Ceeing compassion in care: more than 'Six C'S'?

Abstract

Compassion is an apparently simple word. It is, however, actually a highly contested and ambiguous concept which can chase after real content and meaning. But, however, simple it may be or become, the realization of compassion in the UK National Health Service (NHS) is not easy. This is because compassion does not exist as an essence or good that can be dispensed. It is a range of activities and attitudes whose practice is inflected by complex contextual ecologies. In the broader debate about compassion in care, there has been a tendency to focus on the actions or behaviours of healthcare professionals that are perceived to be indicative of ‘compassionate care’. The focus on actions as indicators of compassion is understandable in the light of the shortcomings that have been identified in the care delivered in some parts of the NHS, but it overlooks the complexity of compassion as a state of mind or intellectual outlook. Distinguishing between compassion as a state of mind and actions that show compassion is important, but it can be challenging in health care as there are a myriad of contextual and organization factors that impact on the quality of care such as staffing levels (Ausserhofer et al., 2013; Aiken et al., 2014; Ball et al., 2014). The NHS Commissioning Board Chief Nursing Officer for England and the Department of Health Chief Nursing Adviser (2012) published ‘Compassion in Practice’ which set out their vision and strategy for the delivery of care with compassion to patients by nurses, midwives, and care staff. The aim of this vision and strategy was to ensure that nurses, midwives, and care staff consistently deliver high quality to patients predicated on the six key principles of courage, competence, communication, commitment, care, and compassion (NHS CB CNO England & DH CNA, 2012, NHS, 2014). As a result, over time Compassion in Practice has come to be known colloquially as the ‘6 c’s’ of care. ‘Compassion in Practice’ was initially set out as a three-year strategy to build a culture of compassion in care in the NHS when it was published in 2012. Since then, the delivery of safe, high-quality care has become a priority for governments and healthcare professionals across the globe (Dixon-Woods et al., 2013; Jha et al., 2013; Najjar et al., 2013; Robert et al., 2014). In the UK, the Francis (2013), Berwick et al. (2013), Keogh (2013), Clwyd & Hart (2013), and Andrews & Butler (2014) reports have all underscored the imperative to ensure that patients consistently receive the best possible care with compassion, dignity, and respect. Given that tenure of ‘Compassion in Practice’ is coming to an end, this is an opportune moment to revisit the concept of six c’s of care and to start ‘Ceeing compassion’ in a broader sense.