(Steel et al., 1991) and is believed to account for at least 5% of all cases . These recent developments have been paralleled by a growth in services offering genetic counselling to individuals with a family history of breast cancer. Assessment of the psychological impact of these services and of subsequent participation in screening programmes has been advocated ; however, to date, little research has addressed these issues. Women at increased risk because of a family history of cancer may bear a heavy emotional burden (Wellisch et al., 1992;) and a recent US evaluation of genetic counselling services suggested 27% of clinic attenders had levels of distress consistent with the need for psychological support . Results from a population-based study of high-risk women indicate that over a third suffer from significant levels of breast cancer-related worry (Lerman et al., 1993

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Purpose This paper aims to discuss the importance of compassion in health care and experiences of Compassion Circles (CCs) in supporting it, placing this into the national policy context of the National Health Service (NHS), whilst focusing on lessons from using the practice in mental health care. Design/methodology/approach This conceptual paper is a discussion of the context of compassion in health care and a description of model and related concepts of CCs. This paper also discusses lessons from implementation of CCs in mental health care. Findings CCs were developed from an initial broad concern with the place of compassion and well-being in communities and organisations, particularly in health and social care after a number of scandals about failures of care. Through experience CCs have been refined into a flexible model of supporting staff in mental health care settings. Experience to date suggests they are a valuable method of increasing compassion for self and others, improving relationships between team members and raising issues of organisational support to enable compassionate practice. Research limitations/implications This paper is a discussion of CCs and their conceptual underpinnings and of insights and lessons from their adoption to date, and more robust evaluation is required. Practical implications As an emergent area of practice CCs have been seen to present a powerful and practical approach to supporting individual members of staff and teams. Organisations and individuals might wish to join the community of practice that exists around CCs to consider the potential of this intervention in their workplaces and add to the growing body of learning about it. It is worth further investigation to examine the impact of CCs on current concerns with maintaining staff well-being and engagement, and, hence, on stress, absence and the sustainability of work environments over time. Social implications CCs present a promising means of developing a culture and practice of more compassion in mental health care and other care contexts. Originality/value CCs have become supported in national NHS guidance and more support to adopt, evaluate and learn from this model is warranted. This paper is a contribution to developing a better understanding of the CCs model, implementation lessons and early insights into impact.

Background/Aims Recent incidents have raised awareness about how corporate decisions and behaviour can negatively affect the health and wellbeing of healthcare professionals. This article uses a case study to explore the harm that failing to follow human resources procedures can cause to individuals, organisational culture and effectiveness, and make recommendations to improve practice. Methods Seven experts from a range of professional backgrounds offered opinions on an individual case study involving the misapplication of a human resources policy, considering how it may have deviated from lawful practice and the potential impact this had on both the individual and the organisation. Thematic analysis was carried out on this qualitative feedback to identify superordinate and subordinate themes. Results The thematic analysis identified four superordinate themes: failure to follow organisational policies; impact on the individual; impact on the organisation; and failure to learn. Conclusions Poor application of human resources procedures can cause harm to individuals and organisations in a number of different ways. Human resources departments need to actively protect the health and wellbeing of the individual/s involved in investigative procedures, rather than focusing solely on executing the process.