Wellbeing conversations

Wellbeing conversations

Creating cultures of wellbeing

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.
Click to reveal transcript

A key aim of the NHS People Plan is to look after our people’s health and wellbeing. Through wellbeing conversations, we aim to create cultures where people feel heard and valued, and in which diversity is respected.This should encourage us all to pass care and compassion on to each other, to patients and to families.

So what is a wellbeing conversation, and how do you have one? A wellbeing conversation is a supportive, coaching-style chat that focuses,one-to-one, on a person’s health and wellbeing.These conversations should be regular and ongoing, and not considered a one-off. While the main intention is for line managers to hold wellbeing conversations with peoplein their team, we should also encourage everyone to support each other by checking in regularly.

But how should you approach a wellbeing conversation? There are a few different ways. For example, you could have them as part of regular 121meetings and check ins. They might happen in the moment, whenever someone seems unwell. You could also touch base during team meetings or shift handovers to see if anyone would benefit from a follow up conversation. Before you start a wellbeing conversation, though, take a moment to reflect on any culturally appropriate approaches you may wish to use, in order to have a conversation that best supports peoples’ diversity.

Whether it’s taking place virtually or in person, it’s important you hold these conversations in safe, confidential spaces.

A great way to start the conversation is simply to ask, “How are you?” and actively listen to the response. Allow the conversation to flow naturally if possible. Where necessary, follow up with open questions that let your colleague share details. For example: What might be having an impact on your health and wellbeing? How are things going – in and outside of work? How can I best support you?

Of course, some people may seem hesitant talking about their personal health. Reassure them you’ll keep any details they share confidential. If they don’t want to engage, let them know that’s okay. Perhaps suggest following up at a later date.

You may also wonder whether you should keep a record of conversations and – if so – where?

You could keep a summary of the conversation by completing a Wellness Action Plan. You could also make reference to the conversations you have had during an appraisal or through ESR. Facilitating wellbeing conversations may feel daunting at first. Remember, though: your role is to hold the conversation, be compassionate and signpost further support.

Finally, please look after yourself and access support when needed. For more advice on how best to get support for yourself, or for someone else, check in with your local HR or Health and Wellbeing team.

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.

Conversationnetwork between 5 people of many races and roles
A network of conversations

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.

Staff Experiences

How wellbeing conversations helped personally and why they are important.

Click to reveal transcript

When I first had a wellbeing conversation, I was concerned there could be some judgement about what I’d said or any of my conditions. But having those wellbeing conversations and continuing the wellbeing conversations, has helped me realise that there is no judgement and my colleagues and friends are there to help.” 

“For the fact that they took the time, and the care to ask me and I mean really ask me, meant everything and their help to me was something that sustained me, during the days that were ahead of me.” 

“I was able to let out all my feelings and how I was thinking and the stress at work it was causing me, it helped me a lot.”

“It also gave me a really good role modelling opportunity where I could watch someone else do this for me positively and that could have a ripple effect how I supported other people as well.” 

“I think the top tips that I would give, is definitely create a relaxing environment for open conversations to happen. Perhaps finding an appropriate environment by asking the staff member where that could be.”

“So, make it clear to them that this is not an appraisal and it’s nothing to do with their work performance, this is an informal chat about how they are feeling.” 

“A holistic approach, not just looking at work stresses, but life stresses and everything else in their life. It should be a safe, friendly and non-judgemental environment.”

“Ask for advice from each other and really do take time to thank each other as well, sometimes we don’t do that enough.” 

“In these kinds of conversations, you need to think about the person or the staff as a precious human being with psychological and mental needs and be open and honest about these conversations.” 

“So, if I had a top tip it would be to check in regularly and make it very informal. Say ‘how are you’ and mean it, and stop and listen to the answer.” 

“A genuine ‘how are you really’ can really change someone’s day, month or even year.” 

“It would impact on creating empowered staff, but also inviting others to join your workplace. It would definitely create a culture of supporting, understanding and being considerate to others.” 

“If everyone had a productive wellbeing conversation, the ripple effect would be reflected on the care we provide for our patients.” 

“I think it would make the workplace and the world a more united, compassionate. Especially with the staff and the managers, and involve the people that are too scared to speak up. If we all have our say, it would help everyone.” 

“We’d understand each other’s issues and be able to respond to them quickly and there would be no more suffering in silence.” 

“Staff would definitely be considerate to each other, hearing each other’s stories, background and diversities, their challenges but also their celebrations. That would definitely allow us to celebrate but appreciate each other in a whole different way.”

Future national resources under development

NHS England and NHS Improvement, working in partnership with NHS Employers, believe that 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.

As such, a suite of resources that aim to support organisations to rollout and embed wellbeing conversations will be developed and shared across the NHS. These resources may include:

  • Supportive organisational implementation toolkits
  • Resources for managers
  • Resources for employee
  • Sharing of best practice and lessons learnt
  • Community of practice events to support implementation

If you have any specific queries on wellbeing conversations, please email [email protected]


Case StudiesThree 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.