The difference managers can make to workplace health

Newsletter articles

23 Nov 2015

Employment Studies issue 22

Jim Hillage, IES Director of Research

Jim HillageThe importance of the role of line managers in employee wellbeing and health has been highlighted by guidelines recently published by the National Institute for Health and Care Excellence (NICE), which were underpinned by an evidence review from IES.

In 2013, IES, in partnership with The Work Foundation and Lancaster University, was commissioned by NICE to undertake a series of three evidence reviews of relevant studies, and an economic analysis to support the production of the guidance. The guidance was published by NICE in June this year.
The studies were based on a systematic review of the available evidence. The first review examined the evidence on the effectiveness of interventions taken by supervisors that could enhance the wellbeing of the people they manage. The second examined the evidence on the effectiveness of organisational interventions that aim to support line managers to enhance the wellbeing of the people they manage. The final review focused on non-intervention studies which explored the workplace factors that facilitate or constrain the ability of line managers to enhance the wellbeing of the people they manage.

The first two reviews found relatively few studies which evaluated the effect of particular workplace interventions to support line managers in managing the wellbeing of their employees. There were many more non-intervention studies and the third review included 65 separate studies plus three good practice guides and 13 literature reviews.

This article summarises the findings of the reviews and the guidance published by NICE earlier this year.

The guidance

The NICE guidance, which is supported by the evidence, covers 11 points. Some of it is aimed at an organisational level, including recommending that ‘employers, senior leadership and managers, human resource teams, and all those with a remit for workplace health’ should make health and wellbeing a core priority throughout the organisation.

In addition, the guidance proposes that organisations should consider their employees’ mental health by creating a supportive environment that enables employees to be proactive in protecting and enhancing their own health and wellbeing. Organisations should also develop policies to support a workplace culture that respects work–life balance. For example, in relation to stress, organisations could refer to the principles of the Health and Safety Executive’s management standards for work related stress. [These cover the job demand and control, workplace support and relationships, the job role and workplace change].1

The IES research highlighted the relationship between fairness and justice in the workplace and employee wellbeing. The guidance picks this up by stating that employers should ensure that any unfair treatment of employees is addressed as a matter of priority, and that line managers should know how to direct employees to support if the employee feels that they are being treated unfairly.

Furthermore they should:

  • Ensure that employees feel valued and trusted by the organisation by:
    • offering support and training to help them feel competent
      promoting team working and a sense of community.
    • Encourage employees to have a voice in the organisation, and actively seek their contribution in decision-making through staff engagement forums and (for larger organisations) by anonymous staff surveys.
  • Value and acknowledge employees’ contributions across the organisation. If practical, act on their input and explain why an action was taken. If employees’ contributions are not acted on, the decision should be explained clearly.
  • Encourage employees to engage with trade unions, professional bodies and employee organisations whenever possible.

Management and leadership

With respect to senior managers, the guidance states that those with a leadership responsibility in workplace health should provide consistent leadership from the top, ensuring that the organisation actively supports a positive approach to employee health and wellbeing and that policies and procedures are in place and implemented. This should be part of the everyday running of the organisation, as well as being integrated into management performance reviews, organisational goals and objectives. Further, senior managers should:

  • Provide support to ensure that workplace policies and interventions for health and wellbeing are implemented for line managers, so that they in turn can support the employees they manage.
  • Ensure that line managers are aware that supporting employee health and wellbeing is a central part of their role, for example by including it in line managers’ job descriptions and emphasising it during recruitment.
  • Display the positive leadership behaviours they ask of their line managers, such as spending time with people at all levels in the organisation and talking with employees.
  • Act as a role model for leadership and proactively challenge behaviour and actions that may adversely affect employee health and wellbeing.

The role of line managers

Line managers are crucial to implementing policy in an organisation. The guidance therefore states that employers should recognise and support the key role that line managers have as the primary representative of the organisation and seek their input. This would include using line managers as a two-way communication channel between the employee and organisation, and encouraging staff to be motivated and committed to the organisation. Line managers’ views should be sought on staff morale and staffing and human resource issues.

It should also be acknowledged that line managers have an important role in protecting and improving the health and wellbeing of their employees through involvement in job design, person specifications, and performance reviews. Line managers should be given adequate time, training, and resources to ensure they balance the aims of the organisation with concern for the health and wellbeing of their employees.

Leadership style of line managers

The guidance states that line managers should adopt a positive leadership style that includes: encouraging creativity, new ideas and exploring new ways of doing things and opportunities to learn; offering help and encouragement to each employee to build a supportive relationship; acting as a mentor or coach; being open and approachable to ensure that employees feel free to share ideas; and recognising the contribution of each employee. Line managers should also have a clear vision that they can explain and make relevant to employees at all levels, and ensure that employees share the same motivation to fulfil their goals. Overall, they should work towards becoming role models who are trusted and respected by employees, and who provide a sense of meaning and challenge and build a spirit of teamwork and commitment.

Further, line managers should try to: consult regularly on daily procedures and problems; promote employee engagement and communication; recognise and praise good performance; and work with employees to produce and agree employees’ personal development plans. They should be proactive in identifying and addressing issues and concerns early, and take preventive action at the earliest opportunity, identifying sources of internal and external support.

Line managers ought to, in particular, avoid negative behaviour such as detachment from colleagues and ignoring employees’ suggestions, ideas and projects, failure to monitor and manage their employees as a group, feeling threatened by competent employees, or withholding information from colleague.

Training of line managers

As line managers play such a key role in ensuring the health and wellbeing of employees, it is crucial that they are trained adequately. The guidance states that all those with a remit for training should ensure that line managers receive training in areas such as effective leadership, the importance of maintaining health and wellbeing at work, and the effect of health and wellbeing on improved organisational performance. They should also be kept up-to-date with changes in the legal obligations and official advice to employers. Other key areas in which line managers should be trained include the implications of organisational change and how to manage it. They should also have good communication skills, including how to have difficult conversations with employees, and be able to develop people’s skills and resolve disputes.

Line managers play an important support role for employees, and line manager training should teach them to agree relevant and realistic targets and also how to recognise when someone may need support (for example, because of problems achieving a work–life balance, demands of home life or unfair treatment at work) combined with an awareness of the services they could be directed to.

In the area of stress management, line managers need to be trained in how to use stress risk assessments to identify and deal with sources of stress, as well as develop workplace solutions to reduce this risk. They should also be able to recognise the internal and external causes of stress, such as excessive workload, financial worries, work–home conflict or family issues and be able to give advice to employees about further support for stress both in and outside the workplace. Line managers should also have equality and diversity training on employee health and wellbeing and know how to manage sickness absence in line with NICE’s guideline on managing long-term sickness and incapacity for work2 (which were also underpinned by an IES evidence review).

All those with a remit for training should therefore ensure that the above skills and behaviours are set out in any documents outlining the skills and knowledge line managers need, and in their performance indicators. They should also ensure that line managers receive training to improve their awareness of mental health and wellbeing issues. This includes increasing their awareness of how they can affect the psychological wellbeing of employees. It also includes equipping managers to identify when someone may have a mental health problem, for example learning to identify signs and symptoms and looking for changes in behaviour and performance. Training should also ensure that line managers can give employees advice on where to get further support.

Job design

Job design and content is an integral part of ensuring employee wellbeing. Line managers should therefore encourage employees to be involved in the design of their role in order to achieve a balance in the work demanded of them. They should also allow them to have a degree of control, appropriate to their role, over when and how work is completed. This should take into account the resources and support available.

If possible and within the needs of the organisation, line managers should be flexible about work scheduling, giving employees control and flexibility over their own time. When implementing flexible working, line managers should be able to balance the needs of the business with the workloads and needs of other employees.

Finally, job design should take into account the effect on physical health when designing jobs. This could include, for example, ergonomic reviews, and giving advice on posture and on moving and handling physical loads. Jobs should be designed to promote and improve the physical health of employees by, for example, helping people to be physically active in their working day. See NICE’s guideline on promoting physical activity in the workplace3.

Monitoring and evaluation

Finally the guidance adds that all those with a remit for workplace health should:

  • Regularly monitor and evaluate the effect of new activities, policies, organisational change or recommendations on employee health and wellbeing and identify and address any gaps.
  • Ensure managers regularly review their own progress in promoting workplace health and wellbeing and acknowledge any gaps in their competencies. Organisations should support line managers in this activity.
  • Identify and use reliable and validated tools to monitor impact.
  • Give line managers a role in monitoring impact.


  2. NICE (2009) Workplace health: long-term sickness absence and incapacity to work
  3. NICE (2008) Physical activity in the workplace

This research was published by NICE in June 2015, as Workplace policy and management practices to improve the health and wellbeing of employees. It is available to download from: