Wellbeing conversations

What is a wellbeing conversation?

The NHS People Plan 2020-21 sets out an ambition

“From September 2020, every member of the NHS should have a health and wellbeing conversation and develop a personalised plan. These conversations may fit within an appraisal, job plan or one-to-one line management discussion, and should be reviewed at least annually. As part of this conversation, line managers will be expected to discuss the individual’s health and wellbeing, and any flexible working requirements, as well as equality, diversity and inclusion.”

NHS People Plan 2020-2021

Vision for the wellbeing conversations

  • Health and wellbeing conversations are intended to be regular, supportive, coaching-style one to one conversations that focus on the wellbeing of our NHS people.
  • By encouraging organisations to embed wellbeing conversations across their system, we aim to create cultures where people feel heard and valued, and in which diversity is respected. This should, in turn, encourage us all to pass care and compassion on to each other, to patients and to our families.
  • Wellbeing conversations should consider the whole wellbeing of an individual (e.g. physical, mental, emotional, social, financial, lifestyle, safety) and identify areas where the individual may need support, signpost them to that support, and regularly monitor their wellbeing over time.

When should I approach a wellbeing conversation?

We know that the wellbeing of our NHS people can be affected by all kinds of factors at work.  Workload, capacity, relationships with colleagues and the physical working environment can all have an impact.  Likewise, factors outside work, including lack of sleep, financial worries, health conditions, caring responsibilities and other personal circumstances, can have an impact – especially if they have changed recently.

The NHS People Plan encourages all NHS organisations to create cultures where our NHS people have regular wellbeing conversations with their line manager or a trusted colleague.  These wellbeing conversations could be held as standalone conversations with a colleague, or incorporated into existing conversations, such as regular 1:1s or during check-ins.  You could also touch base during team meetings or shift handovers to see if anyone would benefit from a follow up conversation.

Who should hold the conversation?

In most cases, a health and wellbeing conversation will be held by a line manager or supervisor, but in some instances colleagues may feel more comfortable talking to another trusted colleague about their wellbeing.

We would also encourage that, across an organisation, teams actively support one another by regularly checking in.

Tip: For some, holding a wellbeing conversation may feel daunting at first. It is important to remember that you are not being asked to provide clinical advice – your role is to hold the conversation, actively listen to your colleague, be compassionate and signpost to further support.

This range of resources aims to support line managers and leaders in having effective and supportive wellbeing conversations with their colleagues.

How should I approach a wellbeing conversation?

Whether it’s taking place virtually or in person, it’s important to hold a  wellbeing conversation in a safe, confidential space.

Before you start the conversation, take a moment to reflect on any cultural considerations that may be relevant.  For example, if you are aware that your colleague has recently experienced a bereavement, consider the different bereavement practices that they may follow depending on their religion or beliefs.  Be aware of any religious festivals or events that are taking place that may have an impact on your colleagues wellbeing, such as fasting during Ramadan.

A great way to start the conversation is by simply asking ‘how are you?’ and allowing your colleague time to reflect and respond.  Actively listen to their response and allow the conversation to flow.  Where needed, follow up with further open questions such as “how are you, really?”, “is there anything that is currently having an impact on your health and wellbeing?” or “how can I best support you?”.

Tip: Some colleagues may not feel comfortable talking about their personal health, and it is important that as a line manager, you reassure them that this is ok.  Perhaps make a suggestion that the conversation will be followed up at a later date.

Key skills for wellbeing conversations

One of the most important skills that you will need in order to facilitate an effective and supportive wellbeing conversation is listening – empathic and active listening.

Michael West has published a range of useful resources on compassionate leadership that reflect on the benefits of active listening.  He recommends that leaders create compassionate cultures, where colleagues feel listened to and supported, by using the following four steps:

  1. Attending – paying attention to your colleagues and “listening with fascination”
  2. Understanding – sharing an understanding of what they are going through
  3. Empathising where relevant
  4. Helping – taking action to signposting to support.

Following these four steps can help less confident or less experienced line managers hold effective wellbeing conversations, where their colleagues feel valued and listened to.

Ahead of holding the wellbeing conversation, you may also want to prepare yourself by checking what local and national support options are available, should you need to signpost your colleague to any specific services.  You may wish to remind yourself of the referral process for your local employee assistance programme or Occupational Health and Wellbeing service.

Good practice for wellbeing conversations

Wellbeing conversation are:

  • Caring and compassionate – they give space to enable employees to holistically explore their wellbeing.
  • Employee led – they enable the employee to lead the conversation and focus on the most important things to them.
  • Supportive – they signpost employees to the most appropriate support.
  • On-going and dynamic – wellbeing changes over time, therefore these conversations should be held regularly.
  • Inclusive – every NHS employee should have ongoing supportive conversations that enable their unique and diverse personal wellbeing needs to be met.

Wellbeing conversation are not:

  • Therapeutic interventions – employees should, where necessary, be signposted to access appropriate support from trained professionals.
  • Judgemental or performance related – wellbeing conversations should not be used for performance management or as a way of judging the quality of someone’s work.
  • A formal mental health assessment – if you think your colleague needs a formal mental health assessment, you can signpost them to a relevant trained professional.

How to approach wellbeing conversations with disabled colleagues

The video below also shares ideas on how to approach a wellbeing conversations with disabled colleagues and why this is important.

Staff experiences

How wellbeing conversations helped personally and why they are important.


More information on training available to support managers to have safe and effective wellbeing conversations.

Case Studies – Three case studies about rolling out wellbeing conversations across the NHS (one of which also includes a toolkit and Personal Wellbeing Plan).

You may download a powerpoint presentation about implementing wellbeing conversations (read only) or just the editable template slides. Accessibility note: The content in this page is the accessible alternative to the powerpoint presentation.

If you have any specific queries on wellbeing conversations, please email ournhspeople.hwb@nhs.net