How to get started

Guidance on how to implement wellbeing guardians is available in this document.

There are several areas to look at and consider when getting started. This section outlines some of the key areas to consider, these are:

Understanding your diverse workforce

Get to know your organisational data and what this is telling you

The first place to start is understanding your diverse workforce and what the wellbeing agenda means to them in the unique context of your healthcare organisation. Your organisational people, human resources and organisational development and occupational health and wellbeing teams can help you.

Nancy Hey, Executive Director, What Works Centre for Wellbeing Centre, shares the importance of data in health and wellbeing interventions.

“Using data helps us to see where we are already doing things that work and where we might have gaps or need to make significant changes. The evidence tells us that it is really important to have an organisational wide approach to improving wellbeing and that is where you will achieve the changes in wellbeing and performance. To do this, you need to know your people, know your context, and how the drivers of wellbeing apply within those contexts. If you can, use consistent questions and approaches to measuring over time to allow you to compare and contrast”.

There are lots of places where you can find data about your diverse workforce. A good starting point would be to familiarise yourself with the data to understand the big picture and dive into the detail where something doesn’t look right, needs exploration and/or improvement. It is not your role as a wellbeing guardian to do all this activity, but data will enable you to question and challenge how things are done.

Using the Model Health System tool

The Model Health System is a data-driven improvement tool that supports health and care systems to improve patient outcomes and population health. It:

  • provides benchmarked insights across the quality of care
  • provides productivity and organisational culture to identify opportunities for improvement
  • incorporates the Model Hospital, which provides provider-level benchmarking
  • provides wellbeing guardians and boards with insights that could help you give a baseline and an indication to priority areas.

To find out more about the Model Health System, you can access the model on the NHS England website.

Staff engagement and drivers for wellbeing

There is a range of data which can help to inform your wellbeing guardian assurance function. By reviewing some of the suggestions below, this data can help you establish what is working well, where you have concerns, where there are possible gaps and where the organisation needs to make changes to support its people better.

National staff survey and People pulse survey

Take a look at the data and commentary from your organisation in the national staff survey results or NHS people pulse surveys. You may wish to look at other local surveys too or consider targeted staff engagement events that work locally for your organisation.

Use benchmarking data, such as those available via the Model Health System, to understand what is happening in other areas. Examine how the data changes over time and the context of what was happening at these different times.

Staff engagement and drivers for wellbeing

Consider the diverse drivers of wellbeing – health, security, environment, relationships and purpose.

“As the NHS we have a definition of staff engagement which is from a wellbeing perspective “a positive attitude held by the employee towards the organisation and its values” and specifies that “engaged staff think and act in a positive way about the work they do, the people they work with and the organisation that they work in”. This is measured across dimensions within the national staff survey, which are motivation, advocacy, and involvement. Evidence suggests that trusts with high staff engagement scores have better outcomes associated with patient satisfaction, patient mortality, infection rates, annual health check scores as well as staff absenteeism and turnover”. Zoe Evans, Head of Staff Engagement, NHS England

A few points to consider which you may wish to implement are:

  • Look and understand your staff survey results for your organisation, particularly those scores around engagement and health and wellbeing themes.
  • Access the national staff survey.
  • Look at looking after our people – retention hub which has a number of useful case studies.
  • Encourage the board/senior leadership team to look at potential workforce health and wellbeing inequalities and ensure they are engaging with and supporting all relevant groups.
  • Look at the impact of the organisations existing health and wellbeing interventions. Have they been evaluated? What has the impact been? Should they be scaled and spread?

Utilising the NHS growing occupational health together strategy and the NHS health and wellbeing framework

Growing occupational health and wellbeing together strategy

NHS growing occupational health and wellbeing together is our five-year strategy to improve the health and wellbeing services for our NHS people, to keep them safe and healthy, and empowered to pass good care onto our patients.

This strategy now forms a mandate for action for integrated care systems and NHS organisations as part of whole system workforce planning, having been included as part of 2023-24 NHS priorities and operational planning guidance. This demonstrates the importance placed in looking after the health and wellbeing of all our NHS people in the workplace.

Health and wellbeing framework

The NHS health and wellbeing framework is a strategic toolkit designed for board/senior leadership teams and those leading the wellbeing agenda. It makes the case for staff health and wellbeing by:

The framework and accompanying resources are designed to be used in a flexible way to meet the needs of your organisation. It can be used to start, revise, or relaunch a programme, and depending on your starting point, your organisation may only need to use some of the elements.

The health and wellbeing framework diagnostic tool is an ideal starting point, to be used by your management team to assess where your organisation sits and help direct future activity. We recommend using the diagnostic tool with the board/senior leadership team, and where possible engage widely with your diverse workforce to benchmark wellbeing and consider areas of improvement.


To support wellbeing guardians, masterclasses have been created to provide a deep dive exploration into several useful topics. A high-level summary of the points covered during each masterclass have been provided below. We will soon be publishing recordings of previous masterclasses on this page.

Masterclass 1: How to use your wellbeing data to know your people and your organisational context

Key points to highlight from the masterclass:

  • The model health system is a data-driven improvement tool that enables NHS health systems and trusts to benchmark quality and productivity. There is a specific wellbeing compartment to the model health system which has been developed specifically to help wellbeing guardians and organisational leaders to give a baseline and an indication of priority areas.
  • This can help organisations to assess and make sure that evidence-based interventions on mental health are deployed for staff to access.
  • Lead and lag indicators have been developed to help organisations make evidence-based decisions. The wellbeing compartment provides organisations with a more balanced perspective in terms of how staff perceived their upstream, or lead indicator, performance as well as the more traditional downstream metrics.
  • Knowing your people and knowing your context is important to ensure organisations are providing appropriate health and wellbeing interventions.
  • People are at their least happy during their life during the period of their ‘working age’ with 48 years old being the average lowest. This mirrors suicide statistics and mental health.
  • The drivers for wellbeing at work to improve feeling good at work are health, security, environment, relationships and purpose. Managers are key to peoples work life happiness, but often managers are the most unhappy with high levels of mental and physical unhealth.
  • Suggestions on where to find health and wellbeing data include staff survey, workforce data, learning and development data, human resources casework, communications, freedom to speak up guardians, equality diversity and inclusion and people data.

Masterclass 2: Exploring the impact of COVID-19 on how to look after our NHS people

Key points to highlight from the masterclass:

  • Evidence from the national staff pulse surveys demonstrated how levels of stress and anxiety were continuing to rise month on month.
  • The biggest driver of staff stress and anxiety was from the growing sense of staff experience feeling less supported due to workload. The gap which exists between the rising demand for healthcare and the size of the workforce is a major contributor to staff experience and health and wellbeing.
  • The people plan identifies three outcomes which are all related to health and wellbeing, these are stated as more people, working differently, in a compassionate culture.
  • Evidence states that when staff experience regular health and wellbeing conversations from their leaders this is the most important factor for staff to feel they are well supported by the team they are a part of and by their line manager.

Masterclass 3: Introducing the violence, prevention and reduction agenda and best practice examples of how wellbeing guardians can support this

Key points to highlight from the masterclass:

  • Violence, prevention and reduction is a health and wellbeing initiative which is embedded into the health and wellbeing framework. Organisation should have processes in place to support staff post-incident but also be working to provide preventative awareness to staff.
  • Organisations are encouraged to work collaboratively with staff to make sure they have a violence, prevention and reduction policy in place which is responding to the issues and needs of what staff are experiencing or have the potential to be exposed to.
  • The violence, prevention and reduction standards deliver a risk-based framework that supports a safe and secure working environment for NHS staff, safeguarding them against abuse, aggression and violence. Wellbeing guardians are encouraged to find out who in their organisation is holding the responsibility for implementing this standard.
  • Wellbeing guardians are encouraged to ask their organisation if they have a violence, prevention and reduction working group in place and if so, are staff networks and the staff voice included in this group in a collaborative approach.