Study Finds Link Between NHS Trust 'Empathy Scores' and Better CQC Safety Ratings, But No Causation Proven

NHS trusts in England that scored higher on an empathy measure drawn from organisational culture, leadership behaviour and practitioner empathy received better Care Quality Commission ratings for patient safety and effectiveness. 5 percent rise in the overall empathy score, trusts had a 76 percent greater chance of a good or excellent rating for patient safety and a 46 percent increase in the likelihood of a good or excellent rating for effectiveness.

The average trust empathy score across England stood at six on a scale of one to 10.

Trusts with higher scores also reported lower staff burnout and absenteeism, and spent hundreds of thousands of pounds less on agency staff, locums and external consultants. Prof Jeremy Howick of the University of Leicester, the study’s lead author, said more empathic organisations have better patient outcomes, staff wellbeing and financial bottom lines.

He added that empathy helps patients because they feel listened to.

The study drew on publicly available data including CQC ratings, NHS staff surveys and financial accounts to assess nine areas of empathy. Staff surveys supplied information on whether trusts maintained a culture of empathy and whether staff felt recognised and rewarded. The research was submitted to BMC Health Services Research but remains provisional because it has not yet been peer reviewed.

While the study shows an association between empathy scores and outcomes, it does not establish causation. Howick noted that previous research has shown empathy can reduce pain, depression and anxiety and improve patient satisfaction. He said that when the evidence is viewed together, it is reasonable to assert that empathy is likely to be causal.

The study comes days after the BBC reported on the treatment of women at the maternity unit of Nottingham university hospitals NHS trust, the focus of the largest maternity inquiry in NHS history. Senior midwives at the trust advised others not to be too kind, and one patient was discouraged from coming to hospital until her baby had died.

Howick said there is a problem with lack of empathy leading to avoidable harm.

The top-scoring 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 of Macquarie University said increasing empathy may improve patient outcomes and carries little downside.

He cautioned that empathy must be built into clinical work through staffing, workload, teamwork and psychological safety rather than reduced to slogans or online training modules.