This systematic review explores why workplace health and wellbeing practices (WHWPs) often fail to improve psychological outcomes, focusing on implementation rather than intervention design. Across 74 studies, the authors identify that successful interventions depend on activating real workplace changes and sustaining them over time. Three critical success factors emerge: continuity of implementation, effective learning processes, and strong governance structures. Notably, improvements often occur through unintended social mechanisms such as enhanced relationships and culture. The findings highlight that organisational context, leadership, and adaptive implementation are central to achieving meaningful and lasting employee wellbeing improvements.