Introduction

National Health Service (NHS) surveys have consistently shown that a considerable proportion of staff (more than 36% in 2016) report feeling ‘unwell due to work-related stress’.1 In addition, the General Medical Council (GMC) recently published reviews on medical education and practice2 and on national training.3 These concluded that ‘a state of unease exists within the medical profession’.4 The GMC’s assessment was echoed by the Royal College of Physicians,5 and work-related stress may even have been implicated in the suicides of young doctors.6 Overwork, low morale and mental health issues undoubtedly affect the medical workforce7 and are likely to have contributed to the first industrial action for decades following threatened imposition of a new contract.8 Strikingly, a recent survey of 30 000 nurses revealed that 53% felt ‘upset/sad’ because they could not deliver the level of care they wanted.9 Emotional well-being at work is therefore an important issue. In 2013, the Francis Report10 made recommendations directed at promoting compassionate care, including the implementation of Schwartz Center Rounds (SCR). ‘Developing People, Improving Lives’—the national improvement and leadership framework—was aimed at addressing this problem and advocates compassionate leadership at all levels of NHS organisations.11

Over the past 8 years, nearly 100 NHS trusts and other organisations (eg, hospices; higher education institutes) have introduced SCR to their settings. The aim is to allow staff from all disciplines to consider their experience of providing care, especially challenging emotional and social issues. It is hoped that by sharing such aspects of work, stress and anxiety can be reduced and thereby the capacity to give more compassionate care to patients enhanced. Our aim in this commentary is to provide an overview of SCR, and describe the organisational processes necessary to set these up. We outline our experience in the hope …