The COVID-19 pandemic resulted in detrimental changes to the way people with cancer received care. It was a time of rapid innovation and development, but cancer services were disrupted, backlogs developed and far less support was available. Clinical decision-making frameworks changed, targeting restricted resources to people with curable diseases. As we have seen in other chapters, oncological outcomes have been adversely affected. These changes have had serious consequences and have resulted in increased psychological morbidity and complexity. The vulnerable and socially disadvantaged have been significantly affected, with existing gaps concerning social inequality, diversity and inclusion widening. Uncertainty, moral challenges and the wider societal consequences of the COVID-19 pandemic have had an impact on healthcare workers, individually and professionally. Studies specifically exploring the cancer workforce have been limited, but wider surveys have reported increased rates of depression, anxiety, stress and post-traumatic stress disorder (PTSD) when compared to pre-COVID-19 pandemic levels in healthcare staff. ‘Compassion fatigue’, ‘burnout’ and ‘moral injury’ are frequently reported. Evidence suggests that this has led to more cross-sector staff choosing to leave the health service. It is acknowledged that leaders and managers have an important role in supporting healthcare workers by promoting cultures and practices that support the long-term health and well-being of staff. Compassionate leadership, emotional containment, trauma-informed approaches and building resilience are discussed in this chapter.