The why, what, and how of health and wellbeing guardians

Why? Importance of health and wellbeing guardians

Health and wellbeing guardians are a key enabler in helping to create an organisational culture where empowering the health and wellbeing of our NHS people is routine and a priority consideration across all organisational activities and decisions.

The NHS people plan commits to looking after all our diverse healthcare people, to ensure that they are safe and healthy.  The NHS growing occupational health and wellbeing together (2022) strategy acts as our roadmap to improve occupational health and wellbeing services  for our healthcare employees. Health and wellbeing guardians therefore seek assurance to ensure that all healthcare employers are creating a culture of wellbeing, looking after their employees, and enabling them to deliver high quality care to patients and service users.

What is a health and wellbeing guardian?

A health and wellbeing guardian is a senior healthcare leader that seeks assurance, independently challenges, and holds the senior leadership team of a healthcare organisation to account for developing a compassionate and inclusive culture of health and wellbeing, to ensure that all employees are cared for and enabled to delivery high quality care to patients and service users.

The previous term of ‘wellbeing guardian’ has been evolved to now become, health and wellbeing guardian. This decision has been made based on feedback from wellbeing guardians that the title needed to reflect the full breadth of both health and wellbeing aspects of what the function covers. This change is in alignment with the original intention set out in the people plan 2020/21, outlining the function to “look at the organisation’s activities from a health and wellbeing perspective and act as a critical friend, while being clear that the primary responsibility for our people’s health and wellbeing lies with Chief Executive Officers (CEOs) or other accountable officers”.

“This is an assurance role at board level, in which the health and wellbeing guardian looks at the organisation’s activities through a health and wellbeing lens. It’s about the health of the organisation not just the individual. The individual, if they have a problem, is more likely to go to the freedom to speak up guardian or other health and wellbeing managers in the organisation rather than to the wellbeing guardian. The health and wellbeing guardian needs to have the ability to check and challenge the executive team on behalf of the board. No executive should be marking their own homework in this space so to have someone who is the health and wellbeing guardian and is a non-executive director is that ideal position”. Dame Carol Black, Chair – Health and Wellbeing Advisory Board, NHS England

How? Key responsibilities of a health and wellbeing guardian

The organisational contexts in which health and wellbeing guardians sit vary across healthcare settings. However, the common key responsibilities for the function of the health and wellbeing guardian can be summarised as:

  • Championing a health and wellbeing culture
  • Seeking assurance that the organisation is supporting health and wellbeing of the workforce
  • Holding to account organisational leaders and the board that they are enabling a culture of health and wellbeing

Further detailed information of how this works in difference healthcare settings (e.g. provider organisations, ICBs and primary care) is provided in the updated Health and wellbeing guardian guidance, together with a suite of supporting appendices.

“My background is as an occupational physician, and I lead the development of the specification of what a health and wellbeing guardian function might look like. The key thing to understand is that this is an assurance function, it’s not an executive role. The responsibility for safeguarding the health and wellbeing of staff lies squarely with the chief executive and the executive team, it’s their legal responsibility. The point of putting a wellbeing guardian on a board is to:

  • make sure there is somebody there to look at what the organisation is doing through a wellbeing lens.
  • ask questions even if they are difficult questions.
  • remind others on the board that wellbeing is important.
  • make sure that when considering the activities of the trust you don’t just look at the finances or the activities in terms of patient journeys, but you’re also thinking about the impact of what people are doing on the wellbeing of staff”.

Dr Paul Litchfield, Chair, What Works Well for Wellbeing Centre