A while back, I was asked to deliver a day programme on health and wellbeing at work.

Delegates had considered the importance of good health and its strong links to productivity and were keen to find ways to minimise the causes of ill health. They opted, initially, to focus on reducing stress in their workforce.

They identified the broad categories of causes of stress in themselves and their staff and mounted these on a “fishbone” analysis framework on the wall.

The fish’s upper bones were used to represent the main causes of concern at work: from the job, the work environment and relationships to career progression and keeping up to date with change. Lower bones were dedicated to causes of concern from outside work: family, home and finance; health, fitness and leisure; social life and even holidays. The majority - and often the more worrying stressors - were generated from life outside work.

In a recent coaching session, one manager concluded that it was pressures outside work that had triggered recent workload management difficulties.

Broken sleep (a new and noisy arrival at home) and new domestic responsibilities and routine were at the root. Tiredness had an impact on performance at work, where tackling the relatively less strenuous, immediate tasks became the early but natural choice. In time, a backlog of larger projects left anxiety, further sleep disturbances and sapped energy in its wake.

A moment set aside to recognise the cause and fathom practical solutions to break the cycle restored peace of mind, concentration and performance.

The impact of an enduring economic crisis upon livelihoods, finances, homes and families can only increase the domestic and family concerns being carried, albeit subconsciously, into the workplace. Simultaneously, service quality and performance must continue to improve in an environment of budgetary constraints. Leaders and managers within this new scenario will need to be in top condition to deliver.

The NHS constitution heralds an era where we and our staff are to be provided with “support and opportunities… to maintain their health, wellbeing and safety” in the workplace.

At the end of the year and currently holding roadshows in each strategic health authority on health and wellbeing in the NHS, the Boorman review will lend further advice.

Investing just a few moments to check for signs of stress means we can act early and offset entrenched problems later.

Above all, do the things we know make for good health and build our reserves of energy? We know what they are - we need to determine to do them. Ringfence time for sleep and relaxation, eat well, exercise often, preserve your social life, spend time with those who encourage and refresh you and, of course, work hard and be productive.