| 29 July 2025
The term resilience is used across various disciplines, and in the NHS and wider healthcare settings, it can be difficult to define. From maintaining critical care during IT outages, to supporting staff wellbeing in emotionally demanding environments, resilience takes many forms.
So how can healthcare organisations translate these broad principles into action to meet growing demands for safe, effective, and adaptable services?
A key starting point is understanding the main types of resilience and recognising how they work together to build capabilities within the workforce and within public services.
Environmental resilience
Environmental resilience is usually concerned with the climate emergency and the stability of the natural world. It’s an important part of ESG (Environmental, Social and Governance) principles, and most organisations have carbon reduction or net zero plans in place.
The NHS is responding with a bold ambition, with their Greener NHS programme, aiming to get to net zero by 2040. Local plans, like the BNSSG Climate Change Adaptation Plan, show how trusts are embedding climate adaptation into estate strategies and service planning.
This speaks to the healthcare system’s contribution towards building environmental resilience, but another important aspect is around how the system responds in times of crisis. Climate change has become a challenge to population health and health systems’ resilience, and when systems aren’t prepared for fluctuations in demand, due to extreme weather for example, service delivery and responsiveness can fall short. According to research published in Elsevier’s Social Science & Medicine journal, vulnerable populations are less protected from health inequalities related to weather, and therefore more likely to be admitted to hospital in adverse weather conditions.
Societal resilience
As understanding of resilience has grown over time and efforts are increasing, societal resilience has become a core concept within the healthcare sector. The UK Resilience Framework 2022, and the launch of the UK Resilience Academy both highlight the need for a whole-of-society approach to resilience.
The COVID-19 pandemic exposed how societal inequalities amplify health risks – and how trust, communication, and cultural competence are essential to effective care.
The ENGAGE project found that public perceptions of risk, trust in institutions, and access to reliable information all influence how communities respond to crises. For example, communities with higher trust in healthcare providers and local authorities are more likely to follow public health guidance during emergencies.
The BMJ highlights that people, not just policies, are at the heart of resilient systems. Investing in community-based care, inclusive workforce development, and public engagement is key.
Organisational resilience
Organisational resilience is the ability of organisations to withstand change without loss of function. In healthcare, the main consideration is how we maintain safe, effective care in the face of things such as workforce shortages, economic pressures, and systemic shocks (including things such as extreme weather episodes, part of environmental resilience considerations above). Organisational resilience is the sum of the efforts that have been put into the system to ensure that they can respond effectively. This is a well-developed and common concept across industries, underpinned by technical standards such as ISO22300 and BS65000. These standards define organisational resilience as the ‘ability to absorb and adapt in a changing environment’ (ISO22316).
The UKG Organisation Resilience Guidance suggests that resilient departments, not only achieve better outcomes during disruption, but they also reap more benefits in times of stability.
At Skills for Health, we support organisations in redesigning roles, modelling workforce needs, and applying scenario planning to build long-term resilience, not just to survive disruption, but to thrive through it.
Operational resilience
Operational resilience is about continuity, ensuring services can withstand and recover from disruption. Winter pressures, staffing shortages, and supply chain issues all test operational limits.
NHS England’s EPRR framework outlines how trusts must respond to incidents. Additionally, The National Occupational Standards (NOS) for Resilience and Emergencies are designed to provide a comprehensive, structured national resource to be used in the development of the resilience workforce. Having recently been updated, these standards will support all areas of resilience, but in operational resilience, it will help guide recruitment, training and performance management for organisations involved in mitigating, planning and responding to emergencies and crises.
Cybersecurity
Cybersecurity is a huge industry in the UK and globally. It is a type of operational resilience, ensuring that systems can repel cyber-attacks and maintain the integrity and safety of essential data and systems in use across the healthcare sector. A growing area of interest in cybersecurity is software resilience – not just protecting the security of systems but also protecting against vulnerabilities introduced through risks such as legacy systems. In June 2024, a pathology lab serving several NHS organisations in South East London, was hit by a ransomware attack that led to data theft and the publication of sensitive information. The impact was significant: over 10,000 outpatient appointments and 1,700 elective procedures were deferred. Yet, thanks to effective response protocols and mutual aid arrangements, the NHS avoided critical failures, including the loss of any transplant organs.
Information and data security eLearning courses are a small way that individuals can be equipped with the knowledge of common cyber threats and how to defend against them – and training should regularly be refreshed for all employees to make sure they are up-to-date with the latest developments in cybersecurity practices, which continue to evolve in the face of changing threat landscapes.
Personal resilience
In the workplace, personal resilience focuses on wellbeing and the ability to be emotionally and mentally resilient to challenges and changes. This is especially important in health and social care, as staff are exposed to significant amounts of stress. As healthcare is delivered by people, their wellbeing is the foundation of the healthcare system’s resilience.
The NHS Leadership Academy emphasises that it isn’t just about “coping”, it’s about recognising stress, accessing support, and proactively building protective factors, including:
- Supportive relationships with colleagues and managers.
- Clear communication and role clarity.
- A sense of autonomy and purpose.
- Access to timely mental health support.
Employee Assistance Programmes (EAPs) are a vital part of the NHS wellbeing toolkit. They often offer support for issues such as poor mental health, bereavement, financial stress, home and family difficulties, work-related stress and burnout.
Resilience types are interconnected
Each type of resilience is interconnected. Strengthening one area supports the others, and together, they form a foundation for sustainable, high-quality care.
Whether you’re rethinking your workforce strategy, planning for future scenarios, or upskilling your teams, we’re here to help you build a more resilient future.
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