Boorman recommendations

Report dictionary definition

The Boorman Review (2009) describes the importance of prioritising staff health and wellbeing within the NHS. A healthier workforce means fewer avoidable days off sick, reduced levels of presenteeism and a more efficient workforce. Healthier, happier staff means better patient care, which should always be the main priority of the NHS. The Boorman Review outlines how to achieve a healthier workforce by establishing 20 recommendations:


Summary of recommendations and key actions

Improving organisational behaviours and performance

Key actions

We recommend that all NHS organisations provide staff health and wellbeing services that are centred on prevention (of both work-related and lifestyle- influenced ill-health), are fully aligned with wider public health policies and initiatives, and are seen as a real and tangible benefit of working in the NHS.
We recommend that all NHS leaders and managers are developed and equipped to recognise the link between staff health and wellbeing and organisational performance, and that their actions are judged in terms of whether they contribute to or undermine staff health and wellbeing.


We recommend that all NHS trusts develop and implement strategies for actively improving the health and wellbeing of their workforce, and particularly for tackling the major health and lifestyle issues that affect their staff and the wider population.


All NHS trusts should implement the guidance from the National Institute for Health and Clinical Excellence on promoting mental health and wellbeing at work and from the National Mental Health and Employment Strategy.
  • Mental wellbeing at work policy
It is essential that all NHS trusts put staff health and wellbeing at the heart of their work, with a clearly identified board-level champion and senior managerial support.


Training in health and wellbeing should be an integral part of management training and leadership development at local, regional and national levels and should be built into annual performance assessment and personal development planning processes.
We believe that high priority should be given to ensuring that managers have the skills and tools to support staff with mental health problems.


Achieving an exemplar service

Key actions

We recommend that, when drawing up a staff health and wellbeing strategy, trusts undertake a proper assessment of key health priorities and risk factors, which should fully reflect their legal requirements in this area.
We recommend that there should be consistent access to early and effective interventions for common musculoskeletal and mental health problems in all trusts, as they are the major causes of ill health among NHS staff.

We recommend that, as well as providing core staff health and wellbeing services to nationally specified standards, all trusts should provide a range of additional staff health and wellbeing services targeted at the needs of their organisation. To do this they will need both to assess the specific needs and requirements of their staff and to engage with staff to determine the services they wish to see provided.

Staff engagement will be critical to ensuring that both the range of services and the way in which they are provided are seen as credible and as addressing staff concerns. Trusts need to go beyond simply meeting their legislative obligations to embrace a wider concept of staff engagement.



It is essential that staff health and wellbeing services that are commissioned following the sort of risk assessment process we have outlined, are then properly resourced.

Core early intervention services should form part of the minimum service specification for staff health and wellbeing recommended in our earlier report.

There should also be nationally agreed service standards for early intervention.

Embedding staff health and wellbeing in NHS systems and infrastructure

Key actions

We now recommend that the NHS Operating Framework should clearly establish the requirement for staff health and wellbeing to be included in national and local governance frameworks, to ensure proper board accountability for its implementation.

We recommend that the Care Quality Commission’s annual assessment of NHS organisations and their delivery partners should in future include standards and targets for staff health and wellbeing. Similarly, NHS Improvement should consider support for staff health and wellbeing in its assessment process for foundation trust status as well as in its in-year monitoring arrangements.

It is important that the approach to improving support for staff health and wellbeing is developed in consultation and partnership with staff and trade unions.

We recommend that all NHS organisations put in place a staff health and wellbeing strategy, developed with the full involvement of staff and staff representatives, and that its implementation is routinely monitored, reported and discussed with staff and their representatives.

It is essential that staff health and wellbeing strategies, and the services that are subsequently commissioned, are available to all staff on an equitable basis.


It is also important that delivery of staff health and wellbeing services is properly monitored and regularly assessed and reviewed.

Why Register?

Great reasons to register with NHS Employers

  • A personalised website
    Manage your profile and select topics of interest to you
  • Access your dashboard
    Bookmark useful content to help you quickly find what you're looking for
  • Get involved
    Contribute to our Talking Points discussions, comment on and rate our webpages
  • Keep up to date
    Receive the latest newsletters and media summaries

Log In