Organisational Readiness and Preparedness for Trauma-Informed Practice Across UK Frontline Services: A Mixed-Methods Study

Background: Frontline professionals in health, social care, and emergency response settings are routinely exposed to potentially traumatic events. Trauma-informed practice (TIP) frameworks highlight two key elements. Organisational readiness refers to the structural, cultural, and leadership conditions that support trauma-informed approaches. Organisational preparedness reflects the practical ability to recognise trauma exposure, respond effectively, and support staff. Despite growing policy attention, little empirical evidence describes how frontline workers experience these factors in organisations.Objective: This study explored frontline staff experiences of TIP across UK services. It focused on organisational readiness, including policies, leadership, systems, and cultural responsiveness, and preparedness, including psychological safety, confidence to seek support, clarity of support pathways, and stigma. The aim was to identify strengths, gaps, and priorities for improvement.Method: A cross-sectional online survey was completed by 325 frontline workers across NHS, social care, and emergency response sectors. The survey assessed organisational readiness and preparedness across four clusters: organisational structures and systems, workplace culture and psychological safety, leadership and workforce capability, and wellbeing and access to support. Quantitative data were summarised descriptively and integrated with qualitative themes derived from reflexive thematic analysis.Results: Participants reported partial organisational readiness, including access to Employee Assistance Programmes, informal peer support, and visible leadership endorsement of staff wellbeing. Preparedness to respond to trauma exposure was uneven. Psychological safety was often limited, with many participants unsure where to seek support or reporting concerns about confidentiality and professional consequences. Leadership training in TIP principles appeared limited, and communication about support pathways and organisational expectations was frequently unclear.Conclusions: Frontline services show some strengths in trauma-informed readiness, but important gaps remain in organisational preparedness. These relate particularly to psychological safety, managerial capability, stigma, and access to support. Strengthening leadership capability, improving communication, and creating safe and consistent help-seeking pathways are essential for sustainable trauma-informed workplaces.