Supportive and compassionate leadership leads to higher levels of patient satisfaction

Caroline O'Regan
Caroline O’Regan

Supportive and compassionate leadership was associated with lower work pressure on staff and more influence over decisions, which in turn were linked to higher levels of patient satisfaction, according to a new cross-sectional analysis of NHS datasets in England writes Caroline O’Regan, RCSI Graduate School of Health Care Management.

Healthcare has always faced complex challenges and the pandemic tested the very fabric of its dynamic systems and people. As we begin recovery and emerge many have been left asking fundamental questions “How do I lead now?” “I can never go back to old ways of leading/Managing People” and for some reflecting on work and career choices in health and social care.

Achieving positive outcomes in health and social care means commitment is shared by everyone in the organisation taking responsibility and making it a personal priority to ensure success of the organisation as a whole, rather than focusing only on individual or teams success” (TKF 2015). Reinforcing a collaborative and inclusive leadership approach.

We know that leaders in health and social care have huge influence over the success of the organisation and its environment. A burden of responsibility many take seriously. We also know that the people who choose careers in health have deeply rooted values in helping others? If the role and the key challenge of health care organisations is to ensure the delivery of continuously improving safe quality care, positive patient satisfaction whilst creating a supportive workplace environment where staff have opportunities to continue grow and develop and their individual well-being is taken seriously; What is the most effective leadership style?

Studies have shown that the most effective leaders in health and social care ensure that the voice of patients is consistently heard at every level; patient experience, concerns, needs and feedback (positive and negative) are consistently attended to (TKD 2015) and we know that there is a consistent relationship between patient satisfaction4, clinical safety and clinical effectiveness across a range of health care settings. Healthcare organisations that focus on patient satisfaction have better quality of care 5-6 – and the evidence points to the strong link between staff experience and the patient satisfaction. 7-9 (Doyle 2013).

So how should existing and emerging leaders approach their leadership work in health and social care in 2022 in the knowledge that their impact will result in a positive patient experience? A new study shows validates a supportive leadership approach positively impacts on the patient experience.

Dr Thomas West
Dr Thomas West

The study specifically explored the relationships between leader support, staff influence over decisions, work pressure and patient satisfaction, was carried by Dr. Thomas West et al and published in the BMJ Open on February 1.

The objective was to explore the relationships between leader support, staff influence over decisions, work pressure and patient satisfaction.

The cross-sectional study of large National Health Service (NHS) datasets in England in 2010 covered all staff groups in 158 NHS acute hospital trusts in England.

It measured leader support and staff influence over decision making, staff work pressure and objective outcome data measuring patient satisfaction and primary and secondary outcomes.

The study revealed that multilevel serial mediation analysis showed a significantly positive association between leader support and staff influence over decisions. Furthermore, staff influence over decisions showed a negative association with staff work pressure which in turn was negatively linked to patient satisfaction

Serial mediation also showed a positive indirect effect of leader support on patient satisfaction via staff influence over decisions and work pressure and positively linked to patient satisfaction.

The researchers’ study focused on a specific aspect of leadership, namely leader support, and demonstrated how this related to the work environment and patient satisfaction 67-69 and said the results provided evidence that leader support influenced patient satisfaction through shaping staff experience, particularly staff influence over decisions and work pressure.

The limitation of the research (The design of the study compares survey data with contemporary objective data, mitigating the effects of common source bias), is acknowledged and highlights important avenues for future research in healthcare leadership. However, the findings add to the ever-increasing swell of evidence and benefits for health and care leaders and managers in adopting a supportive compassionate leadership approach. It also provides evidence, which may help guide the theoretical ‘rebuilding’ of traditional leadership theories, as well as offer, practical guidance for practitioners 70

“Patients’ care is dependent on the health, well-being, and effectiveness of the NHS workforce. That, in turn, is determined by the extent to which leaders are supportive in ensuring that work environments are managed in a way which protects the well-being of staff, said the study.”

West THR, Daher P, Dawson JF, et al. The relationship between leader support, staff influence over decision making, work pressure and patient satisfaction: a cross-sectional analysis of NHS datasets in England. BMJ Open.
2022;12:e052778. doi:10.1136/