Health and wellbeing conversations

Staff talking

We know that the wellbeing of staff is affected by a range of work-related factors, including workload, autonomy, working relationships, team support and the working environment.

External factors also have a significant impact such as lack of sleep, financial worries, health conditions, caring responsibilities, childcare responsibilities and other personal circumstances.

Health and wellbeing should be regularly discussed in teams and line management relationships. Specific health and wellbeing conversations can be incorporated into existing discussions or may be implemented as a stand-alone discussion, some examples include: 

  • line management conversations – such as 1:1s 
  • annual appraisals 
  • job planning discussions
  • stand-alone wellbeing conversations, facilitated by a line manager or trained colleague
  • team meetings and away days.

Health and wellbeing conversations guidance

The NHS People Plan asks that all NHS staff have a health and wellbeing conversation, and are supported to develop a personalised wellbeing plan, from September 2020. Find out more about this ask in the NHS England and NHS Improvement health and wellbeing conversations guidance.

Here are some ideas for things you might consider to ensure quality health and wellbeing conversations and plans are embedded within your organisation.

Who will hold the conversation?

In most cases this may be a line manager or supervisor, but in some cases staff might want to have this confidential discussion with someone else. Consider who else might have the skills, confidence and expertise to hold a sensitive conversation with colleagues – for example, mental health first aiders, members of your HR/OD function, other line managers in the same department, staff network leads, freedom to speak up guardians or wellbeing champions.

How will you embed annual wellbeing conversations for all staff?

Health and wellbeing conversations could be incorporated into existing processes, such as 1:1s, appraisals or job planning discussions. Alternatively, you could consider developing a new stand-alone process. Consider how any actions will be recorded from the conversation, either using existing paperwork/systems or by building on approaches such as Mind's wellness action plan.

What support, training and guidance will those hosting the conversation need?

Providing the right support to those hosting the conversations is important. You need to ensure the discussions are sensitive, open and valuable to staff members. Here are some elements to consider in your approach:

Guidance – line managers or facilitators will need guidance on what the health and wellbeing conversation should cover, what it shouldn’t cover, rules around confidentiality and safeguarding and to set the expectations of their role in the conversation and any follow up actions. 

Skills - many people will already have the listening skills, emotional intelligence and sensitivity needed for this conversation, but others may need more support to feel confident having these conversations. See our web page on training for line managers

Signposting – consider what additional information and signposting details would be useful. These conversations may cover a broad range of work-related and personal issues, can you provide signposting to support for potential topics? See our support available for NHS staff web page for an outline of free national support services for staff.  

Support – it’s important that line managers/conversation facilitators know where they can go for support. In particular, you should consider what support mechanisms you have in place if it’s necessary to break the confidentiality of the conversation due to safeguarding concerns. 

What support, information and guidance will staff need?

Staff members may also be nervous about discussing their personal health and wellbeing with others. You might want to consider the following in your approach:

Communications – how can you build trust and confidence in your workforce that these conversations are to support their wellbeing?

Guidance – as with facilitators, staff members should be given clear guidance as to what to expect from the conversation, the types of topics they will discuss, the confidentiality of the conversation and what happens after the conversation. 

Evaluation and monitoring

How will you measure, monitor and evaluate the completion and quality of these conversations? You may be able to use existing processes to monitor the number of conversations held, and could consider using staff survey results, local pulse surveys and focus groups to understand the quality of these discussions. 

Resources to support health and wellbeing conversations

The NHS Employers emotional wellbeing toolkit supports individuals, teams and line managers to assess their own wellbeing and to have open discussions about the staff's wellbeing. The toolkit contains a range of resources which can support health and wellbeing conversations, including:

Mind's wellness action plan – Mind has developed a template to guide managers and staff through discussions about mental health, to help them identify specific challenges and actions to improve wellbeing. 

How are NHS trusts embedding wellbeing conversations?

North Cumbria Integrated Care NHS Foundation Trust has replaced their annual appraisal with quarterly discussions between managers and staff, covering a range of topics including wellbeing, learning and development and performance.  For each quarterly discussion, managers are given prompts to discuss elements of wellbeing with their staff members. For example, a discussion about the things which have a positive or negative impact on their wellbeing, and identify things that would improve their wellbeing. 

Warrington and Halton Teaching Hospitals NHS Foundation Trust has developed a check-in meeting process for managers to support staff through the pandemic. This discussion focuses on recognising the contribution of staff during the Covid-19 pandemic, explores their physical and mental health, and any support the staff member needs. The trust has developed a manager template and detailed manager guidance to support this process.

Wirral Community Health and Care NHS Foundation Trust has embedded health and wellbeing conversations into their annual appraisal process. The appraisal conversation template guides staff and managers through a range of topics relating to wellbeing, including work-life balance, the team culture, and any actions or areas for improvement. 

Tips for holding health and wellbeing conversations

  • Ensure you have a confidential space to hold the conversation – whether it’s taking place in person or virtually.
  • Give yourself enough time for the discussion, and make it clear you can have a follow-up conversation if needed.
  • Prepare by reading your organisation’s guidance and help the staff member prepare by ensuring they do the same.
  • Think about open questions you could ask as part of the discussion. You might want to consider some of the following: 
    - How is your general wellbeing at the moment?
    - What is having a positive effect on your wellbeing at work?  
    - What is having a negative effect on your wellbeing at work? 
    - What would improve this?
    - Do you have any personal health and wellbeing goals that we can support you with?
    - Are there any issues inside or outside of work that have an impact on your health and wellbeing that you would like to talk about?
  • Using a tool like the emotional wellbeing toolkit can start an open conversation with your staff member.
  • Wrap up the meeting by summarising any actions, reassuring the staff member of confidentiality and re-iterating any signposting.
  • Seek support yourself if you need any support for your own wellbeing. 

Building health and wellbeing into everyday conversations

In addition to implementing health and wellbeing conversations and plans in response to the NHS People Plan, line managers, teams and colleagues should regularly openly discuss wellbeing. This section outlines a few different ways wellbeing can be build into everyday conversations.

Team wellbeing

Positive relationships and culture within teams support and foster a positive staff experience. When managers make time for and listen to their staff, this makes a difference to the team’s wellbeing and also to the patient experience. Managers could work with their team in a range of ways:

  • regularly update the team on organisational or departmental health and wellbeing initiatives and support mechanisms – such as counselling, EAP services, coaching and staff networks 
  • open up a discussion with the team. For example, ask “How can we work together to support the health and wellbeing of the team more effectively?”
  • be aware of what’s going on in the team. Are you aware of team members that are showing signs of stress? Do you understand the health and wellbeing needs of your team?
  • enable staff members to take time out of their day, for example, to access support or take part in wellbeing interventions
  • role model healthy behaviours, including taking breaks, staying hydrated and having something to eat.

Sickness absence and return to work meetings

The way a manager responds when staff call in sick can make a difference to how they feel about work. It could even affect the length of this absence and future absences. Compassionate and effective return to work meetings shows employees that their absence was noticed, that they were missed, and that the employer wants to take the time to find out how they are. They also show that effectively managing sickness absence is a priority for the employee’s wellbeing. Key questions managers could ask staff could be:

  • What’s the reason for the absence?
  • How long do you think you’re likely to be off?
  • Is there any work you’ve been doing that needs to be picked up while you’re off?
  • Is there anything else that may be affecting your wellbeing at the moment?
  • How is your general wellbeing now following your recent absence?
  • Are there any issues inside or outside of work that have an impact on your health and wellbeing that you would like to talk about?

Find out more about managing conversations around sickness absence in our sickness absence toolkit.  

Get in touch

If your organisation has any helpful resources on health and wellbeing conversations with staff, please email us at healthandwellbeing@nhsemployers.org

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