“Performance, People & Pressure: Rethinking Wellbeing in Public Service” - Sally MacDonald

Performance culture in public service often focuses on targets and outputs. But lasting performance starts with people — their wellbeing, resilience, and capacity to serve.

When organisations understand that performance isn’t just about numbers but about people’s ability to stay well and connected, lasting change follows — for teams, communities, and the quality of service they deliver.

The Performance Paradox

Public services — policing, fire, ambulance, health, social care — must demonstrate performance. They are accountable to the public, audited, inspected, and measured.

Yet the current culture of performance often equates measurement with management: targets, KPIs, dashboards. These become the definition of performance rather than one indicator of it.

From a trauma-informed perspective, this creates a paradox:

Performance starts with people before it ever shows up in results.

You can’t sustain high performance from a workforce that is constantly under pressure or emotionally depleted.

True performance begins with people — and the state of their wellbeing.

Beyond Crisis Support — Building Sustainable Performance

Over the past decade, public services have made real progress in supporting staff wellbeing.

Initiatives like TRiM (Trauma Risk Management), Blue Light Mental Health Champions, Employee Assistance Programmes, and Occupational Health pathways have changed the conversation.

People are more aware. Leaders are more open. Psychological support is no longer something whispered about in corridors.

These systems are saving lives. They’ve made it possible for officers, paramedics, firefighters, and social workers to speak openly about the impact of trauma — and to seek help after major incidents.

That’s something to celebrate.

But what about the everyday load?

While these systems respond well to critical incidents — shootings, fatalities, suicides, major events — they rarely account for the daily realities:

• Cumulative exposure to distress that chips away at resilience

• Vicarious trauma from repeated contact with pain or violence

• Individual differences in history, background, and coping capacity

• Constant organisational change and pressure to do more with less

Every day, police officers, paramedics, firefighters, nurses, crime scene investigators, and social workers experience things that would stop most people in their tracks.

But because it’s “part of the job,” the impact often goes unseen — and unprocessed.

Because stress and trauma in these roles aren’t always one big event — they’re the small, relentless moments that build up:

• The social worker carrying the stories of families in crisis

• The police officer managing another sudden death before breakfast

• The paramedic consoling a child while suppressing their own distress

• The firefighter pulling someone from a crash site while trying not to picture their own family

• The crime-scene investigator examining images and evidence that linger long after the shift ends

• The nurse juggling too many patients and too few breaks, absorbing others’ pain with no time to process it

• The call-handler listening to fear, grief, and anger for ten hours straight

This is vicarious trauma — the slow, unseen erosion of emotional capacity through exposure to others’ pain.

When it isn’t recognised, it quietly reshapes how people think, feel, and perform.

A system may look supportive — because “aftercare” exists — but it’s fundamentally reactive. It steps in after moral injury or burnout appear and tends to overlook the accumulated exposure that public-service professionals face day after day.

The Invisible Cost of Compassion Fatigue

When your role is to serve, protect, and support, compassion is part of the job description.

But compassion is also an energy that needs to be replenished. Without regular opportunities to process and reset, even the most dedicated professionals begin to show signs of compassion fatigue — emotional numbing, detachment, irritability, loss of empathy, or cynicism.

This isn’t a lack of professionalism or care. It’s a biological signal that the body and mind have reached their limit.

And that state directly impacts performance:

• Slower reactions under pressure

• Decreased focus and decision-making

• Reduced empathy in public or victim interactions

• Lower morale, higher absence, more burnout

The ripple effect reaches the wider community: service quality drops, mistakes increase, and trust suffers.

Recognising and addressing compassion fatigue isn’t just about caring for staff — it’s about protecting the performance and integrity of the whole service.

Performance Isn’t Just About Targets — It’s About Capacity

Public services rightly need to demonstrate accountability, standards, and measurable outcomes.
But performance isn’t purely behavioural — it’s biological and emotional.

If a workforce is living under chronic stress, no amount of targets, supervision, or training will restore true performance.

A trauma-informed approach changes the question from:
“Why is this person not performing?”
to
“What’s happening for this person that’s affecting how they show up?”

For example:

• The “disengaged” team member may be frozen or overwhelmed

• The “confrontational” colleague might be running on adrenaline

• The “burned-out” officer may be cycling between exhaustion and overdrive

Until organisations understand this — and build ways to help staff recover and reset, not just react — they’ll keep losing good people to burnout, resignation, and ill health.

The Next Evolution: From Reactive Support to Proactive Prevention, Recovery and Resilience

Our existing frameworks — TRiM, Blue Light Champions, Employee Assistance Programmes, and Occupational Health — are vital foundations.

The next evolution is to move from systems that respond to trauma to cultures that understand, anticipate, and prevent it.

This is how we build truly high-performing public services — where accountability, wellbeing, and compassion coexist, and where caring for the people who serve is recognised not as a cost, but as the foundation of excellence.

To build sustainable performance, wellbeing has to be embedded, not just available after a crisis — and it has to reach everyone, from leaders to front-line staff, creating shared responsibility from the top down and the bottom up.

Building resilience isn’t only about bouncing back from adversity; it’s about developing awareness and flexibility to meet challenges before they overwhelm.

That means:

• Educating leaders and managers in how stress and trauma affect behaviour, focus, and communication

• Equipping all staff with a basic understanding of stress responses and practical tools to self-regulate, recover, and support one another

• Bringing awareness of stress and trauma into everyday supervision, team meetings, and personal development

• Normalising brief recovery practices during shifts — small pauses, reflective check-ins, peer-to-peer moments of connection

• Creating psychological safety so people at every level can talk about how they’re coping without fear or stigma

When entire teams feel safe, supported, and valued — and people have the knowledge and tools to recognise and regulate their own stress responses — they don’t just perform better; they sustain that performance.

Reducing the Impact, Building Capacity

We can’t remove stress or trauma from public service — they’re part of the work.

What we can do is reduce their impact by understanding what’s happening in the body and mind when ongoing stress and exposure to trauma start to shape how we think, feel, and perform.

When people and leaders are educated about the biology of stress and trauma, they begin to recognise when they or others are under strain, know how to regulate and recover, and build the flexibility to respond rather than react.

That shift — from reacting to responding — is what keeps people well, performance strong, and service quality at its best.

And when organisations create cultures that support this — where awareness, compassion, and regulation are part of everyday practice — that’s when wellbeing, resilience, and performance become truly sustainable.

From Strategies to Culture

Across policing, fire, health, and social care, national frameworks now set clearer expectations and pathways for support — a real step forward (for example: Oscar Kilo’s National Police Health and Wellbeing Strategy 2024–26, the NFCC Health & Wellbeing Framework, the NHS Long-Term Workforce Plan, the HSE Management Standards, and Social Work Employer Standards).

The opportunity now is translation: turning solid strategies into daily habits and shared skills — helping everyone, from leaders to frontline staff, understand how stress and trauma affect them, notice cumulative load, make space for brief resets, and develop the flexibility to stay grounded under pressure.

That’s how strategies become culture — where wellbeing, resilience, and performance reinforce each other.

The next step is cultural: building on these strategies so we move from well-designed systems on paper to everyday practices that understand, anticipate, and reduce the impact of stress and trauma — for staff and for the communities they serve.

Personal Reflection

After 28 years in policing and collaborative work across public-sector and multi-agency settings, I’ve seen both sides: great systems and great intentions — and the hidden toll of everyday exposure.

When we teach people why their body and mind feel the way they do, and give every member of staff — from leadership through to the front line — the tools to pause, regulate, and recover, we protect both people and performance.

That’s the culture I’m building through Strong Horizons . Empowering resilience, inspiring growth.