Article

Health and wellbeing conversations

Guidance for line managers conducting health and wellbeing conversations with staff.

14 July 2025

The NHS People Plan, part of the NHS 10-year health plan, emphasises the importance of health and wellbeing conversations and encourages the development of personalised wellbeing plans for staff. The NHS Long Term Workforce Plan further emphasises the importance of retaining our valued NHS workforce. Employers should critically evaluate their wellbeing offerings and the staff experience at all career stages. A positive staff experience and comprehensive support are crucial for encouraging staff to remain in the workplace.

Embedding wellbeing into workplace culture

Health and wellbeing conversations should be a cornerstone of our workplace culture.  These discussions must become a regular part of our routine, seamlessly integrated into existing processes like one-to-ones, appraisals, or job planning meetings. Alternatively, you might develop a dedicated process for these vital conversations. It's essential to ensure that any actions to support your colleagues are thoroughly documented, whether through existing paperwork and systems or a personal wellbeing plan.  

Embedding wellbeing into everyday team conversation

In addition to promoting health and wellbeing conversations and plans in response to the NHS People Plan and Long-Term Workforce Plan, line managers, teams and colleagues should regularly and openly discuss wellbeing. This section outlines several ways to integrate wellbeing into everyday conversations.

Team wellbeing

Positive relationships and a supportive culture within teams are essential for fostering a positive staff experience. When managers make time for and listen to their staff, it significantly impacts the team’s wellbeing and the patient experience. Managers can work with their team in various ways:

  • Regular updates to keep the team informed about organisational or departmental health and wellbeing initiatives and support mechanisms, such as counselling, EAP services, coaching, and staff networks.
  • Open Discussions to initiate conversations with the team. For example, ask, "How can we work together to support the health and wellbeing of the team more effectively?"
  • Stay alert to what’s happening within the team. Are there team members 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 to access support or participate in wellbeing interventions.
  • Role modelling healthy behaviours, including taking breaks, staying hydrated and having something to eat.

Who leads the wellbeing conversation?

In most cases, a health and wellbeing conversation will be led by a line manager or supervisor. However, there are instances where staff may prefer to have this confidential discussion with someone else. While the primary goal is for line managers to engage in wellbeing conversations with their colleagues, everyone within the team must support one another by regularly checking in.

Consider who else might possess the skills, confidence, and expertise to hold a sensitive conversation with colleagues. This could include 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. 

It is also important to note that line managers are in a unique position to make and implement changes for their staff. Therefore, they must be kept informed to provide the appropriate support for their colleagues.

Watch NHS England's video, What is a Wellbeing Conversation? below.

  • Supporting those who host health and wellbeing conversations is crucial. These discussions must be sensitive, open and valuable. Here are key elements to consider:

    Guidance - The person facilitating the conversation requires clear instructions on what topics to covers, how to maintain confidentiality and safeguarding protocols. They should also understand their role expectations including how to manage the conversation and any necessary follow-up actions.

    Skills – Many individuals already have the listening skills, emotional intelligence and sensitivity required for these conversations. However, some may need additional support to feel confident in their ability to conduct them effectively. For more information, visit our training page for line managers.

    Signposting – Think about what additional information and resources might be helpful. These conversations can address a wide range of work-related and personal issues. Can you provide guidance and support for potential topics?

    Support – It's crucial for line managers and conversation facilitators to know where they can seek support. Specifically, consider what mechanisms are in place for situations where breaking confidentiality is necessary due to safeguarding concerns.

  • Staff members might feel uneasy about discussing their personal health and wellbeing with others. To ease their concerns, consider the following in your approach to the conversation:

    Communications – How can you build trust and confidence in your workforce to ensure they understand that these conversations are genuinely intended to support their wellbeing?

    Diversity and Inclusion – How can you deepen your understanding of your colleagues and identify any culturally appropriate approaches that may be necessary?

    Guidance – Just like facilitators, staff members need clear guidance on what to expect from the conversation. This includes the topics that will be discussed, the confidentiality of the conversation, and the steps that will follow afterward.

  • Improving the wellbeing of our NHS people is a long term culture change and we are committed to supporting NHS organisations to implement wellbeing conversations through the co-design of resources and shared learning. The following resources have been developed by NHS England in partnership with NHS Employers:

     

  • North Cumbria Integrated Care NHS Foundation Trust

    North Cumbria Integrated Care NHS Foundation Trust has replaced its 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

    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 (PDF) and detailed manager guidance (PDF) to support this process.

    Wirral Community Health and Care NHS Foundation Trust

    Wirral Community Health and Care NHS Foundation Trust has embedded health and wellbeing conversations into its annual appraisal process. The appraisal conversation template (PDF) 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.

    Lancashire and South Cumbria NHS Foundation Trust

    Lancashire and South Cumbria NHS Foundation Trust designed and developed a conversation workbook which would sit alongside and complement its current system, with the aim of ensuring meaningful wellbeing conversations took place during staff appraisals.

    Northern Care Alliance NHS Group

    Northern Care Alliance NHS Group explored various inclusive and compassionate ways to empower its staff to confidently discuss how they are feeling, through information conversations with their colleagues or during a confidential wellbeing conversation with their line manager.

    Staffordshire and Stoke-On-Trent CCGs

    Staffordshire and Stoke-On-Trent CCGs explored how to use wellbeing conversations to support colleagues to work from home in a safe and ergonomically suitable environment, where necessary, reasonable adjustments had been made.

    University Hospitals of Derby and Burton NHS Foundation Trust

    University Hospitals of Derby and Burton NHS Foundation Trust has created a health and wellbeing plan (PDF) that underpins the wellbeing conversation. The trust has shared this plan with its staff forum, wellbeing networks, executive colleagues and board wellbeing guardians who have all contributed to the plan. The plan has been launched with inclusion in organisational development work and will be embedded in appraisal, induction and leadership training.

    • Ensure you have a confidential space to hold the conversation, whether it’s in person or virtually.
    • Give yourself enough time for the discussion and make it clear that a follow-up conversation can be arranged if needed.
    • Prepare and read 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. 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?
    • Summarise any actions, reassure the staff member of confidentiality and reiterate any signposting.
    • Seek support yourself if you need any assistance for your own wellbeing.