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 may help you to develop and review your health and wellbeing approach.


Workforce Stress and the Supportive Organisation - Health Education England (HEE), April 2019

HEE launched a new framework which challenges employers to consider the role their organisation plays in staff health and wellbeing. Used alongside NHS England's Health and Wellbeing framework it helps employers evaluate the impact of their systems, processes and culture on staff health and wellbeing, and consider how they can better support their staff.

For more information access the full framework. 

The Chartered Institute of Personnel and Development (CIPD) and Simply Health - Health and wellbeing at work report, April 2019

A new report from CIPD and Simply Health published shows a rise in stress is linked to poor management.

The research, which surveyed 1,078 organisations across the UK referencing 3.2 million employees shows that stress is a growing problem, and 37 per cent of UK businesses have seen an increase in stress-related absence. 

The report shows the top three causes of stress related absence are:

  • 62 per cent - workloads/volume of work
  • 43 per cent - management style
  • 30 per cent – relationships at work.

For more information access the full report.

NHS Health Education England NHS staff and learners' mental wellbeing report, February 2019

The report, led by Commission Chair, Sir Kenneth Pearson, reinforces the importance of promoting and supporting the wellbeing of NHS staff and those learning in NHS settings. The report looks at what the NHS are doing currently, where there is excellence and where the NHS can aspire to excellence. Take a look at our dedicated web page which can help support you to implement some of the recommendations from this report. 

What works centre for wellbeing - evidence base knowledge bank, January 2019

The evidence based knowledge bank is a free downloadable tool that makes accessing evidence based data as easy as possible. Over the past three years, the centre completed 16 systematic reviews on wellbeing which include culture and sport, work and learning and community wellbeing. The reviews have been collated into one searchable excel spreadsheet for you to access and download. To find out more visit the What Works Wellbeing website.

Institute of Employment Studies - Designing and testing a return on investment tool for employee assistance programmes (EAPs), January 2019

The Institute of Employment Studies new report Designing and testing a return on investment tool for EAPs outlines how a tool has been created to calculate the return on investment (ROI) of EAPs, offering employers the chance to take an evidence based approach to their workforce health interventions. The tool aims to offer a simple, online solution to assess whether investing in EAPs can deliver a ROI by reducing sickness absence and preventing mental health problems in the workplace. Take a look at the report and tool in more detail.


Bridging the gap:an evidence-based approach to employee engagement, Institute of Employment Studies, 2018

This paper interestingly demonstrates that employee engagement is not a single concept but instead it consists of different levels, ranging from the job to the organisation. It advises that organisations must decide what engagement means to them, in order to effectively measure and improve it. It presents multiple drivers of job and organisational engagement, which organisations can incorporate into a holistic strategy and embedded into people management practices and systems.

A realist informed mixed-methods evaluation of Schwartz Center Rounds® in England, 2018

This report is the first large-scale evaluation of Schwartz Rounds in the UK.  The report highlights that Rounds offer a safe, reflective space for staff to share stories with their peers about their work and its impact on them. Interestingly, the report shows that there was no change in engagement, but poor psychological wellbeing reduced significantly.  Take a look at the report in more detail for the full findings.

Men’s mental health and work – The case for a gendered approach to policy, 2018

This report assesses the changes in recent decades that have influenced men’s role in the workplace and what impact it has on health and more importantly, how to address it. It was written by The Work Foundation and supported by financial grants from the British Safety Council and NAPP Pharmaceuticals Ltd.

The evidence suggests that mental health and support services may need to be looked at through a ‘male lens’, including the importance of work and looking at the workplace as a setting for providing support.

Mental Health at Work 2018

Funded by The Royal Foundation as part of their Heads Together campaign, Mind created the Mental health at work tool. The tool covers a range of resources and examples from different organisations including businesses, charities and the government. It covers:

  • support for line managers
  • ways to assess your organisations approach
  • ideas to improve workplace culture
  • help to develop policy and practice.

New Musculoskeletal Core Capabilities Framework 2018

Skills for Health, with Health Education England, NHS England, Public Health England and the Arthritis and Musculoskeletal Alliance have launched a musculoskeletal core capabilities framework aimed at practitioners who will be the first point of contact for people with musculoskeletal conditions. The framework comprises 14 capabilities in four domains.

Domain A - Person-centred approaches.
Domain B - Assessment, investigation and diagnosis.
Domain C - Condition management, interventions and prevention.
Domain D - Service and professional development.

Promising practices for health and wellbeing at work, 2018
The report Promising practices for health and wellbeing at work  from Rand Europe was commissioned by Public Health England to generate a better understanding of the positive impact on staff health and wellbeing of workplace wellbeing interventions. 

The report presents case studies of health and wellbeing interventions based on submissions presented to an open portal.  A  number of examples are highlighted that demonstrate positive commitment to data collection and an understanding of the impact of their intervention . 

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 (RSPH) and Calouste Gulbenkian Foundation: That age old question report, June 2018

RSPH along with the Calouste Gulbenkian Foundation 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, such as employment.  It provides tips for employers to support wellbeing and resilience in preparation for later life and ideas on 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 organisations 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 organisations can develop 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 (eg 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 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

This 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, 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. Our dedicated web page can help support you to implement some of the recommendations from the report. 

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 web pages.

Measuring National Wellbeing, Office for National Statistics, 2016 
This document was published by the Office for National Statistics. The report collates information collected by UK Household Longitudinal Study 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. 

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


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