Compassion sits at the heart of health and social care, but compassion is not an inexhaustible resource. Jadie Tranter, Chief Clinical Consultant at Outcomes Consulting, explores the growing impact of compassion fatigue, secondary trauma and burnout—and why workforce wellbeing must become a strategic priority.
Compassion Fatigue, Secondary Trauma and the Workforce Retention Challenge in Health and Social Care
Over the course of my 25-year nursing career, I have had the privilege of working alongside some of the most dedicated professionals in health and social care. From frontline nursing and safeguarding roles to executive leadership, quality improvement and service transformation, one thing has remained constant: the unwavering commitment of our workforce to support some of the most vulnerable individuals in society.
Yet behind that commitment lies a question that leaders, commissioners and regulators can no longer afford to ignore:
Who cares for the carers?
Across health and social care, workforce retention remains one of the greatest challenges facing providers. While much attention is rightly given to recruitment campaigns, vacancy rates and workforce growth, less attention is often paid to the emotional impact of caring.
Recent workforce data paints a complex picture. Turnover rates in adult social care have improved significantly, but almost one in four workers still leave their role each year. Vacancy rates across children’s social care remain high, while mental health has become the leading cause of sickness absence within the NHS. These figures tell an important story. Recruitment matters, but retention matters more. To retain our workforce, we must first understand the emotional cost of caring.
When Caring Comes at a Cost
Compassion sits at the heart of health and social care practice and is embedded within the Nursing and Midwifery Council Code, which requires registrants to prioritise people, practise effectively, preserve safety and promote professionalism and trust.
However, compassion is not an inexhaustible resource.
Professionals working across health and social care are routinely exposed to trauma, safeguarding concerns, abuse, neglect, mental health crises, end-of-life care and behavioural distress. While supporting others through these experiences is often rewarding, repeated exposure can come at a personal cost.
One of the realities we still do not talk about enough is the emotional impact of caring. The very qualities that make people exceptional practitioners—empathy, compassion and commitment—can also leave them vulnerable to compassion fatigue, secondary trauma and emotional exhaustion.
Compassion fatigue can develop when staff continue to give emotionally without sufficient opportunities to reflect, recover and replenish their own wellbeing. Alongside this, repeated exposure to the experiences of others can result in secondary or vicarious trauma, affecting confidence, resilience and ultimately a person’s ability to remain in the profession.
In my experience supporting services across children’s services, adult social care and specialist care environments, I have seen dedicated professionals continue to give everything to those they support whilst quietly struggling themselves.
Burnout: More Than a Workforce Challenge
The World Health Organization recognises burnout as an occupational phenomenon resulting from chronic workplace stress that has not been successfully managed.
Burnout rarely develops overnight. More often, it emerges gradually through sustained operational pressures, staffing shortages, increasing complexity of need and limited opportunities for recovery and reflection.
The pressures facing our workforce have never been greater. More than 83,000 children are currently looked after by local authorities in England, representing an increase of more than 20% over the past decade. Demand for children’s services continues to grow while workforce pressures remain significant.
At the same time, NHS organisations continue to report record levels of mental health-related sickness absence. In a single month during 2025, NHS staff lost more than 600,000 working days due to anxiety, stress, depression and other psychiatric illnesses.
Over the years, I have seen highly skilled professionals begin to lose confidence, withdraw from colleagues and question whether they can continue in roles they once found deeply rewarding. Rarely is this because they no longer care. More often, it is because they have cared for others for so long without receiving the support they need themselves.
Through our work at Outcomes Consulting, we regularly support providers experiencing the impact of workforce fatigue and emotional exhaustion. What begins as pressure on individual staff members can quickly become evident at an organisational level through increased sickness absence, reduced engagement, difficulties retaining experienced staff and challenges in maintaining continuity of care.
This is why workforce wellbeing should never be viewed separately from quality assurance, governance or service performance. They are intrinsically linked.
When staff are supported, services are more resilient, continuity of care improves and outcomes for the people being supported are stronger. Workforce wellbeing is not simply a people issue; it is a quality issue.
Creating Cultures Where People Thrive
Throughout my career, I have learned that people perform at their best when they feel safe, valued and able to speak openly.
Psychological safety is about creating environments where staff can raise concerns, ask for help and share challenges without fear of blame or judgement. The healthiest organisations are not those without problems; they are those where people feel confident enough to talk about them.
Alongside this, reflective practice remains one of the most valuable tools available to leaders. More than a requirement for professional revalidation, effective reflection provides staff with the opportunity to process difficult experiences, learn from practice and build resilience.
When organisations invest in psychological safety, reflective supervision and compassionate leadership, they are not only supporting their workforce; they are strengthening the foundations upon which safe, effective and person-centred care is delivered.
Leadership Matters
After more than two decades in leadership, one observation remains consistently true:
People rarely leave because they stop caring.
More often, they leave because they have cared for too long without feeling cared for themselves.
Compassionate leadership plays a critical role in workforce retention. Effective leaders recognise the signs of emotional exhaustion, encourage reflective practice, create psychologically safe environments and support staff wellbeing proactively rather than reactively.
Encouragingly, national workforce data demonstrates that retention can improve when organisations invest in their people. Recent reductions in turnover and vacancy rates across health and social care show that workforce stability is achievable. However, sustainable improvement requires continued investment in wellbeing, leadership, culture and professional development.
The future sustainability of our sector depends not only on recruiting new staff but on retaining the experienced professionals we already have.
At Outcomes Consulting, we understand that sustainable services require sustainable people. Through leadership development, workforce support, reflective practice and organisational improvement, we work alongside providers to build resilient services capable of delivering positive outcomes for both the people they support and the workforce that supports them.
Looking Forward
Compassion fatigue, secondary trauma and burnout are not new challenges. However, their impact on workforce retention has never been more significant.
As a sector, we have become increasingly skilled at measuring outcomes for the people we support. We now need to place the same emphasis on understanding, protecting and investing in the wellbeing of those delivering that support.
After 25 years in nursing and leadership, one thing remains clear to me: the quality of care experienced by the people we support will always be influenced by how well we care for the people providing it.
If we are serious about improving retention, strengthening services and delivering high-quality care, workforce wellbeing can no longer be viewed as an optional extra. It must be recognised as a strategic priority for the future of health and social care.
Who cares for the carers? The answer to that question may determine the future sustainability of our sector.
