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Dr Zofia Bajorek

Implications for Employee Health, Wellbeing and Patient Outcomes in the NHS

Authors: Dr Zofia Bajorek Dr Zofia Bajorek

27 September 2013

The CIPD report released yesterday (26th September) Real-life leaders: closing the knowledge-doing gap’ provides some worrying findings regarding line-management, that if not addressed by both occupational psychologists and workplace practitioners, could result in negative organisational outcomes and employee wellbeing. 

Recent changes in the delivery of HR has seen a shift of many core HR activities, such as recruitment, undertaking performance appraisals, coaching, checking quality and pastoral care (including staff health and wellbeing) to front line-managers.  Consequently, a line-manager’s relationship with their employee is a critical factor in an employee’s overall experience of work. Hutchinson and Purcell (2008) highlight that when employees feel positive about their relationship with line-managers, organisational outcomes should improve as a result of higher levels of organisational commitment, loyalty and job satisfaction.

The report discusses how the pressure on line-managers to deliver performance objectives is creating barriers to supporting the interests of team members (including their health and wellbeing), indicating a task management vs. people management culture.  28% of line-managers had to put organisational priorities (such as achieving objectives) above the interests of wellbeing of team members, with almost one in four junior managers saying they did not have time for one-to-one people management and to respond to employer needs.  The CIPD report also highlights that 36% of line-managers had not received any training for the role, and were promoted to the position of line-manager as a result of their performance record rather than their people management skills.

The report raises particular concern when applied to the healthcare sector.  The Boorman (2009) review reported that over 80% of staff who responded to the survey believed that the health and wellbeing of staff had an impact on patient care.  Organisations which had prioritised staff health and wellbeing reported improved patient satisfaction, lower infection rates, had stronger quality scores, higher levels of staff retention and lower rates of sickness absence than those who did not.

The limited implementation or provision of health and wellbeing services by line-managers could also result in employees having high levels of sickness absence. NHS employees already have unfavourably high levels of staff absence in comparison with other government departments (an average of 10.7 days, compared with 9.7 days in the public sector as a whole, and 6.4 days in the private sector). The importance of staff health and wellbeing practices, and the role of line-managers to deliver them is therefore important to consider, especially as staff absence results in indirect costs to patient care (associated with the use of ad-hoc temporary staff costs and reduced productivity). 

A recent study by the Health and Work Development Unit at the Royal College of Physicians (2012) had reported that line management involvement in health and wellbeing programmes were a key element to its success. Where organisations had made strong progress in implementing the NICE 'health and wellbeing work place guidance' it had reduced sickness absence and improved quality of care.

With over one million staff employed by NHS organisations, the experiences of employees, and consequently how they are line managed is of great importance; for their sake, for the teams in which they work, and for patient outcomes.  Healthcare organisations need to not only train and support line-managers in people and time management in order to enable both consistent and sustainable performance from line-managers, but further research needs to be undertaken into the characteristics of what makes a ‘good’ line-manager, in the context of wellbeing and staff absence.