The role of compassion in social work

Being treated with compassion makes a big difference to service users, but promoting and measuring it within a professional setting will be difficult, writes Andrew Mickel

Care workers with a long list of routine tasks to complete, and a fixed amount of time in which to complete them, may be forgiven for failing to show compassion at times. But compassionate care makes an enormous difference to service users’ lives, says Andrew Voyce, who uses mental health services in Bexhill.

He explains: “Last week I had a situation with my social housing landlord, and two fairly high-powered housing people wanted to come to my flat to discuss the matter. I mentioned this at the day centre, and staff rearranged the interview so that it took place at the day centre so that they could support me.

“In the old days you wouldn’t get very much of that at all. You’d usually have to deal with everything yourself and could end up feeling very isolated and unsupported.”

Transform

The use of compassion can transform the standard of care and improve patients’ experience so much that last month health secretary Alan Johnson announced that metrics to measure the standard of nursing care in the NHS would include compassion. This will form part of a quality framework covering patient care in the workforce strategy of Lord Darzi’s review of the NHS.

But could such a system of measuring compassion be effective for care workers as well? There is no agreement on what exactly compassion means. At its loosest, it is treated as near-synonymous with “dignity” and “respect” – a non-specific blend of empathy and humility that adds a dimension of care beyond the routine expectations of competency.

As of yet, there has been no word on what form the metrics for nurses would take.

Dignity

Social care is, in many ways, ahead of nursing in measuring compassion.

There are already some attempts to stimulate the less quantifiable side of care such as the role of dignity champions and the dignity agenda as a whole.

Personalisation could also push compassion further as providers have more scope to work with users. Lucianne Sawyer, the president of the UK Home Care Association, PAs with home care workers who, in extreme examples, are timed to see how long they visit each user.

“PAs are able to use the time in a much more flexible way in agreement with the service user, so you can bank time and do something the user really wants to do, rather than the approach we’ve endured over the past few years. That’s person-centred, because it’s not based on what services they need, but what they want to do.”

Skill or personality?

Resources do affect how compassionate a care worker can be, but most people consider it something that should shine through regardless of working conditions. So underpinning the debate about trying to measure compassion is the question of whether it is a developable skill or a personality trait.

Ultimately, attempts to increase compassion rely on triggering something in care workers themselves. And the results of that, as shown by Voyce, can be appreciated by users much more than metrics can measure.

“The impression is that they are generally compassionate people. They don’t let on that they might be having a difficult time and still put your needs first. They must be in very awkward situations, but they always come up smiling,” says Voyce.

• What do you think? Can compassion be measured. Should it be a key part of the job?
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• This is an edited version of an article that appeared in 31 July 2008 issue of Community Care under the headline “Compassion: more than just chemistry/”