Competent Compassion

SMMGP – what does that mean to you? Substance Misuse Management Good Practice perhaps? But it means we need to answer a very important question:

What is “good practice” and how do we measure it?

We have guidelines and protocols to follow which are needed and generally helpful – but when it comes to evaluating what we do, it seems that the CQC are concerned with processes and structures, the commissioners mainly want to know about “successful completions” (still!) – and the GMC and NMC want to know all about our mistakes. Managers want their organisations to run smoothly and profitably and the frontline workers are too busy just keeping their heads above water under the deluge of need.

But no one is actually looking at what is really important.

In reality - the thing that makes all the difference to people is the quality of the one to one interaction between a person seeking help – and the person giving it.

What happens between the service user and the practitioner, the patient and the prescriber, the enquirer and the receptionist – this is what matters.

Let’s think about it for ourselves – it is true in so many areas of our own lives. It’s about that interaction and how it makes us feel and whether we’ve been heard, and our particular need is met.

To distil it down to its essential elements -

It’s all about competent compassion.

If I am seeking help from you – I want you to be competent - to know what you are doing and how to help me effectively – and I want you to be compassionate – to understand where I am coming from, my feelings and need – to connect with me where I am.

I want you to demonstrate competent compassion.

One without the other is either going to be a significantly less effective or significantly more dangerous than it should be – and will definitely not result in good practice.

And perhaps we can all think of examples of “care” where there was a lack of either competence or compassion – or both.

However - if “competent compassion” became a central personal and corporate ethos for all of us working in the substance misuse field – and beyond - we would be then not only doing our best for the people we are helping – but we would also be able to evidence it.

Competent Compassion is simple, it is memorable, and it brings together well documented aspects of care and concepts that are already widely accepted as vital to good care.

We need to shift the focus from what is currently measured and scrutinised and make sure that the focus is on the quality of that one to one interaction at the centre of everything we do.

Fair enough - but how then can this be measured?

Actually, it’s not that hard.

There are Competent Compassion Check Ups available that can be used in the one to one interaction.

They are individually tailored for the practitioner, the service user and an observer (if there is one).

They can be used by one or all participants involved in a consultation.

They are simple, easy and quick to fill in, and comprise brief explanations of competence and compassion and have 2 short narrative boxes and 2 rating scales.

So, for example - they can be used by practitioners to keep a check on whether there are particular areas of competence they need to improve on and whether something is getting in the way of working compassionately with a person.

They can be a great source of patient feedback.

They can be used to demonstrate that an organisation is serious about quality where it matters.

They can be used for personal formative assessment and appraisal needs – demonstrating progress and learning.

And if competent compassion permeated whole organisations – then even relationships between different layers of management and workers could be revolutionised – imagine people wanting to treat each other with competent compassion across our organisations!

And the really good thing is that it doesn’t cost any money – and it would not take a lot of time to implement.

Here is the website for more information, publications and history:

So, what’s next?

I am looking for people to catch the vision.

I am looking for people to help lead the way in focussing on quality where it really matters.

I am looking for people to take this to others and say, “what’s stopping us – let’s do it”.

Do contact me for further information via the website and let’s see what we can do together to make this revolution happen.

Dr Joss Bray is the founder of Competent Compassion and is the Clinical Lead for Drug and Alcohol treatment in the North East Prison Cluster. He has also worked extensively in psychiatry, general practice, community substance misuse services and residential substance misuse treatment services.