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#reflect2repair – improving access to reflective practice for health and care staff

Bev Fitzsimons 11 November 2021

This autumn and winter we are promoting and celebrating the value of reflective practice for health and care staff.


A new strand in our work over the coming months will be to highlight the importance of reflective practice as the NHS moves into the winter and the workforce faces increasing pressure.

This is in response to the uniquely challenging context in the health and care system at the moment. As the Covid pandemic continues, it is placing ongoing strain on the whole system from primary care through to intensive care. This year, seasonal flu – largely absent last year because of Covid lockdowns – is more prevalent, adding to the pressure. And of course the NHS faces the uphill task of eating into the backlog of elective treatment that has built up, along with an unknown volume of undetected cases from people who, for a whole variety of reasons, didn’t get the help they needed during lockdown.

Meeting these challenges requires a workforce that is at full strength. Instead we have a health and care workforce that is under-capacity, with a significant retention problem and not enough new people coming through to fill vacancies. Staff are exhausted; many feel undervalued. NHS staff survey data show increases in workplace stress. Many clinical professions report that staff are leaving their roles, heightening the problems.

Why are we focusing on reflective practice?

Firstly, we know from over a decade of supporting Schwartz Rounds in health and care organisations – and from the evidence that has built up over this time – that reflective practice makes a big difference to individuals, and to organisations’ cultures.

But another reason to focus on this issue through the coming months is that we have also learned – through our work on inclusivity, from earlier research, and ongoing communication with the Schwartz Community – that there is more we need to do within organisations where Schwartz Rounds and other mechanisms for reflection are running, to ensure that as many people as possible are able to benefit.

In particular there are three groups that we have in mind:

  • Under-represented groups of people who face systematic disadvantage, such as those with protected characteristics
  • Those for whom attendance at Schwartz Rounds is a challenge owing to their workload, shift patterns or level of autonomy in their work
  • Executives and senior leaders, who we know can face particular challenges engaging with Schwartz Rounds because of their seniority and a perceived need to avoid appearing vulnerable within their organisation.

This autumn and winter, when we know the pressure will bite for many people working in health and care, we want to work with our community and networks to increase access to reflective practice and consider how leaders in organisations can create the circumstances that allow this to happen. For our community, this generally means attending Schwartz Rounds, but we hope our activities will raise awareness of the benefits of reflective practice generally and encourage others to consider it.

How will we do this?

We can only do this with the support of the Schwartz Community. We believe many of the answers on how to resolve these particular challenges lie within the community – executive sponsors, facilitators, clinical leads and Schwartz steering groups – and we want to surface new tools and techniques for encouraging participation in reflective practice, promote them to our networks, and celebrate them as a community.

  • We will be looking to hear from our Community and highlight examples of practices that have increased participation in reflective practice within their organisations, that can be emulated elsewhere.
  • We will look to work with senior leaders, to find ways of enabling them to engage fully in Schwartz Rounds.
  • We want to learn as much as we can, as part of our ongoing work on diversity and inclusion, about how best we can embrace the full diversity of our health and care workforce.
  • And we want to celebrate this work by sharing our messages about the benefits that reflection on the emotional impact that work in health and care can bring to individuals and organisations, to help others advocate for establishing reflective practice in their own organisations.


We are labelling this work #reflect2repair – because we believe that improved access to reflective practice for health and care staff can go some way to repairing the system, and helping to build compassionate organisational cultures that support staff to deliver the best care for patients.