Prioritising empathic communication to enhance patient experience

This CW Innovation Fellowship case study explores co-designing clinical empathy and communication, in both routine and digitally enabled care. The digital transformation project is led by Sarah Gashier, CW+ Art and Design Research Volunteer and CW Fellow.

From Lived Experience to Better Care: Co-designing Clinical Empathy and Communication

Project summary: Clinical empathy and communication as experienced and defined by patients, in both routine and digitally enabled care.

Story of the project

There are strong associations between consistent, empathetic communication and patient safety and experience. Evidence shows that poor communication and a lack of empathy can harm patients, reduce trust and increase healthcare use.

My involvement with CW+ is rooted in how art supported my recovery, and how my family and I experienced the hospital environment as a source of comfort during treatment. As an Art and Design Research Volunteer, I collect feedback from patients, visitors and staff about how art and music affect their hospital experience.

Nationally, communication accounts for the largest complaint subject in Hospital and Community Health Services, with 17.6% of new complaints relating to communications in 2024-2025. Of 179 complaints analysed across both Chelsea and Westminster Hospital and West Middlesex University Hospital from July to December 2025, 99 (55%) fell within categories related to interpersonal communication and behaviours associated with patient-perceived clinical empathy.

The project combines lived experience, academic evidence, local patient feedback and co-design with patients and clinicians to identify and test practical ways of improving patient safety, trust and experience.

I began developing the project through the CW Innovation Fellowship in 2025, drawing on repeated experiences of living with a long-term condition and not feeling believed or listened to. In one example, concerns about medication side effects were attributed to anxiety, delaying recognition and contributing to repeated admissions, avoidable harm and loss of trust.

Outcomes

With mentoring from Dr Sadia Khan, the project has evolved from discovery towards co-design and small-scale testing, initially within cardiology and virtual care. This approach focuses on helping patients feel listened to, believed and involved in their care.

I initially believed immersive virtual reality could help clinicians better understand patients’ experiences. Through the Fellowship, I learnt not to become fixed on a solution before fully understanding the problem. I reviewed research, analysed local Patient Advice and Liaison Service (PALS) and complaints data, and gathered insights from patients and clinicians.

Early outcomes include:

• Clinician engagement and buy-in;
• Multidisciplinary steering group; and
• Greater consideration of empathy and communication in clinical and research discussions.

Sarah also presented the project to the CW+ Innovation Advisory Board in April 2026 and spoke on the “Listening to Patients: Co-Designing Services for Better Outcomes” panel at National Health Executive’s online conference in May 2026, broadening engagement with clinical, innovation and improvement audiences.

The project has established a digital empathy strand, exploring how patients feel heard, reassured and supported within virtual wards. Digital empathy is an emerging and under-researched area, and validated tools designed specifically to measure it in virtual care remain limited.

Sarah also developed cross-industry learning connections with Amazon and The Dorchester Academy, drawing on insights from retail and hospitality about listening, emotional experience and the systems that enable empathetic behaviour.

Advancing the project through CW Innovation Fellowship collaboration

CW Innovation Fellow: Sarah Gashier

Role: CW+ Art and Design Research Volunteer
Organisation: CW+, charity that works in partnership with Chelsea and Westminster Hospital NHS Foundation Trust

Sarah applied to the Fellowship to transform lived experience into a structured improvement project, rather than leave it as a personal story. The most valuable elements have been protected space, mentoring and sponsorship from Dr Sadia Khan, and access to clinical and innovation networks.

Participating in the Fellowship as a patient also brings a perspective not always represented in improvement work. I hope to strengthen co-design by listening earlier, valuing lived experience as expertise, and developing practical changes with patients rather than for them.

The Fellowship strengthened Sarah’s skills in co-design, stakeholder engagement, systems thinking, evaluation, storytelling and influencing, while giving the project credibility and creating opportunities that would otherwise have been difficult to access.

A major Fellowship outcome has been my role as a co-applicant on an NIHR Research for Patient Benefit study of surgical virtual wards, where I am helping ensure empathy, reassurance, communication and patient experience are considered.

Sarah move from a broad idea to an evidence-informed project with governance, partnerships and a realistic route to testing. Being part of a Fellowship based within the Trust gave Sarah access to local data, mentoring, networks, key stakeholders, expert support and peer learning.

Next steps

The next phase will involve co-designing practical interventions with patients and clinicians, initially within cardiology, and testing one change at a time through Plan-Do-Study-Act (PDSA) cycles.

The specific intervention has not yet been agreed and will be determined through co-design. Possible options include a concise communication prompt, patient storytelling, lived-experience reflection or staff development.

Impact has not yet been measured. Interventions and measures will be agreed through co-design with patients before testing. Measures are likely to assess whether patients feel heard, reassured, supported and involved in their care, alongside staff feedback and relevant process measures. This focus reflects evidence that patients perceive clinical empathy when clinicians listen to them, believe their accounts and recognise them as experts in their own bodies. As one cardiothoracic surgeon said during an exploratory conversation, “Patients know their bodies.”

Learning could then be shared through the Q Community, a health and care improvement network, and adapted for other specialties and virtual-care pathways.

For more information on the CW Innovation Fellowship, which was previously called the Horizon Fellowship, visit the CW+ website. Visit the Innovation Directory to see this year’s Fellows and read more about their projects.