Most of it never reaches a spreadsheet
Across the UK economy, work-related stress costs employers around £51bn a year, and close to half of that is presenteeism: people at their desks and not really working. It rarely lands as a sick day, so it rarely gets managed. In 2024/25 the HSE recorded 22.1 million working days lost to stress, anxiety or depression.
The usual provision only works for the people who put their hand up. A counselling line needs someone to ring it, and most people would rather not: they do not want to talk about it, or to leave a record of it that outlasts the call. For some, in a regulated role, that record can threaten the job itself. So the help sits there, paid for, and the people it is meant for are the least likely to use it.
It is now being enforced against employers
The HSE issued the University of Birmingham a Notification of Contravention. The University had pointed to its sickness-absence figures, employee assistance programme (EAP) usage and occupational-health referrals to conclude that stress was not a significant issue. The HSE did not dispute the data and found the breach anyway: the University "cannot demonstrate sufficient understanding of the risk to your staff from work-related stress."
The HSE’s point was that the data, on its own, did not show the University understood the risk to its staff or was managing it.
Read against the case law set out in full on the long-form case, an EAP on its own no longer shows that a firm has understood the risk to its staff. The HSE does not have to act for that to matter: the same expectation sits behind any later question of whether a firm took reasonable care.
Care nobody has to ask for
Nobody has to explain anything. A counselling line only reaches the people who ring it and say out loud that they are struggling, and plenty never will, least of all someone whose job could turn on there being a record of the call. Massage is different. You sit in the chair for half an hour, and the colleague at the next desk cannot tell whether you came in stressed or with a stiff shoulder from five-a-side.
Think of it as servicing. You keep the van running so it does not strand someone halfway through a job, and people need looking after for the same reason, only replacing them takes a lot longer. Most of it builds up slowly: a stiff neck, or too much on one person for too long. Regular sessions keep that kind of thing from turning into time off, or into someone leaving without ever saying why. No crystals, chakras, bells or gongs, just a therapist and a table in a meeting room or a small screened space.
Where massage sits
The tier most firms leave empty
NICE Guideline NG212 stacks these tiers, each meant to add to the one below. A counselling line and occupational health cover the bottom tier. The middle tier, where massage sits, is the one most firms leave empty.
What it’s worth
Illustrative, and not a promised return. How these numbers are worked out.
The salary is only part of what each desk costs; the rent, rates and fire-safety get paid whether or not anyone is sitting there.
I am not going to promise it saves you money. The studies are on individuals, not on a workplace where only some people book, so any saving is a fair argument rather than a proven return. The concrete case for the budget review is duty of care, and that holds however many people turn up. It is a supplement that sits alongside the stress risk assessment, the workload monitoring and the manager training a firm still needs, and does not stand in for them.
What a visit looks like
Chair or table, set up in a meeting room or a quiet corner. Thirty-minute focused slots or hour-long sessions, up to sixteen people across a day. The same therapist every time, so your team sees a familiar face rather than a rota of strangers. Setup takes ten minutes and packdown five. I arrive on time, work quietly, and leave the room as I found it.
Heated table, fresh linens, oil, and a screen or the blinds for privacy if the room is open. Nothing that turns the office into a spa.
DBS-checked, £5m public liability cover, commercial motor insurance, and GDPR-compliant. Invoiced in arrears, 14 days to pay. I hold public liability, not professional indemnity, and I am not a regulated clinician.
Already on site atPristine Auto Care · Henry Ismond Joinery · Elicitate.ai
How firms pay for it
It goes through the books as staff welfare and is tax-deductible. A one-off half-day can sit under the £50-a-head trivial-benefits allowance, so the first visit is usually tax-free. Anything recurring is handled cleanly through a PSA. The full tax position, with the HMRC references, is on the pricing page for your accountant.
Pick the one that fits your firm
It runs differently depending on the work. Start with the one closest to home.
Informed commentary, and in places informed legal opinion, by an author with a paralegal background and a direct commercial interest in the conclusion. It is not legal or tax advice. Take qualified advice before acting on the regulatory or compliance points.
How these figures are worked out
Floor (2025–26): employer National Insurance at 15% above £5,000 and auto-enrolment pension at 3% of qualifying earnings, £6,240 to £50,270 (gov.uk; The Pensions Regulator), plus employers’ liability insurance. Premises and facilities: about £7,700 per workstation, the average for 20-year-old stock across the North West’s main office centres (Preston £6,315, Liverpool £7,421, Manchester £9,450), covering rent, business rates, fit-out, and the hard and soft facilities management a building in use needs, with utilities and most statutory compliance sitting inside that figure (Lambert Smith Hampton, Total Office Cost Survey). IT and software: amortised hardware plus Microsoft and Google UK list prices (Turner & Townsend; Grove Financial).
Worked through, a £32,000 salary becomes about £37,000 once National Insurance and pension are added, and about £45,500 once the North West premises, facilities, IT and software are counted. A firm of 40 on that basis costs roughly £1.48m to £1.82m a year.