Across the British healthcare system, a silent crisis is unfolding, one that transcends statistics and manifests in a profoundly human question: “What do I do now?” This isn’t merely a cry for help from individuals; it is a symptom of systemic cracks in the very foundations designed to support our healthcare professionals and, by extension, the public they serve.
From exhausted clinicians in A&E, to dedicated line managers struggling to pick up emotional pieces without a roadmap, the support systems meant to protect our carers are visibly failing. This is no longer a matter of mere awareness; it is a critical issue of access, trust, and ultimately, decisive action.
Having engaged extensively with leaders and front-line staff across the sector, from NHS executives and private providers to paramedics, nurses, and HR and wellbeing teams, a clear and concerning pattern has emerged. Not one of ill intent, but of broken systems that are severely impacting the very individuals we rely upon to safeguard our collective health.
Three inconvenient truths the system must confront
1. Psychological trauma as a neglected health risk
We meticulously apply protocols for physical injuries: ergonomic training, lifting guidelines, musculoskeletal recovery programmes. Yet, psychological injuries are too often dismissed as personal burdens or incidental by-products of demanding roles.
What if we were to treat trauma with the same rigour as any other workplace hazard?
This would entail identifying psychosocial risks such as excessive job demands, inadequate control, and insufficient recognition. It would mean implementing proactive control measures to mitigate burnout, moral injury, and isolation. Crucially, it would require regular, systematic reviews of support effectiveness, mirroring our approach to physical safety measures like slips, trips, and falls.
If trauma was presented visibly on an X-ray, it would be unthinkable to ignore it. Why then do we wait until an individual is irrevocably broken before intervening?
2. Generic support breeds distrust in high-pressure environments
The traditional Employee Assistance Programme (EAP) model, with its generic advice, strict eligibility thresholds, and distant phone numbers on a poster, has remained largely unchanged for decades. For a trauma-trained nurse, a paramedic who has witnessed profound suffering, or a shift worker in a high-stakes environment, this model often feels detached, impersonal, and fundamentally mismatched to their unique needs.
Healthcare professionals do not simply need “a professional”; they require someone who truly comprehends their lived experience.
They seek individuals who have walked the wards, navigated the chaos, and understand the nuanced difference between needing a meaningful debrief after a traumatic shift and requiring long-term therapeutic intervention. Without this crucial element of “cynical support” (support from those who have genuinely walked in their shoes) trust erodes before a crisis even materialises.
Consequently, people either refrain from seeking help or, after a single dismissive encounter, never attempt to reach out again.
3. Line managers are burning out trying to fill the void
Line managers are not therapists or crisis intervention specialists. Yet, driven by genuine care and concern, they often step in when formal support pathways collapse. They absorb emotional distress, triage situations for which they lack training, and spend countless hours attempting to find solutions they simply do not possess.
The inevitable cost is a growing cohort of managers succumbing to burnout, mirroring the very teams they strive to support.
Empowering managers extends beyond additional training modules; it demands providing them with a reliable and trustworthy support system for their people, a system that alleviates their burden rather than adding to it.
A system stretched to its limit – and a choice to make
While numbers alone do not encapsulate the full narrative, they offer a stark reflection. EAP uptake rates stubbornly hover around a mere 3%. In contrast, well-designed, human-centric models demonstrate usage rates fifteen times higher. This disparity is not indicative of a sudden increase in ill-health; rather, it signifies that individuals finally feel safe enough to be honest and empowered to seek early intervention.
Unless we fundamentally transform how we care for our carers, not merely in rhetoric, but in concrete action, we risk irrevocably losing the trust, the energy, and the hope that are the lifeblood of our entire healthcare system.
Therefore, the critical question before us is not, “Can we afford to change?” Instead, it is: “What does it truly cost us if we do not?”
Behind the uniforms and job titles are dedicated individuals quietly, yet profoundly, asking: “What do I do now?”
Let us not meet that question with silence.
Written by Mackenzie Davis, Sonder
