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“The ‘Francis effect’ at risk but not dead,” says charity supporting strong growth of Schwartz Rounds

05 February 2015

Two years after Sir Robert Francis’ Inquiry into Mid Staffordshire NHS Foundation Trust recommended Schwartz Rounds as a way to help bring about positive culture change in the NHS, the number of organisations signed up to run Rounds has reached 104 – a four-fold increase since April 2013.

When The Point of Care Foundation took over responsibility for supporting the Schwartz Rounds programme from The King’s Fund in April 2013, there were only 23 organisations running the proven reflective practice technique.

Jocelyn Cornwell, chief executive of The Point of Care Foundation, said: “Two years after the publication of the Francis Inquiry, the positive uptake of Schwartz Rounds across the NHS and beyond shows organisations are embracing culture change.

“But while the ‘Francis effect’ is not dead, it is a difficult time for the NHS. There is a risk that the energy put into supporting staff to deliver excellent care in the wake of the Francis inquiry will slip. The challenge will be to keep supporting staff to deliver excellent patient care in the face of immense financial, capacity and organisational pressures. The Point of Care Foundation maintains that the NHS cannot deliver good care unless it provides good support to staff. Schwartz Rounds provide much needed support to healthcare staff.”

Schwartz Rounds are expertly facilitated, confidential, meetings where staff from all backgrounds and professions voluntarily come together to discuss the emotional and social challenges associated with their jobs. The underlying premise for Rounds is that the compassion shown by staff can make all the difference to a patient’s experience of care, but that in order to provide care with compassion, staff must themselves feel supported in their work.

Rounds have been shown to be an effective strategy for providing support to healthcare staff and for enhancing relationships among them and with their patients (Lown and Manning, 2010).

Macmillan counsellor Russ Hargreaves, who facilitates Schwartz Rounds at Chelsea & Westminster NHS Foundation trust, said: “The life of a healthcare professional is an unusual one. You deal with a daily diet of trauma, loss, death, dying and chronic ill health, and that really takes its toll. Unless you want a healthcare service full of robots, you have to address that emotional need. We knew that if we began to look after staff, if we began to explore the emotional burden of working with patients, the effect would be that patients felt better cared for. It’s a win-win situation.”

Of those organisations signed up to run Rounds, 64 are NHS acute trusts, 17 are hospices, 10 are mental health trusts and 7 are community trusts. The Point of Care Foundation is also working with three private providers, two Welsh health boards and one ambulance trust, as illustrated in the table below.

Organisations signed up to run Schwartz Rounds, by type

Acute Hospice Mental Health Welsh Community Private Ambulance Total
64 17 10 2 7 3 1 104
62% 16% 10% 2% 7% 3% 1% ≈ 100%


In 2015, the Foundation will focus on supporting the development of Schwartz Rounds in community and other settings as well as acute hospitals, where Rounds have traditionally been strongest.

Notes to editors

Sir Robert Francis, in the public inquiry into care at Mid Staffordshire NHS Foundation Trust, says Schwartz Rounds are a good method for bringing staff together for the benefit of the patient (paragraph 20.129, page 1394 of the third volume).

The ‘Francis effect’ refers to the drive to improve patient care, and support for staff, which happened after the publication of the public inquiry into care at Mid Staffordshire NHS Foundation Trust.

It typically takes about six months between organisations signing up to run Schwartz Rounds and running their first Round. This is to allow time for training, setting up the Rounds organising committee and recruiting speakers.

A team of researchers based at King’s College London are currently undertaking a national evaluation of Schwartz Rounds. The study aims to uncover to what extent participation in Schwartz Rounds affects staff wellbeing at work, improves relationships between staff and patients, and aids the provision of compassionate care in the UK.

Evidence on the benefits of Schwartz Rounds is presented in: Lown, Beth A., and Colleen F. Manning. “The Schwartz Center Rounds: evaluation of an interdisciplinary approach to enhancing patient-centered communication, teamwork, and provider support.” Academic Medicine 85.6 (2010): 1073-108.

About The Point of Care Foundation

  • The Point of Care Foundation is an independent charity dedicated to improving patients’ experience of care and increasing support for the staff who work with them.
  • We provide evidence and resources to support health and care staff in the difficult work of caring for patients.
  • We believe a truly patient-centred approach – focussed on listening, understanding and responding to the needs of the whole individual – is essential to the delivery of the best possible quality of care.
  • For further information about our work please visit our website or follow us on Twitter @pointofcarefdn.

For further information, please contact Creina Lilburne on 07941 156 827.