Hospitals ranked highly for empathy see better outcomes for patients and staff, study finds

Hospitals with higher empathy scores had better patient and staff outcomes, according to provisional research on NHS trusts in England.

The study suggests trusts with higher empathy scores also spent less on agency staff, locums and consultants.

Researchers created an empathy score for NHS trusts using publicly available information on organisational culture, leadership behaviour and practitioner empathy.

The work found that even modest increases in a trust’s overall empathy score were linked to gains in patient safety, effectiveness, staff wellbeing and finances.

The research has been submitted to BMC Health Services Research, but the results are provisional because the work has yet to be peer reviewed.

Prof Jeremy Howick, at the University of Leicester and lead author of the study, said: “More empathic organisations have better patient outcomes, staff wellbeing and financial bottom lines.

“Empathy helps patients because they feel listened to.

“If you’re not listening to the patient, or they don’t feel able to share all their symptoms, you won’t understand what they are going through and you cannot make an accurate diagnosis.”

The report found that trusts with higher empathy scores were more likely to be rated “good” or “outstanding” for effectiveness and patient safety by the Care Quality Commission.

The Care Quality Commission is the regulator for health and social care services in England.

Small improvements in empathy were also associated with lower burnout and absenteeism among staff.

Burnout is a form of work-related exhaustion that can affect a person’s health, performance and ability to stay in their role.

The researchers also found that trusts with higher empathy ratings spent less on agency staff and external consultants.

The study comes days after the BBC revealed details of the treatment women received at the maternity unit run by Nottingham university hospitals NHS trust.

The trust is the focus of the largest maternity inquiry in NHS history.

Senior midwives were found to have advised others not to be “too kind”.

One patient was reportedly discouraged from coming into hospital so firmly that when she arrived, her baby was dead.

The report also said the letters “FOH” appeared on a whiteboard next to the names of several heavily pregnant women, shorthand for “fuck off home”.

Howick said: “There’s a problem with lack of empathy leading to avoidable harm.

“I wouldn’t want to generalise, but there is a problem and it needs to be improved.”

Howick and colleagues analysed publicly available data including CQC ratings, NHS staff surveys and financial accounts.

They ranked trusts across nine areas of empathy.

Staff surveys provided information on whether trusts had a culture of empathy and whether staff felt recognised and rewarded.

The average NHS trust empathy score was six on a scale from one to 10.

For every 2.5 per cent increase, researchers found a 76 per cent greater chance of the CQC rating a trust good or excellent for patient safety.

The same increase was linked to a 46 per cent greater chance of being rated good or excellent for effectiveness.

Trusts with the highest empathy scores spent hundreds of thousands of pounds less on agency staff and consultants, according to the researchers.

While the study found a link between empathy, patient care and staff wellbeing, it does not prove that increasing empathy directly caused the improvements.

Patients and staff may also do better at well-run trusts where empathy is more likely to develop.

Howick said there was still reason to believe empathy could play a role.

Previous research has suggested empathy may help reduce pain, depression and anxiety, as well as improve patient satisfaction and quality of life.

Howick said: “Our study doesn’t establish causation, but if you look at the evidence in the round, it’s reasonable to assert that it’s likely to be causal.”

The study does not list the worst-performing trusts.

The top trusts for empathy included Cumbria, Northumberland, Tyne and Wear NHS foundation trust, Pennine Care NHS foundation trust and Birmingham Women’s and Children’s NHS foundation trust.

Prof Jeffrey Braithwaite, who studies health systems at Macquarie University in Sydney, Australia, said increasing empathy may well improve patient outcomes and did not have much downside.

He said: “The danger is that empathy becomes another slogan on a poster or another online training module.

“The real gains will come when NHS trusts redesign clinical work itself. This means staffing, workload, teamwork, psychological safety and responsiveness to patients.

“Wouldn’t that make empathy more likely rather than merely hoped for?”