"Calling it Out": The Compassion & Candour Conundrum

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I have personal skin in this game. Someone I love became suicidal after “calling out” malpractice to a regulatory body in a senior public sector leadership role. They fell off a cliff - figuratively and almost literally. Their livelihood and their whole sense of self was destroyed.

So I am intimately and painfully aware of the complexities of Speaking Up, Calling it Out or whatever term we choose. There is so much to lose from speaking uncomfortable truths - and often so little to gain.

I find myself wondering over and over: how can we embed both candour and compassion into everyday organisational life?

The new NHS “Leadership Way” outlines well-intentioned principles : being Compassionate, Curious and Collaborative. The NHS is now dripping in behavioural principles and espoused values. And in 25 years, I have seen few effective, meaningful approaches to upholding the rhetoric in practice (Please do share any examples here. If you or your organisation is good at this, please pass on what you’ve learnt!)

To avoid the principles losing credibility, we need to focus on what they mean in our everyday experience. How can we learn, develop and practise naming uncomfortable things in compassionate ways? How could we stay compassionate without tiptoeing around and brushing difficult issues under the carpet? How shall we deal effectively with tricky dynamics without leaving the people involved bruised, emotionally shattered or worse?

This is a personal as well as a professional learning curve for me. I’m either too candid and upset people. Or my compassion for others means I put up with things which are really not OK. I don’t think it’s just me; thousands of NHS colleagues I work with seem to grapple with this too.

Maybe I (possibly we?) need to hone the art of Fierce Compassion or Kind Candour. I understand it in my head. I support it in my heart. Yet I find it really hard in practice - especially in the moment when I need it.

I see this conundrum every day in my work, particularly in the NHS, where compassion is fast becoming a leadership mantra. It’s unarguably crucial and an all-round good thing, especially given our Covid19 experiences. And compassion can also be incredibly difficult when things simply aren’t OK; aren’t right; aren’t in line with expectations; aren’t good enough.

In such scenarios, NHS interactions typically lurch into fear-based and fear-inducing behaviours motivated by protectionism: protecting self, protecting the status quo and protecting organisational reputation.

So, how do we find the balance between Compassion and Candour which will support high quality care? My hunch is we need more than the data collection, measurement, monitoring and gathering of best practice promised by NHSEI.

Candour with Compassion is of life-or-death importance. It’s critical to safe patient care. It’s vital to colleague wellbeing.

I think it’s fair to say that collectively in the NHS, we have a huge development gap here, at individual, team, organisational and system level.

If you’re someone with questions, experience, ideas, thoughts, comments or suggestions about how we might crack the Compassion & Candour Conundrum, let’s connect together.

I’d like to bring together a community of people who want to embed Compassion with Candour into everyday work.

If this sounds like you, shall we explore this deeply together, to see what difference we can make?