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The answer is not “resilience training”; nor is it telling people that they themselves are the problem and that if only they were mentally and physically tougher everything would be fine. A common theme emerging from the articles in the new BMJ collection on rethinking health and care systems (www.bmj.com/rethinking-health-and-care-systems) is that treating people with kindness, dignity, compassion, recognition, value, and autonomy is at the heart of making sure the systems can cope with shocks. And it starts from the top. A powerful report on the experiences of smaller hospitals during the pandemic identified that even “very senior managers felt that they had no peers within organisations with whom they could freely share their concerns.”5 If we are not able to ensure that leaders have the support they need to be resilient, what hope do we have of ensuring that they are able to support their teams effectively?

ic identified that even “very senior managers felt that they had no peers within organisations with whom they could freely share their concerns.”5 If we are not able to ensure that leaders have the support they need to be resilient, what hope do we have of ensuring that they are able to support their teams effectively? It also extends beyond the needs of health and care staff to looking at the needs of carers and of volunteers. In its 2022 report, Carers UK identifies that only 25% of carers had had a carer’s assessment—a local authority evaluation of their willingness to care and the support they need—in the past year. Of the 75% who were not assessed, almost two fifths did not even know what an assessment was.6 The NHS Volunteering Taskforce report published in June 2023 noted that the covid-19 pandemic had highlighted the vital role of volunteering.7 It contains important recommendations for raising the profile of volunteering and the number of volunteers—including in relation to crisis response—but nowhere does it reference supporting the psychological needs of volunteers.

June 2023 noted that the covid-19 pandemic had highlighted the vital role of volunteering.7 It contains important recommendations for raising the profile of volunteering and the number of volunteers—including in relation to crisis response—but nowhere does it reference supporting the psychological needs of volunteers. To ensure that we create resilient and sustainable health and care systems we must invest in the people who deliver the care and support and in the buildings and technology that enable those people to work more effectively. This requires a plan, which should be based on pandemic experience and the projected needs of those who are or may be reliant on the services. Learning from the pandemic is key to better planning; otherwise, we walk blindly through a tunnel with no light in sight. Investing in people will create resilience, which in turn will make health and care systems sustainable in the long term.