “Reverse Golden Rule” tells people to “treat others how they want to be treated.” This well-known adage might just be the key to connecting people through a shared workplace culture. Empathy impacts the way we experience the world around us and how we interact with others. At a time when empathy is at the forefront of conversations on a global scale, it’s more important than ever to understand the practical applications of empathy in daily life and how to reap the benefits of empathy in the workplace.

CarolynThis is based on multiple organisations. My company C&C Empathy Training, concentrates on the health/social care sector and medico-legal and works with these organisation and their very valuable staff on how to use empathy in leadership roles, in complaints and serious incident situations and patient safety. I believe, at the heart of any learning, each organisation and each individual must have the desire to wish to learn, and if not present before the training takes place, then leave with that desire to from feeling engaged in the training they have just received.

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That’s what people who attend my training feedback to me, their desire to be more empathic from attending my session. That’s the key, that personal motivation. Hearing examples of the real life effect of the absence and presence of empathy weaved throughout any conference session, or full day creates this desire. With 100% recommending my courses and 100% rating them as relevant to practice, I have no doubt of the positive impact empathy and empathy training can have on people’s professional and personal growth.

Click on image for an overview of services offered by Carolyn and C&C Empathy Training

Example comments:

  • I found it a really powerful session, which made me reflect on how processes and systems can block empathy and also how we sometimes think we are listening to someone but we really are not
  • Very powerful message – will always remember
  • I hung onto every word as it was relevant, important and well presented. The points touched upon will help me as I support individuals and families to obtain answers to questions regarding care and treatment of their loved ones.


News: Government to protect NHS whistleblowers from employment discrimination

Empathy and emotional awareness within the field of NHS complaints, quality, patient safety, and leadership are the essence of my lived and breathed work.

CarolynComing from a counselling background but significantly following the loss of a 15-year-old child in a hospital, I now train healthcare and legal professionals on many aspects of what gets in the way of honest sharing and understanding vital emotional data to prevent prolonged psychological harm (Duty of Candour) for all involved. So I am pleased to read that further steps are going to be taken to support staff working in the NHS.

‘NHS whistleblowers will be protected from discrimination when applying for another job in the health service under draft regulations introduced by the Government on 19th March, 2018.

Part of efforts to make the NHS “the safest healthcare system in the world”, the proposed powers mean NHS employers will not lawfully be able to discriminate against job applicants who have previously blown the whistle on potential risks to patient safety.

Any applicants who face discrimination will get legal protection and NHS employers will face tough penalties if applicants’ complaints are upheld.

For too long we have failed to protect those who are brave enough to speak out when others won’t Caroline Dinenage

The move is part of the Government’s wider drive to develop a culture of openness and transparency within the NHS.

Caroline Dinenage, Minister of State for Care, said: “These important measures should ensure staff can raise concerns knowing they are protected by the law and that their career in the NHS will not be damaged as a result of wanting to do the right thing.

“For too long we have failed to protect those who are brave enough to speak out when others won’t.

“We want to make the NHS the safest healthcare system in the world so we must build a culture of openness and transparency among our staff.”

The changes were a key recommendation in Sir Robert Francis’ Freedom to Speak Up Review, which found a number of people struggled to find employment in the NHS after making protected disclosures about patient safety.

The measures sit alongside existing initiatives, which includes a Freedom to Speak Up Guardian role within every NHS organisation as well as nationwide pilots to support NHS whistleblowers and help them back into work.

Subject to parliamentary approval on March 19, the regulations will give applicants a right to complain to an employment tribunal if they have been discriminated against because it appears they have previously spoken out.

It will also enable compensation to be awarded if a complaint is upheld.’

Promoting a collaborative responsibility towards the NHS and on the basis that whether patient, loved one (like I was), nurse, consultant or CEO, each and every person is a human being. A human being that is fallible and vulnerable, as well as strong and compassionate. Driven by emotions and fears. Having gone through the NHS complaints system myself, and now working with many complaints staff, to empower and inspire staff to be open and honest, providing care and protection also is vital in promoting a psychologically healthy NHS as well as safe one. All supporting an emotionally healthy culture for staff, that can be then transferred to the patients and loved ones.

New format CCET PNG To see more of how I can work with organisations to promote an empathic and emotionally aware culture, click on the brochure or here

For testimonials see here


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News: Trusts have improved because they have strong, visible leaderships that is compassionate and inclusive, says Dr. Paul Lelliot, deputy chief inspector of hospitals

 Strong leadership is vital to deliver improvements in mental health trusts, according to the CQC. As they call for improved leadership.

The commission has today published a report exploring how seven NHS mental healthtrusts have made significant improvements in the quality of care.

It found that there were common themes driving improvement across the featured trusts, with strong, visible and listening leadership being vital.

Inspectors also found that good leadership and good governance “go hand in hand,” and most of the trusts had made changes to their systems and processes to drive improvement.

The report features specialist mental health trusts that have achieved significant improvements on re-inspection, as shown by their CQC ratings.

The featured trusts were Oxleas NHS Foundation Trust (FT), Somerset Partnership NHS FT, Lincolnshire Partnership NHS FT, South West Yorkshire Partnership NHS FT, North Staffordshire Combined Healthcare NHS Trust, Calderstones Partnership NHS FT, and Sheffield Health and Social Care NHS FT.

For many trusts, a poor CQC rating was a stimulus for improvement, with CQC reports used as a ‘springboard’ to make changes.

The report found that good leaders engage and empower staff, and that cultural changes support improvement.

It notes the importance of an environment where staff feel empowered to speak up, as well as the benefits of looking outward, working with other organisations within the local health and care system and voluntary sector.

Good and improving trusts recognise that lasting improvement depends on organisations working together, as well as taking into account the views and experiences of patients and the public.

Dr. Paul Lelliot, deputy chief inspector of hospitals and lead for mental health, said that it is “encouraging” that these trusts have demonstrated their ability to improve, whilst the mental health sector struggles with challenges including an unprecedented demand and workforce shortages.

He said that these trusts have improved because they have strong, visible leaderships that is compassionate and inclusive, which engages and empowers front-line staff, unlocking their full potential to develop and improve care.

“In this report, we give examples of how these trusts have worked hard to strengthen their leadership through training, mentoring and development; including through working with NHS Improvement.

“In particular, the report emphasises the essential role of strong clinical leadership that ensures that medical and nursing staff are fully at one with the trust’s ambitions,” he added, encouraging others to learn from the case studies to help them in their improvement work.

Original source:

A Journey Through Leadership Using Empathy

A journey in Leadership using empathy

Key Learning Outcomes:
– Who are we? Understanding & developing the human connection
– How to identify and understand emotionally focused thinking and practice and staff focused leadership
– How lack of empathy in one-on-one encounters has the potential to cause psychological harm, how to respond to others using empathy
– How to cultivate empathy and inclusive leadership- communicate at a deeper level
– How to use your new skills to enhance the human connection and handle difficult conversations
– How to manage empathy to prevent burn out and improve retention
Understand reflexive leadership and how to use these skills for staff well- being and productivity


Description: This one-day course examines, in a unique, thought provoking and human way, the important role empathy and emotional awareness plays in inclusive leadership, staff well-being and productivity, and what erodes it. Delegates will develop understanding of the psychology of emotionally focused thinking and outcomes and learn essential skills to understand and implement effective relationship focused work, underpinned with empathy and emotional development.

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C&C Empathy Training packages:

Click on link to see the full range of packages that C&C Empathy Training can help you with embedding empathy into your organisation.


News: Nursing Times highlights a ‘bullying culture’. Managing harmful behaviour.

An article published in the Nursing Times talks of a ‘bullying culture between accident and emergency department nurses at a hospital trust in Merseyside has led to “tribal divisions” between staff and has been perpetuated by bosses failing to intervene, an independent report has found’. It goes on to say….

‘The behaviour has been going on for many years and is aimed at newly promoted band 6 sisters, according to the report on Arrowe Park Hospital, which is run by Wirral University Teaching Hospital NHS Foundation Trust.

Unedifying” comments were made by staff about colleagues, which suggested they did not understand one another’s role, expertise or personal circumstances, said the researchers.

It includes nurses undermining colleagues in front of less experienced staff, “aggressively” challenging their decisions, withholding information, and making comments suggesting they did not deserve the promotion, said the report.

They warned that these behaviors had been allowed to persist due to senior staff failing to address the issues.

“By allowing them to go unchallenged, people have at least been given passive permission and at worst, inadvertent encouragement to behave badly.’                                           Carolyn

It is very sad to read an article about bullying in nursing, indeed bullying in any environment, as nurses are no different from anyone else, human beings, capable of immense care and also uncompassionate behaviour.

With the work that I do with healthcare professionals on developing and communicating empathy and their own emotional awareness, alongside my background of counselling, people are always interested in understanding where bullying behavior comes from. The unconscious processes often play emotionally and how often we don’t understand the psychological damage it can do to the person on the receiving end.

Although my training is not about bullying specifically, the areas looked at explores the power and lack of empathy toward another, along with a lack of emotional awareness, both individually and organisationally. However, it does this through analysis of a case study, my story, that in fact has elements of the above but in a situation whereby my openness and honesty, allow people to feel empathy, and challenge their own thinking and biases, in a supportive, non-threatening environment. 

We all carry around many influencing factors in how we communicate and behave. We all have the ability to be manipulative and defensive, as well as kind and open. We all catch emotions from another (why culture is so important). Leaders often screenshot-11ask me the best way to develop empathy in their organisation, and my answer is, for it to be demonstrated from the top. With empathy being one of the most crucial skills in leadership, it is vital that the message is loud and clear in the cultural vision.

We all have our own ‘Funnel of Life’ to contend with. It’s why honesty from others about their vulnerabilities and unhelpful emotions, as well as helpful ones, speak again and again to the many people I work with in training workshops, or conferences. Screenshot (236)

woman-2696408_1280Behaviour that causes psychological harm to another, must always be challenged, I have suffered psychological harm from healthcare professionals myself, and bullying attitudes. The change though comes in people the most when they actually understand why they act as they do, and start to recognise the impact they are having on another and desire to act differently. Empathy and emotional awareness are key factors in this. Often to get to that point, however, you need to create the right environment to for people to start to examine themselves and who they actually want to be in a supportive way.  

Carolyn Cleveland, C&C Empathy Training #empathyenvoy 

original news source:

Visit my website for more information

“You’re the best physician I’ve ever worked with.”

Oncology fellow at Duke University Medical Center, Jeremy Force, who had never met this particular female patient but, was assigned to stop by her room to discuss her decision to enter the hospice.

Having just attended a course on using empathy to benefit clinical outcomes through understanding patient stories, Force used new found skills to try and understand the emotional experience of this patient at a point where clinical skills were not going to cure her. As he listened intently, not always an easy thing to do as we so often want to ‘fix’ things, the female patient cried. She expressed that she was exhausted and worried about the impact her death would have on her two daughters.

Force acknowledged how hard what she was going through was during the 15-minute conversation they had and shared with her he also had two children and that the hospice was designed to provide her additional support. When he saw her a few day later in the corridor, this patient said to him, “You’re the best physician I’ve ever worked with,” Force remembers her telling him. “I was blown away,” he says. “It was such an honour.”

This story is a couple of years old but it is worth telling again as empathy in communication and the importance of listening to what I refer to in my empathy training as the emotional data to understand the emotional experience of another. Whether I am working with complaints and serious incident teams, patient experience teams, clinical frontline staff or those in leadership roles, it is the emotional experience that they are supported to hear, feel and understand. Missing this vital thing is to carry out often procedures in an exemplary manner, yet leaving someone feeling unheard and sometimes uncared for; the total opposite of what most in the healthcare system who go through rigorous training and grueling workloads, to achieve.

There is now such overwhelming evidence that has linked empathy to greater patient satisfaction, better outcomes, decreased physician burnout, and a lower risk of malpractice suits and errors. Understanding another’s experience is an important part of making a human connection. A human connection that not only supports and gives to the patient but supports and gives back to the medical staff.

Being a good healthcare professional means understanding people not just clinical skills, but I would argue too that being a good patient, requires understanding your healthcare professional too. Empathy is part of communication and communication is not one way. The doctor, for example, building an empathic human connection, allows for this to develop from both sides.

I experienced this from my GP who cared for me, and I do not use that word lightly, because that is exactly what I felt, cared for, when my adopted daughter died unexpectedly in the hospital, leaving me with many tormented questions. His clinical skills were needed to support me as a non-medical person to understand, but his recognition of my emotional experience was vital and communicated in words, body language time and his eyes.

I clearly remember one day, driving to the surgery in a grief-stricken haze. I actually don’t know how I got from my house to the surgery. I was then sitting in front of him in his room, barely able to string two words together. He started fairly clinically and then all of a sudden he stopped and just looked at me. I knew at this point he was seeing what I was feeling and he was not feeling sorry for me, but starting to empathise and feel with me. He saw that day, my torment, pain, sadness, shock. And the reason I know he saw these emotions was because he mirrored them back to me. His face started to change and he too had a look of torment, pain, sadness, and shock. Maybe for different reasons, but in that silent moment, I felt completely understood. It shocked me a little even to see myself reflected in his facial expression but gave me a huge sense of safety at a time that I felt I had little emotional safety to anchor myself too. It consolidated the trusting relationship I had with him as my GP. There are interactions you remember forever and this is one of them. A very good interaction in a very bad situation.

It’s part of why I do what I do now. Why I believe in learning through narratives and total openness and honesty. Yes, study after study is backing up the benefits of training empathy in healthcare, but alongside that, I have felt its benefits, just as Force and his female patient did.

Empathy: the POWER of understanding and imaginatively entering into another person’s feelings

Collins English Dictionary

The original source for Jermey Force story:

To see more on the empathy training I do see: