The pressures I explored in my last blog on health and social care recruitment — skills shortages, burnout, funding pressures, competition from the public and private sectors, and the demands on frontline services — have not gone away. If anything, they have sharpened the need for a more strategic approach.

For health and social care charities, recruitment can no longer be treated as a reactive exercise. When a Chief Executive, Head of Services, Finance Director, Safeguarding Lead, Fundraiser or Operations Manager steps down, the gap is rarely just operational. It can affect continuity of care, staff confidence, governance, safeguarding oversight, income generation, culture and, ultimately, the people the charity exists to serve.

What is the hidden cost of “like-for-like” recruitment?

Replacing a role exactly as it was misses a strategic moment. Roles quietly expand over time, and re-advertising an overloaded job description sets the next person up to struggle. When someone leaves, the instinct is to move fast — but the smarter first step is to pause and re-scope.

Before going to market, charities should ask:

•      Has the role changed since it was last recruited?

•      Is the job description realistic?

•      Are we asking one person to carry too much?

•      Does the salary reflect the responsibility and emotional complexity of the role?

•      Are the reporting lines clear?

•      Is there enough support around this post?

•      What would make someone successful here in year one?

•      What might make them leave?

Too often, organisations recruit into roles that have gradually expanded over time. A Head of Services may be expected to lead delivery, manage safeguarding risk, support commissioners, oversee monitoring and quality, supervise managers, handle crises and contribute to strategy. A fundraiser may be expected to grow income quickly without investment in systems, data, case for support or donor stewardship. A Chief Executive may be expected to stabilise finances, support an exhausted team, modernise governance, develop partnerships and remain visible to service users, funders and trustees.

These are not impossible roles. But they do need to be honest roles, scoped around what one person can realistically carry.

When does retention really start?

Before the appointment is made. Retention begins during recruitment: the way a role is scoped, described, assessed and discussed tells candidates a great deal about an organisation, and a rushed process, vague expectations or an overinflated job description can create problems long before the successful candidate starts.

Strong candidates notice all of this. Before accepting a role, they are weighing whether the organisation is clear about its priorities, whether the Board understands the pressures on the team, whether the role is properly resourced and carries real authority to make change, and whether workload, wellbeing, safeguarding and governance are taken seriously. Most fundamentally, they are asking: can I see myself staying here?

This is particularly important in health and social care charities, where candidates are often motivated by purpose but still need sustainable working conditions. Commitment to mission does not remove the need for clarity, support, fair pay, good management and healthy boundaries.

The Department of Health and Social Care’s 2026 to 2027 adult social care priorities emphasise that high-quality care depends on the skills, commitment and wellbeing of those who provide it. That principle is equally relevant for charities delivering health, care, mental health, disability, ageing, counselling, family support, homelessness, addiction, domestic abuse, bereavement or community services.

If organisations want people to stay, they need to recruit with retention in mind from the very beginning.

The growing importance of progression

One of the biggest retention risks in health and social care charities is the lack of visible progression.

Many people enter the sector because they care deeply about the work. But if they cannot see how to develop, gain recognition, build skills or move into leadership, they may eventually leave.

This matters for charities of all sizes. Not every organisation can offer a large internal career ladder, but every organisation can think more intentionally about development.

That might include:

•      Creating deputy or lead roles

•      Supporting managers with coaching

•      Investing in safeguarding, finance, governance or fundraising training

•      Building cross-organisational project opportunities

•      Encouraging future leaders to engage with trustees

•      Planning succession for key roles

•      Offering mentoring between senior and emerging leaders

•      Reviewing whether qualifications are essential or simply traditional requirements

For charities, the message is clear: development is not a luxury. It is part of workforce resilience.

What role should trustees play in recruitment and retention?

A strategic one. Recruitment and retention are governance issues, not just operational ones. High staff turnover, exhausted managers, salaries falling behind, and safeguarding concentrated in too few people are strategic risks — and trustees need to see them clearly before a departure turns risk into crisis.

Trustees do not need to manage day-to-day recruitment, but they do need to ask the right questions:

•      Do we understand our key person dependencies?

•      Are we investing enough in leadership and management capacity?

•      Are our salaries realistic in the current market?

•      Are our expectations of senior staff sustainable?

•      Do we have succession plans for critical roles?

•      Are we hearing honest feedback from our staff teams?

•      Is our recruitment process inclusive and accessible?

•      Are we supporting the wellbeing of our people?

In many charities, the people delivering services are highly committed. But commitment can mask fragility. Organisations often only realise how dependent they were on one person when that person leaves.

Recruiting for resilience

So what does recruiting for resilience look like in practice? It means:

•      Being clear about the outcomes the role needs to deliver, not just listing every possible responsibility

•      Assessing values, emotional intelligence, judgement and leadership style alongside technical skills

•      Looking for candidates who can work with complexity, ambiguity and compassion

•      Being honest about the pressures, while showing candidates the support, culture and purpose that make the role worthwhile

•      Considering transferable skills from adjacent sectors, while carefully assessing whether candidates understand the realities of this work

•      Moving at pace, without rushing the thinking

And it means recognising that the appointment is only the beginning. Onboarding, Board engagement, first-year priorities and development support all shape whether a new recruit succeeds and stays.

In the current market, the strongest organisations will be those that treat every recruitment process as an opportunity to strengthen the whole system around the role. They will be honest about pressures, thoughtful about structure, serious about development and committed to recruiting people who can sustain the mission over time.

Can Charisma help?

At Charisma, we understand that recruitment in health and social care charities requires more than technical matching. These appointments call for sector understanding, sensitivity to safeguarding and governance, awareness of funding and workforce pressures, and careful assessment of values, resilience and cultural fit.

This specialist area is led by our Senior Consultant, Sandra Smith. Sandra spent five years working in the care sector, building relationships with families, the local community and professional partnerships, and has personal experience of supporting her own parents through their dementia journey and a loved one through mental ill health. That lived and professional experience has given Sandra a deep understanding of the challenges facing mental health, health and social care charities, and of their impact on individuals and families.

Whether you are recruiting a senior leader, strengthening your Board, planning succession, or reviewing a role that has become too difficult to fill, I would welcome a conversation. Charisma offers a free initial consultation, and Sandra and I are always happy to talk through what you are facing and whether we can help.

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