Evidence base

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The below documents and reports have been influential in shaping thinking and approaches in health and wellbeing across the NHS. These will help you to develop and review your health and wellbeing approach.


Public Health England, Work, worklessness and health: local infographic tool, June 2018

This infographic tool aims to raise awareness of issues relating to work, worklessness and health. It presents local employment data alongside corresponding regional and national values, for areas such as:

  • MSK conditions
  • Employment gaps for people with learning disabilities, long-term conditions and mental health conditions
  • Local spotlight on sickness absence

The tool also provides points for discussion and reflection in order to explore the local context, along with directing to external documents for further information. Employers can use this resource to assess their local community, and target their organisational health and wellbeing strategies accordingly.

The Royal Society for Public Health’s (RSPH’s) and Calouste Gulbenkian Foundation: That Age Old Question Report, June 2018

RSPH along with the Calouste Gulbenkian Foundation has published a report examining how attitudes to ageing can affect our health and wellbeing.  It explains that ageist attitudes harm older people as they lead to direct age-based discrimination – which can promote social exclusion, impact on mental health, and affect wider determinants of  health like employment.  It provides tips for employers to support wellbeing and resilience, in preparation for later life and ideas how to promote age diversity in the workplace.

NHS Health and Wellbeing Framework, May, 2018
This framework brings together best practice, research and insights in one accessible place to help NHS organisations improve staff health and wellbeing.  It contains input from 12 NHS organisation’s who are doing great things around this agenda and has been steered by an advisory board that includes Dame Carol Black, MIND and Arthritis Research UK. 

The framework is an interactive document that makes the case for staff health and wellbeing, sets out clear actionable steps and provides guidance on how organisation’s can plan and deliver a staff health and wellbeing plan. A diagnostic tool has also been created to support implementation of the framework and help organisations identify key areas of focus when planning or improving a health and wellbeing programme.

Stress: Are we coping? (The Mental Health Foundation) May, 2018.
This report explains what stress is and how stress can affect us physically and psychologically.  It describes how long term health conditions, work, money, technology and social media can cause us to feel stressed.  It includes top ten actions an individual can do to help reduce and manage their stress.  We all know the workplace has a duty of care to look after staff but these actions encourage people to learn ways of managing, reducing, and preventing stress which are important tools for mental and physical health and wellbeing.  The report also looks at stressors that are beyond a person’s direct control (e.g. living in poverty, discrimination, with long-term health problems etc.) so organisations must also consider what can be done at a wider community and societal level to mitigate and reduce long-term stress. 

Long-term sickness absence: a biopsychosocial survey, April 2018
Joint research released from The At Work Partnership and the Work Foundation evidences the reason someone takes long-term sickness absence and remains off sick, isn’t just down to the diagnosis given on the fit note or sick certificate.  The survey also found:

  • 3.2 per cent of working time is lost to sickness absence in respondents’ organisations (which were generally large employers in both the private and public sectors) – equivalent to 7.3 days per employee a year
  • just under half (46 per cent) of total lost working time due to sickness absence is from absences lasting 20 working days or more
  • the employee believing their ill health is caused or made worse by work, poor support from the manager and disciplinary issues prolonged absence
  • stress and mental health were the most common reasons for long-term sickness absence referrals to occupational health

The Chartered Institute of Personnel and Development (CIPD), UK working lives: in search of job quality report, April 2018 - the report considers seven key dimensions of job quality and focuses on policy and practice actions that aim to improve working lives. It acknowledges the importance of promoting good mental health and improving the health and wellbeing of the workforce.  The key health and wellbeing findings in the report state:

  • 44 per cent of workers say work has a positive impact on their mental health
  • 30 per cent say they are often or always energised at work, in contrast with 55 per cent who feel under excessive pressure, exhausted or regularly miserable
  • being well is working well: health and wellbeing is the single most important aspect of job quality in terms of key outcomes
  • overall, work tends to have a positive impact on people’s health and wellbeing, but substantial proportions of people see negative, potentially quite serious, impacts. The most common conditions are musculoskeletal and anxiety or depression.

The report includes top tips on how you can improve mental health and wellbeing in the workplace.



National Forum for Wellbeing at Work: Compassion at work toolkit, December 2017
This toolkit, authored by Fiona Meechan, Lecturer in Healthcare Leadership and Management at the University of Manchester is supported by the Compassion at Work sub-group.  It sets out the business case for compassion at work and provides examples of what this means and how it can be implemented in practice. It also covers what is meant by the terms ‘empathy’ and ‘compassion’ in the workplace, what happens without it, why we lack it and how we can foster compassion.

The National Forum for Wellbeing at Work brings together HR Directors and Chief Medical Officers from over 30 leading global companies and major public sector institutions and is dedicated to improving workplace wellbeing. It was established by Professor Cary Cooper of Alliance Manchester Business School and Dr Paul Litchfield, Chief Medical Officer at BT.

Thriving at work – The Stevenson/Farmer review of mental health of employers,  October 2017 – following the request from the Prime Minister at the beginning of 2017, Paul Farmer and Dennis Stevenson undertook an independent review into how employers can better support the mental health of all people currently in employment including those with mental health problems or poor wellbeing to remain in and thrive through work. This extensive report includes recommendations employers can adopt regardless of their workplace type or size.

Mental health at work: The business costs ten years on, September 2017 - this report highlights that mental health problems in the UK workforce cost employers almost £35 billion last year. The updated figures highlight that the overall costs are broken down into £10.6 billion in sickness absence, £21.2 billion in reduced productivity at work, or ‘presenteeism’ and £3.1 billion in replacing staff who leave their jobs because of their mental health. The report also finds that by far the largest part of the business cost is in the form of reduced productivity among people who are at work but unwell, ‘presenteeism’. This costs businesses twice as much as sickness absence relating to poor mental health. The remainder of the cost relates to turnover – people leaving their jobs as a result of poor mental health.



Sickness absence in labour market, Office for National Statistics, 2016 - This is a report by the Office for National Statistics detailing sickness absence figures in the labour market from 1993 - 2013. The full report can be read on the Office for National Statistics webpages.

Measuring National Wellbeing, Office for National Statistics, 2016 -This document was published by the Office for National Statistics (ONS). The report collates information collected by UK Household Longitudinal Study (UKHLS) and explains the current state of national wellbeing in the U.K. The measuring national wellbeing report can be read in full on the Office for National Statistics website. 

Physical activity benefits, 2016 - A year on from Public Health England publication of their national physical activity framework, Everybody Active Every Day, the Chief Medical Officer, Professor Dame Sally Davies launched an infographic for health professionals outlining the benefits of physical activity. Your copy of the infographic can be downloaded here.



The NHS Constitution, October 2015 -The NHS Constitution includes a commitment to 'Provide support and opportunities for staff to maintain their health, wellbeing and safety'. This commitment remains as strong now as it did when the Constitution was launched in January 2010. Read more about the NHS Constitution on the GOV.UK website

Satisfied employees and higher productivity go together. National Institute of Economic and Social Research for the Department for Business, Innovation and Skills, January 2015 - This report is the first in the UK to examine how employee job satisfaction is postiviely associated with workplace financial performance, labour productivity, the quality of output and service. The press release for this report can be found on the National Institute of Economic and Social Research for the Department for Business, Innovation and Skills website.



How to engage staff in the NHS and why it matters, The Point of Care Foundation, 2014 – This report is about how the happiness of healthcare professionals impacts patient care. The report aims to remind people that staff engagement matters and that there is plenty of room to improve it in the NHS. Read more on this from The Point of Care Foundation.

The NHS Five Year Forward View, NHS England, October 2014 - The Five Year Forward View starts the move towards a different NHS, recognising the challenges and outlining potential solutions to the big questions facing health and care services in England. It defines the framework for further detailed planning about how the NHS needs to evolve over the next five years. Staff health and wellbeing is a key topic. Visit the NHS England webpages.

Worker wellbeing and workplace performance, Public Health England (PHE), October 2014 - This report provides a review of the information on employee wellbeing and its impact on workplace performance. It looks at how wellbeing in the workplace is measured and defined; what employee and job characteristics influence wellbeing in the workplace; what employer practices have the greatest positive impact on workplace wellbeing and the evidence linking employee wellbeing and business performance. For the full report on worker wellbeing and workplace performance, visit the Public Health England website.

Commuting by walking or cycling 'can boost mental wellbeing' NICE, September 2014 - This NICE article details the benefits of exercising whilst commuting to work of mental wellbeing. It suggests that active travel can boost your mental wellbeing as well as helping you to keep physically healthy. To read this article on commuting to work, please see the NICE website. 

Business in the Community Report on Mental Health, March 2014 - The Business in the Community Report details the costs of mental health to businesses and setting out a case for employee mental wellbeing measures, as both good for employees themselves and beneficial for the company as a whole. It provides data about the cost of both absentee and presenteeism and suggests practical ideas to help improve the mental wellbeing of your employees. To view the Business in the Community Report on Mental Health.

Wellbeing and health policy, Department of Health, February 2014 - The 'Wellbeing and Health Policy,' published by the Department of Health (DH), contains a series of documents covering areas, such as, why wellbeing matters, how it varies across the life course, why social relationships are key to wellbeing and why the wellbeing of health service staff affects service delivery. Some important findings, that are wellbeing related, include:

  • good wellbeing adds years to life and improves recovery from illness
  • health and wellbeing is associated with broader positive results
  • our wellbeing influences the wellbeing and mental health of those close to us
  • health and wellbeing affects how staff and health care providers work with implications for patients
  • good health and wellbeing may ultimately reduce the healthcare burden

View the wellbeing and healthy policy on the Department of Health website. 

You can find older pieces of health and wellbeing evidence on our webpages.





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