The Challenge

Recent survey activity undertaken by the British Medical Association and the 2021 NHS Staff Survey reported concerning levels of threatening behaviour, violence or verbal abuse to doctors, nursing staff, receptionists, and healthcare assistants. It is also suggested that these instances of negative behaviour have been increasing since the COVID-19 pandemic.

This concerning data indicated a continuing need for initiatives to help ensure staff feel as though they have the skills and techniques needed to handle these increasingly difficult situations with compassion and look after their own wellbeing. NHS England commissioned escalla to design, develop and deliver a training initiative that would meet this need.

Following an extensive consultation period with staff across the NHS and the National Health and Wellbeing Team at NHS E&I, escalla designed a comprehensive training initiative intended to positively contribute to the creation and maintenance of a compassionate and inclusive culture between colleagues and with patients. This initiative, aimed at supporting patient-facing primary and secondary care staff across NHS England, trained more than 2400 individuals in diverse topics such as levels of listening, emotional intelligence, and compassion fatigue.

Meeting the Challenge

Each training session, tailored to the distinct operational requirements of the NHS in timing and format of delivery, was designed to equip participants with the practical skills and confidence to handle challenging conversations with compassion.

Practicality and the relevance of training materials to a participant’s everyday role were at the centre of the Compassionate Conversations training, informing training content and the delivery methods used. A core component of this training initiative was skills practice, with several exercises in each training session dedicated to participants increasing their competence and confidence in handling difficult conversations with compassion.

Skills practice sessions were tailored to the situations and challenges shared with escalla by NHS staff in the consultation period of the process. Facilitated by expert trainers from escalla, in-event activities allowed participants to explore different responses, skills and tactics that would help them in their daily working lives. When asked to rate how useful these activities were, more than 93% of participants were satisfied or very satisfied that the skills and tactics discussed would be useful to them when they returned to work.

Participant wellbeing was another focus of this initiative. Training materials were designed to support participants in looking after their own wellbeing, the wellbeing of their colleagues, and in developing a broader understanding of the support available to them. After attending the training, participants reported an average confidence level of 8.7 out of 10 in understanding their own mental health and wellbeing after their session. They also reported a slightly higher score of 8.8 out of 10 in knowing how to better support their colleagues with mental health or wellbeing concerns.

escalla’s Internal Capability

Despite a short lead time between contact award and initiative launch, escalla mobilised a team of highly experienced facilitators with a wealth of relevant experience to support the country-wide programme roll-out within three months.

A large majority of participants (96%) told us that they were satisfied or very satisfied with the knowledge and expertise of their facilitators, further stating that the communication and engagement from facilitators was very good or excellent (96%).

Facilitators with expert technical knowledge in on-line learning were also available to participants during their training session, support that further enhanced participation across the initiative.

Outcomes

A comprehensive programme of evaluation was embedded within this initiative, incorporating qualitative reflection and quantitative assessment from training participants contemporaneously. This embedded measurement ensured the frequent and repeated measurement of training effectiveness, learning outcome achievement, and participant satisfaction. In feedback from more than 2000 participants, 95% told us that their training experience had been very good or excellent. This far exceeded the contractual key performance indicator provided by NHS England in advance of initiative launch, which was a participant satisfaction rating of greater than 70%.

This initiative was positively received and highly successful based on feedback data from more than 2000 training participants. Not only did more than 93% of respondents tell us that they would recommend this training to their colleagues, suggesting a high value of session content, there was a 24.7% increase in confidence for participants in handling difficult situations with compassion after attending their training session. Six weeks after the training, some participants also provided follow-up assessments of their confidence. This increase was seen to be lasting for participants, with 87% of participants telling us that they agreed or strongly agreed that they felt more confident in handling difficult conversations with compassion. This was a clear demonstration that the initiative met the learning outcomes and that participants left the training feeling more competent, confident, and better supported at work.