Case Study · Healthcare
Co-designing and delivering a multi-cohort empathy and leadership programme for NHS middle managers across the North of England. Independently evaluated. Funded by Health Education England.
The Challenge
NHS middle managers occupy one of the most empathically demanding positions in any organisation. They are expected to lead with compassion — to NHS patients, to clinical teams under pressure, to colleagues navigating institutional change — while simultaneously managing operational targets, staff shortages, and the weight of a system under chronic strain.
The challenge is not a lack of empathy. It is an unexamined relationship with it. Too little perceived empathy erodes team trust and patient outcomes. Too much — without regulation, without physical grounding, without the ability to read and respond rather than absorb — produces exactly the burnout and staff churn that the NHS cannot afford.
NHS R&D North West identified this gap at the heart of their middle management development challenge. They needed a programme that addressed empathy not as a wellbeing concept but as a leadership capability — one grounded in the NHS Healthcare Leadership Model, which identifies empathic leadership as one of nine core domains of effective leadership practice.
The Programme
Stuart Nolan was involved in the design and delivery of the Leading a Culture of Research and Innovation programme from its inception — working alongside the NHS R&D NW leadership team, a creative communication facilitator, leadership development professionals, and somatic experts to build a blended immersive programme for NHS middle managers.
Each cohort comprised approximately 25 NHS middle managers from clinical backgrounds across the region. The programme was delivered as a residential over two days, followed by two further one-day workshops and an ongoing online community. It was fully funded by Health Education England.
Stuart's Contribution
Within each cohort Stuart delivered two distinct but connected sessions, both grounded in the Threefold Model of Empathy and the NHS Healthcare Leadership Model.
A workshop exploring the physical dimension of empathy specifically within a healthcare context. Participants worked through the relationship between empathy and the NHS Leadership Model — examining how empathic leadership operates across all nine domains, and in particular how the balance between too little and too much perceived empathy directly links to burnout and staff churn.
The session used SNC's physical empathy exercises to give participants a direct, embodied experience of empathy as a trainable capability — not a disposition — and introduced the concept of physical empathy as a tool for regulation as well as connection.
A facilitated LEGO Serious Play session in which participants developed their individual and collective strategy for leading a culture of research and innovation within their teams. Working with physical models to externalise thinking that is often tacit, participants built and shared realistic, actionable strategies for their specific organisational contexts.
Each participant left with a documented Real Time Strategy — a grounded, personally authored plan for embedding R&I culture within their team — alongside the language and methodology to bring colleagues with them.
Stuart was really skilful at making the link between empathy and the world of health and social care in which we work.
What Changed
The programme was independently evaluated by NHS R&D North West associate Kate Bulpin using a Realist Evaluation methodology — a rigorous framework designed for complex social interventions. The following outcomes were documented across participants.
Participants reported increased self-confidence in their leadership capabilities and improved understanding of how to lead through influencing others — addressing the core deficit identified at programme outset.
Increased openness to new ideas and approaches, with participants experimenting with creative practices in teaching and clinical contexts — including the redesign of educational frameworks and clinical team engagement approaches.
Colleagues of participants reported improvements across four measures: knowledge of communities of practice, curiosity about research and innovation, feeling their line manager listened to them, and feeling part of a high-performing team.
Participants built and sustained strategic networks that increased awareness, engagement and participation in research and innovation — contributing to a documented shift in cultural mindset around the value of research in everyday clinical practice.
Multiple participants reported measurable increases in their teams' involvement in research trials and researcher career development programmes — outcomes attributable in part to the leadership and empathy capability developed on the programme.
Improved understanding of the value of self-care and reflective practice for individual leadership capacity — directly addressing the burnout risk identified in the programme design, with participants reporting lasting changes in their daily leadership habits.
Independent Evaluation
The programme was evaluated using a Realist Evaluation methodology — a framework specifically designed to understand how, for whom, and under what conditions a complex social intervention works. Four cohort-specific evaluation reports were produced in addition to the Realist Evaluation. All are publicly available.
Kate Bulpin, NHS R&D North West Associate. A comprehensive evaluation of outcomes and impact across the first cohort, with findings consistent with cohort-specific evaluations across subsequent programmes.
The full programme documentation, cohort details, and links to all four cohort-specific evaluation reports on the NHS R&D North West website.
What This Means for You
The NHS R&D North West programme demonstrates what SNC's methodology delivers at scale — across four cohorts, three regions, and the full range of clinical middle management roles. The physical empathy and LEGO Serious Play components used here are available as standalone workshop engagements or as part of a longer programme.
If your organisation is navigating similar challenges — empathy capability in leadership teams, burnout risk, or the need to build cultures where people genuinely lead rather than manage — the methodology is the same. The application is bespoke.
A 30-minute discovery call costs nothing and commits you to nothing. We'll establish whether there's a fit and agree what good looks like before any money changes hands.
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