Research & Insights for Workplace Wellbeing

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Workplace Health and Wellbeing in Small and Medium Sized Enterprises (SMEs): A Mixed Methods Evaluation of Provision and Support Uptake

Paul A. B. Wilson; Joanna R. E. Brown; Ewan Macdonald; Jill Pell; Martie van Tongeren; Daniel F. Mackay

International Journal of Environmental Research and Public Health

2021 February

DOI: 10.1016/S2468-2667(25)00038-6

MDPI

Licence Label: CC BY 4.0

This mixed-methods study examines how small and medium-sized enterprises (SMEs) approach workplace health and wellbeing, and why uptake of external support often remains low.  The authors combine survey data with qualitative interviews to understand both provision and barriers. While many SMEs recognise the value of supporting employee wellbeing, formal strategies are often limited. Provision tends to be informal, reactive and dependent on leadership interest or available time.  Cost, time constraints and uncertainty about available support reduce engagement with external programmes. SMEs frequently prioritise business survival and operational demands over structured wellbeing planning.

The findings suggest that practical, accessible and context-sensitive support is essential if SMEs are to strengthen workplace health provision.

SME's face different pressures than large organisations.

  • SMEs often rely on informal wellbeing approaches

  • Leadership attitudes strongly shape provision

  • Time and financial pressures limit structured activity

  • Awareness of external support is inconsistent

  • One-size-fits-all programmes may not work in smaller businesses

  • Practical, low-burden solutions are more likely to gain traction

  • Policy and provider approaches must reflect SME realities

For HR advisers, policymakers and providers, this paper reinforces that workplace wellbeing in SMEs requires flexibility, clarity and alignment with operational realities.

© 2021 The Author(s). Licensee MDPI, Basel, Switzerland. The original work remains the intellectual property of the authors and publisher. Commentary by The Well Crowd. © The Well Crowd Ltd. 2026. All rights reserved. This content provides a summary and independent commentary on the original research and does not reproduce the original publication. It is intended for informational purposes only and does not constitute professional or medical advice. No part of this content may be reproduced or distributed without prior written permission.

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