The benefits of practising empathy in our work

Empathy makes our work more rewarding. The more connected we feel to the people we engage with, the better our conversations and outcomes. For the people and communities we work with, empathy shows that we see them, which supports openness and honesty. Together, we deepen our understanding — including the “why” behind what’s happening, not just the “what.”

Take the example of missed appointments — a common issue in health and public services. Missed appointments increase costs and waiting times. Through Co-create’s work, we’ve seen common factors: unclear communication, inflexible booking systems, and people feeling the service doesn’t value their priorities.

Tasked with addressing this, the central research question is roughly “why did you miss your appointment?”.  Empathy helps us to understand how this question could feel blaming. It also reminds us that the question that brought us to them might not feel significant in their lives. This has led us to questions that invite connection such as “What was your day like leading up to the appointment” or “how do you feel about this service?”.

 

What can get in the way of empathy?

We tend to find the resource for involvement when something’s not working: people aren’t getting their vaccines, or tenants aren’t reporting damp issues. Our core question therefore becomes a form of “how can we get people to do the thing they’re not doing?”. Using co-design or other collaborative approaches reframes our question as “How can we solve this together?”, shifting the tone to something more relational and constructive. Another solution is to work with historically marginalised communities and give them space to set the direction.

The challenges we focus on are usually defined by services, not by the people affected. It can be hard to find resources for the priorities of the people and communities we serve – especially if we don’t know what those priorities are yet.

It is of course reasonable that services have priorities. But so do individuals and communities and they may be different. We can start to address this by building in time and methods that let people share what matter to them, even when the initial driver for the work is a service priority. We can make this happen through facilitating open forms of engagement focused on conversations, and building relationships rather than simply answering our questions in the most efficient way we can (e.g. closed questions surveys). We can go further by using participatory evaluation methods that let participants define the outcomes that are important to them.

Our involvement challenges usually require us to answer questions that relate to more people than we can realistically communicate with. “Why do people who live in this area have worse health outcomes?”, or “Why are people of this age more or less likely to get vaccinated?”. These are important questions, but the challenge for involvement is that people connect with other people – not categories. As a disabled person, I have represented disabled people in involvement activities. When I’m speaking as a representative or example of the category rather just as me, it’s harder to connect. And when outputs from involvement are shared, it’s harder for others to empathise with a category than an individual story. We might analyse insights at a group level later, but in the moment empathy is much more accessible if we focus on the individual.

 

Demonstrating empathy through our methods

Feeling empathy isn’t the same as showing it. We may feel empathy personally, but it can get hidden behind our methods, and therefore not experienced by the people we hope to connect with. So we sometimes need to create a separation between the service aims and how we engage with people. While a central question might be “how do we change this behaviour?” (i.e. missing an appointment), our engagement with people who have missed appointments should focus on exploring these choices and finding solutions together.

The language we use to frame our question matters here – “behaviour” can feel judgemental, “choices” invites understanding. Co-create’s experience is that this approach allows us to achieve our aims more effectively, and build better relationships along the way.

We often use a “ladder of involvement” to explain visually the different levels of power participants have in different forms of involvement. I particularly like this one:

Slay, J. & Stephens, L. (2013). Co-production in mental health: A literature review. London: new economics foundation

When we choose our methods, we also send a powerful message about how much we trust and value participants. As a patient, am I simply asked if I liked a service, or do my views have enough value that you want to know how I think we could improve it, or to involve me in that process?

For example, the GP contract requires practices to have a Patient Participation Group (PPG) to “obtain feedback”. Feedback is useful, but patients can offer much more. Moving along the ladder to “doing with”, we can  work together to create visions for future care, develop improvement ideas, and assess progress.

 

Creating spaces that show we care

When it comes to the moment of engagement, how we meet matters. Creating safe and welcoming spaces benefits everyone, and shows we care about the individuals involved, rather than just carrying out a task. Some practical ways to do this:

• Plan questions carefully so that they are open and supportive, opening up opportunities for interaction rather than closing them down
• Being mindful of the power you hold in your interactions
• Paying (or otherwise recognising) people who aren’t paid to be there through their job role (more thoughts on that in this video)
• And when we go to where people are rather than ask them to come to us, we show we value them and their comfort enough to make the effort

 

Conclusion

Empathy for the people and communities we work with makes our work more effective and more human. But sometimes we can find that the empathy we start with gets squeezed and shaped by system requirements, and comes out looking very different. We need to be aware of the different ways in which our empathy can get lost in translation as it makes its way through the systems we work in.

This doesn’t mean ignoring what the system needs. Showing we care helps us meet those needs better — by designing responses that work alongside the people they’re for.