Looking beyond the frontline: senior healthcare leaders’ personal, professional and psychological experiences of the COVID-19 pandemic in the UK

Purpose The ubiquitous impact of the COVID-19 pandemic on healthcare required agile and resilient leadership to navigate novel and evolving clinical challenges as well as changes in government and regulatory directives. Despite the pivotal role of healthcare leaders, their experiences of the pandemic are not understood. The current study explored the impact of the pandemic on senior healthcare leaders in the UK. Design/methodology/approach A cross-sectional survey was completed by 40 participants working in director or executive positions in physical or mental healthcare settings within the UK during the COVID-19 pandemic. Findings High levels of burnout (median = 9) and secondary traumatic stress (median = 7) were apparent, though moderate levels of compassion satisfaction (median = 12) were maintained. Scores of helplessness (median = 40) and moral injury (median = 19) were at the lower end of their respective scales. Younger age, the absence of formal leadership training and professional registration were risk factors for poorer psychological outcomes. Most leaders (95.0%) reported that the pandemic impacted on their wellbeing, and experienced multifarious occupational challenges, several of which were associated with distress. Specific challenges included experiencing a COVID-19-related death within the workplace and greater psychological unpreparedness for the organisational impact of the pandemic. Practical implications The impacts of the pandemic for healthcare workers extend beyond the frontline of healthcare. Further investigation of the experiences and distress of healthcare leaders through a moral injury framework is needed. Formal leadership training and mentoring, and the implementation of strategies that increase psychological preparedness for large-scale crises may prove fruitful in mitigating distress in this overlooked population. Originality/value To the authors knowledge, this is the first paper in the UK to explore the experiences and support needs, going forward, for healthcare executive leaders.