This article considers the benefits to NHS organisations of looking after the health and wellbeing of staff. It also examines the consequences if staff wellbeing is neglected. The author sets out the policy background and the findings of major reviews into health and sickness in working life, generally and in the NHS. At the core of this article is a discussion about the need to establish a culture promoting staff health and wellbeing, to meet the pledges of the NHS Constitution and to respond to the quality and productivity challenges that the NHS faces. The article draws out the essential features of organisations necessary to achieve these goals.