ABSTRACT
This is new for this edition, born out of concern that institutions increasingly appear to have become risk averse, and clinicians more fearful of making ‘mistakes.’ The chapter begins with a discussion of Schwartz rounds, designed, in the service of fostering compassion, to bring staff together to discuss the emotional and social rather than the technical aspects of their work. The impact of the organisation and its ethos is regarded as a legitimate focus of supervision. The chapter discusses how supervision relates to the clinical governance agenda, the prominence of which has increased in response to scandals such as Shipman, Mid-Staffordshire NHS Trust and the sexual exploitation of children in Rotherham, Rochdale and elsewhere. Emphasis is placed on the importance to well-functioning organisations of a learning culture rather than a ‘watch-your-back’ ethos. This involves privileging the use of leadership and management tools intended to gain the whole-hearted support of staff, rather than top-down power tools involving coercion and punishment.
