Guest blog by Janet O'Neill
Undertaking an MSc in Workplace Health and Wellbeing enabled me to align wellbeing with OH practice. Being a member of the Educating OH Public Health England Framework working group in 2016, I used my new understanding to influence the need for wellbeing within occupational health (OH). These standards are used as a baseline for OH higher education such as at RGU, Cumbria and, more recently, Derby Universities.
The Keeping Britain Working report stated that good work is good for health and the role of OH is to support good work. Various organisations position OH with wellbeing e.g. HSE Occupational Health and Wellbeing and the NHS Growing Occupational Health and Wellbeing together programme. The recent SOM Leadership Competency Framework includes an essential domain for OH delivery “Leading organisations”, a core element of wellbeing leadership.
Wellbeing without OH is like a spade without a gardener.
The strategic problem: Many UK employers have scaled wellbeing activity, but capability, standards and evaluation are inconsistent. The new Affinity Health at Work Framework (2026) found widespread role ambiguity, variable standards, and low confidence in strategic analysis and evaluation across wellbeing roles; it proposes a competency spine that centres evidence use, governance, data ethics, psychosocial risk, and impact evaluation including return on investment (ROI) and/or value of investment (VOI), capabilities that mirror OH’s established governance culture. When these capabilities are weak, programmes become activity‑led rather than risk‑led, and impact is hard to prove. Positioning OH outside wellbeing leaves a gap between culture‑building and clinical/occupational risk management. Positioning OH within wellbeing closes that gap and anchors wellbeing in population health principles, statutory duties, and measurable outcomes.
The education and regulation case: Public health is already embedded in OH nursing (OHN). PHE’s Educating Occupational Health Nurses (2016) sets a public‑health‑centred curriculum for OHN training: determinants and inequalities, organisational health risk assessment (physical and mental), behaviour change, health promotion, and the reciprocal effects of work and health. It expects leadership, business skills, and high‑quality placements that translate theory into practice - precisely the scaffolding a strategic wellbeing function need. The NMC’s SCPHN standards (2022) go further. Across six spheres of influence (A–F), they require SCPHN‑OH nurses to operate with high autonomy, evidence use, evaluation, data/informatics, and leadership for healthy places and population health. OHN outcomes emphasise using legal/regulatory frameworks, business acumen, and sector‑level influence on design services responsive to individuals and organisations. In other words: OHN proficiency is built for strategic wellbeing. If we keep wellbeing and OH apart, we ignore the regulator’s articulation of OH as a public‑health specialty in the workplace.
So, regulatory and education frameworks place OH in population health and prevention, not just clinical case management. Housing OH with wellbeing reflects how the profession is trained and regulated to practise.
The governance and risk argument: Wellbeing needs OH to meet its duty of care. The Affinity framework embeds data protection, digital ethics, and evidence‑based decision‑making as core organisational practice factors for wellbeing roles. It also highlights persistent capability gaps in evaluation and analytics at senior levels. OH can close those gaps: clinical governance, confidentiality, lawful basis for processing, and risk escalation are routine in OH practice and directly transferable to wellbeing governance.
Moreover, the NMC SCPHN qualification requires advanced digital/technological skills and application of legal, regulatory and governance requirements. When wellbeing units take on screening, triage or sensitive health data, OH’s oversight mitigates risk and ensures proportionate, lawful data handling, especially around surveillance, psychosocial risk assessment, or crisis response. Without OH at the table, wellbeing risks operating with insufficient clinical governance, especially where activities drift into health assessment, data processing, or safety‑critical decision‑making.
The operational value: Employers need clear thresholds for non‑clinical vs clinical support, consistent return to work (RTW) plans, and adjustments that sustain work. The Affinity framework’s practice domain (“support interventions”) sets out RTW/adjustments, crisis management, and knowledge of OH/case‑management pathways, a blueprint for integrated wellbeing‑OH pathways. Aligning wellbeing with OH clarifies escalation routes, and standardises RTW content (demands, adjustments, timelines, relapse indicators). When OH is embedded with wellbeing, triage becomes risk‑led and timely, RTW advice is specific and defensible, and clinical time is focused on complexity, improving outcomes and reducing avoidable absence.
The measurement gap: OH turns wellbeing into an accountable, investable function. The Affinity review found organisations struggle to evaluate wellbeing consistently; ROI/VOI literacy is uncommon across professional backgrounds. Yet boards need proof: impact on absence, turnover, productivity, and equity. Embedding OH within wellbeing unlocks routine use of occupational data, surveillance insights, and RTW outcomes to evidence value and target investment. OH education mandates critical appraisal, data/informatics, evaluation, and dissemination, exactly the capabilities required to move from “campaigns” to continuous improvement and risk reduction. Public Health Skills and Knowledge Framework reinforces public‑health practice (including workplace public health) as data driven and evaluated.
Q&A
Q Will embedding OH medicalise wellbeing?
No. The point is not to medicalise wellbeing, but to professionalise it, combining culture and prevention with proportionate clinical oversight and risk management.
Q Isn’t wellbeing broader than health risks?
A Yes. OH standards require population‑level leadership, business acumen, and healthy workplace design. OH brings methods (assessment, surveillance, evaluation) that help wellbeing deliver inclusive, measurable improvements.
Q Can’t wellbeing just partner with OH when needed?
A Partnership helps, but structural integration fixes the recurring problems identified by Affinity: role ambiguity, poor escalation, inconsistent data standards, and weak evaluation.
Positioning OH with Wellbeing ensures a single evidence model, so organisations can prioritise, fund, and govern wellbeing as a strategic risk programme, not a discretionary perk. Workplace wellbeing protects and improves population health at work, reduces risk, and supports sustainable performance, with OH not an adjunct but the driver. OH is already placed inside public health and embodies evidence for wellbeing governance, analytics, and RTW capability. The public health case for good work demands integrated, risk‑led action. Positioning OH as a key part of wellbeing is how organisations move from initiatives to outcomes, with defensible governance, earlier intervention, and a measurement system board can trust.
Janet O’Neill is an Occupational Health Nurse specialist, Deputy Head of the National School of Occupational Health and Head of PAM Academy, PAM Group.