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Beyond the Checklist: Why Compassionate Care is the Heart of Healthcare

Reese Marlowe in Health & Wellness November 2025 • 4 min read.

"A critical look at the Francis report and the Royal College's response: Are we truly putting patients first?"

The Francis report, an investigation into the devastating failures at Mid Staffordshire NHS Foundation Trust, served as a stark wake-up call. It forced a profound examination of the National Health Service (NHS), raising crucial questions about its moral compass, the impact of management practices, and the feasibility of truly patient-centered care within an increasingly industrialized system.

At the heart of the report was a call for compassionate care throughout the NHS. Yet, the path to cultivating and measuring such compassion remained unclear. In response, the Royal College of Psychiatrists issued occasional paper OP92. While acknowledging the failures at Mid Staffordshire, it stopped short of questioning the fundamental business model driving healthcare.

This raises a critical question: Is the current business model for healthcare truly fit for purpose? Sue Bailey, then College President, rightly criticized the Trust's failure to prioritize patients and highlighted the dangers of apathy and learned helplessness among healthcare professionals. However, the College's response seemed to lack a deeper conceptual exploration of compassionate empathy, care, and the philosophical underpinnings of person-centered medicine.

The Missing Piece: A Moral Framework for Healthcare

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The question of how deeply practitioners' compassionate values resonate and whether they stem from healthy moral communities is key. The College's Centre for Quality Improvement (CCQI) has a vital role in addressing these issues, and their work holds foundational potential. Furthermore, the wisdom and practices of various faith groups can serve as valuable resources for cultivating compassion. It's also crucial to recognize the interconnectedness of professional well-being and patient care.

In our experience, maintaining compassion under the weight of immense workloads, staff shortages, inappropriate team dynamics, and intrusive management is incredibly challenging. Each of these factors needs direct attention and solutions.

Workload Management: Implement strategies to reduce excessive workloads and ensure manageable patient-to-staff ratios.
Staff Support: Provide robust support systems for healthcare professionals, including counseling, mentorship, and opportunities for peer support.
Team Dynamics: Foster positive and collaborative team environments where staff feel valued, respected, and empowered.
Management Training: Equip managers with the skills and knowledge to lead with empathy, prioritize staff well-being, and create a supportive work environment.

The proposal outlined in OP92 to publish a code of ethics for College members is a step in the right direction. However, this code should be part of a broader moral and ethical framework applicable to all healthcare settings. As Gilbert et al. have pointed out, the moral integrity of the NHS is questionable due to limited patient choice and insufficient evidence of efficiency savings. The erosion of professional idealism and the impact of target-driven mindsets can lead to a loss of vocation and compassion. Is the business model, in its current form, truly compatible with the delivery of compassionate care?

A Kairos Moment: Seizing the Opportunity for Change

The College's plan to update its response to the Francis inquiry within six months presents a crucial opportunity. Collaboration with other medical Royal Colleges, professional and patient groups, and moral philosophers is essential to ensure a comprehensive and impactful revision. It's a Kairos moment – a pivotal point where medicine must decide whether the business model is truly serving its purpose. We must not miss this chance to prioritize compassion, ethics, and patient-centered care at the heart of healthcare.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1192/pb.bp.114.047514, Alternate LINK

Title: The College Reply To Francis Misses The Big Question: A Commentary On Op92

Subject: General Medicine

Journal: The Psychiatric Bulletin

Publisher: Cambridge University Press (CUP)

Authors: John Cox, Alison Gray

Published: 2014-08-01

Everything You Need To Know

What was the main purpose of the Francis report, and what critical issue within the National Health Service (NHS) did it bring to light?

The Francis report primarily aimed to investigate the failures at Mid Staffordshire NHS Foundation Trust. It exposed significant shortcomings in the National Health Service (NHS), particularly concerning its moral compass and the feasibility of patient-centered care amidst the pressures of an industrialized system. The report emphasized the urgent need for compassionate care throughout the NHS.

How did the Royal College of Psychiatrists respond to the Francis report, and what key aspect did their response seem to overlook?

In response to the Francis report, the Royal College of Psychiatrists issued occasional paper OP92. While acknowledging the failures at Mid Staffordshire, the response did not deeply examine the fundamental business model driving healthcare. It lacked a thorough exploration of compassionate empathy, care, and the philosophical foundations of person-centered medicine.

What is meant by a 'moral framework' in the context of healthcare, and why is it considered a missing piece in current practices?

A 'moral framework' in healthcare refers to the ethical principles and values that guide healthcare professionals in their interactions with patients and colleagues. It encompasses compassionate values, empathy, and a commitment to patient well-being. It is considered a missing piece because current practices often prioritize efficiency and targets, potentially overshadowing the importance of these ethical considerations. The College's Centre for Quality Improvement (CCQI) plays a vital role in building this framework, which is further supported by examining wisdom and practices of various faith groups. Without this framework, the professional idealism can erode, leading to the loss of compassion.

What practical challenges do healthcare professionals face in maintaining compassion, and what solutions can address these challenges?

Healthcare professionals often struggle to maintain compassion due to immense workloads, staff shortages, inappropriate team dynamics, and intrusive management. Solutions include implementing strategies for workload management, providing robust staff support systems such as counseling and mentorship, fostering positive and collaborative team environments, and equipping managers with the skills to lead with empathy and prioritize staff well-being.

What is a 'Kairos moment' in the context of healthcare reform, and why is the Royal College's updated response to the Francis inquiry considered such an opportunity?

A 'Kairos moment' signifies a critical juncture or opportune time for decisive action and change. The Royal College's plan to update its response to the Francis inquiry represents such a moment because it provides a pivotal chance to prioritize compassion, ethics, and patient-centered care. Collaboration with medical Royal Colleges, professional and patient groups, and moral philosophers is essential to ensure a comprehensive and impactful revision. This is a chance to re-evaluate if the current business model truly aligns with the goals of patient-centered care.