What would happen if construction treated health with the same confidence, discipline and urgency as safety?
That question sits at the heart of this episode of Build and Thrive, where Jennie Armstrong is joined by Rob Cheeseman, Head of Health at Balfour Beatty. It is a wide-ranging conversation about occupational health, occupational hygiene, wellbeing, ISO 45003, health exposure reporting, flexible working and what the construction site of the future could look like.
But beneath all of those topics is one clear message: health cannot remain something separate, specialist or too difficult to tackle. It has to become part of how construction plans work, manages risk, supports people and learns from what happens on site.
As Rob says in the episode: “We know how to manage risk in the industry. It’s what we do. Every single day we manage risk. Yet when it comes to health, we sort of go, ‘Ooh, that’s a bit different, isn’t it?’ And it’s not.”
For anyone working in construction, health and safety, occupational health, wellbeing, leadership or project delivery, this episode is full of practical insight. This blog summarises some of the key themes, but the full conversation is also available as a podcast and video, so if this resonates, it is well worth listening to or watching the episode in full.
Rob Cheeseman’s route into construction health
Rob’s background did not begin in construction. His early career was rooted in sport, exercise, rehabilitation and occupational health. After studying sports science, exercise physiology and kinesiology, he moved into rehabilitation and later occupational health, working in blue light services before making the move into construction around seven and a half years ago.
That background shaped how he sees health at work. Rather than viewing occupational health as a narrow clinical function, Rob became interested in the idea of a joined-up service: one that could support people from the start, understand workplace exposures, connect with clinicians where needed, and create a more complete picture of health risk.
When he moved into construction, he immediately noticed the scale of the challenge. Compared with other sectors, construction brought a bigger, more complex environment, with more moving parts and a much wider range of risks. But it also brought something positive: a strong can-do culture.
Rob describes construction as an industry where people generally want to succeed, want to do the right thing and are willing to give things a go. That willingness matters, because health improvement is not just about having a large team or a bigger budget. It depends on people across the business caring enough to take action.
What does “Head of Health” actually mean?
At Balfour Beatty, Rob’s role covers health, hygiene and wellbeing. That means occupational health, occupational hygiene and workplace wellbeing are not treated as three disconnected areas. They are part of one integrated health approach.
This is important because many organisations still silo these areas. Occupational health may be seen as clinical support, occupational hygiene as specialist measurement, and wellbeing as campaigns or awareness activity. Rob’s view is that these disciplines need to work together. A rounded health professional does not need to be a specialist in every area, but they do need enough understanding to see how the pieces connect.
Health risk management, for example, starts with anticipating risk, then controlling it, verifying those controls, and using health surveillance where needed. Wellbeing also connects to how people are set to work, whether they have the right tools, whether the work environment is supportive, and whether workplace risks are being managed properly.
The challenge is not to turn everyone into a specialist. It is to raise the basic health literacy of the business so that more people can manage the fundamentals with confidence.
Rob puts it simply: “Our trick should be to teach everybody how to do the basics.”
Making wellbeing tangible
One of the strongest parts of the conversation is Rob’s explanation of how Balfour Beatty makes wellbeing practical.
Wellbeing can easily become vague. Many organisations talk about wanting people to “thrive” or leave work healthier than when they arrived, but those ambitions can become difficult to translate into day-to-day project delivery. For a supervisor, site manager or project team, the question is not whether wellbeing matters. The question is what they are actually being asked to do.
Rob explains that Balfour Beatty uses a simple model: create, manage, support.
Create the right environment at work. Manage workplace risks, including psychosocial risks. Support and signpost people when they need help.
That structure helps make wellbeing less abstract. It also gives the business a way to test where its effort is going. If most activity sits in the “support” bucket, then the organisation may be relying too heavily on reactive help after people are already struggling. The aim is to strengthen the “create” and “manage” elements too, so wellbeing is built into the way work is designed and delivered.
As Rob explains, when people on site hear the word wellbeing, they may wonder whether they are suddenly responsible for someone’s whole life. But when the question becomes, “Can you create the right working environment? Can you manage the risks? Can you signpost support when needed?” the answer becomes much more practical.
It also brings the conversation back to basics. Rob says: “What do I want to be? I want to be paid on time. I want to be paid well. I want to have good welfare facilities. Looked after and not exposed to exposures at work. If you could do that for me, great.”
That is a powerful reminder. Wellbeing is not just posters, campaigns or fruit bowls. In construction, it starts with whether people are treated properly, protected from harm and given the conditions they need to do their work safely and well.
Treating health exposure like safety
Rob and Jennie also discuss one of the most important shifts the industry needs to make: reporting and learning from health exposure incidents.
In safety, the industry is used to reporting incidents, near misses and unsafe conditions. But health exposure can still be treated differently. If someone is exposed to dust, noise, fumes or another health risk, the response may be to correct it and move on. Rob challenges that.
He says: “We intervened and we corrected it. Fantastic. Great. But it still happened.”
That line sums up the issue. Correcting something in the moment is important, but it does not erase the exposure. If a control was missing, not followed or not working as intended, there is still learning to be done.
Balfour Beatty began reporting health exposure incidents around three or four years ago. The aim is not to create blame. It is to recognise what happened, learn from it and prevent it from happening again.
Rob also links this to respiratory protection and silica exposure. If RPE is not being worn correctly, if a worker is not clean shaven for a tight-fitting mask, or if a control is not functioning as intended, the control is not doing what it needs to do. In Balfour Beatty’s case, the business has introduced an RPE standard, accepting only three types of RPE, to create clarity and consistency.
This is where health starts to become more like safety. Not because every exposure will lead to immediate harm, but because every exposure is an opportunity to learn.
As Rob says: “Let’s treat health like safety. We talk about that. So let’s do it.”
ISO 45003 and the journey to consistency
The episode also explores Balfour Beatty’s ISO 45003 journey. Rob is clear that the standard became useful when the business understood where it wanted to go from a wellbeing perspective.
For Balfour Beatty, ISO 45003 was not simply an accreditation exercise. It was a way to create consistency across systems, processes, resources and project delivery.
The business had already completed a gap analysis several years earlier, but at that point decided not to pursue the standard immediately. Later, once the wellbeing model and strategy were clearer, ISO 45003 became a stronger fit. It provided a framework to check whether the right systems were in place and whether projects could access what they needed.
The process was not quick. Rob describes it as a long journey, with extensive audit days across the business. But the value came from working through documents, systems and processes and identifying where things were already strong, where there were gaps, and where improvements could make the approach more robust.
One of the key outcomes was that wellbeing became harder to miss. It was no longer hidden in one document or dependent on one person’s awareness. The process helped make sure that the right language, resources and expectations were built into the business.
The standard is not necessarily right for every organisation in full. Rob acknowledges that it is labour and resource intensive. But he also makes the point that even for organisations not ready to pursue accreditation, a gap analysis can be a very useful starting point. It can help identify small changes that may have a positive impact without requiring the whole journey immediately.
Being braver about the future of work
Another important theme is flexibility and the future construction site.
Jennie raises the question of what construction sites might look like in 2050, especially when other industries have already shifted significantly in how they think about work. Construction still often works around early starts, long hours, travel and rigid patterns that can make wellbeing difficult to improve in practice.
Rob’s response is clear: “We’ve got to be brave.”
He asks what would happen if the industry started with the future it wanted, rather than simply evolving from the way things are done today. What would the ideal site look like? How would it feel? How would it deliver? What would working patterns look like?
Rob gives a practical example: “Why could we not have Monday morning construction starts at 10am, and finish at 2pm on a Friday? We’re not talking about massive pockets of time here, but the difference that would make to the industry would be huge.”
The point is not that one working pattern will solve everything. It is that the industry needs to test different models properly, especially on large projects where clients, contractors and supply chains can come together around a shared approach.
Rob is clear that no single company can change this alone. Project demands, client requirements and commercial realities all matter. But if the industry can collectively trial new ways of working and prove that productivity does not suffer, flexible working could become a major part of improving health, wellbeing and retention.
Collaboration over competition
Towards the end of the episode, Rob reflects on what success looks like over the next five years. His answer centres on consistency, collaboration and shared learning.
He argues that health, safety and wellbeing should not be treated as areas for commercial advantage. They should be areas where the industry comes together, shares what works, admits what does not, and makes it easier for everyone to succeed.
That includes learning from other construction businesses, from industry groups and from sectors outside construction. Banking, finance, emergency services, manufacturing and other industries may all offer useful lessons. Likewise, construction may have insights that others can learn from too.
Rob’s view is that most people in construction want to do the right thing. The challenge is making it easier, clearer and more consistent.
That means sharing standards, being more prescriptive where that helps the supply chain, and reducing unnecessary variation between projects and contractors. For smaller organisations especially, clarity from tier ones can be helpful. When expectations are clear, they can invest in the right kit, training and processes with more confidence.
Key takeaways
- Health, hygiene and wellbeing need to be integrated, not treated as separate silos.
- Construction already knows how to manage risk, so health should not be seen as fundamentally different from safety.
- Wellbeing becomes easier to deliver when it is made practical through “create, manage, support”.
- Health exposure incidents should be reported and learned from, even when they are corrected quickly.
- ISO 45003 can help create consistency, but even a gap analysis can be a valuable starting point.
- The industry needs to be braver about flexible working and the future construction site.
- Health, safety and wellbeing should be areas of collaboration, not commercial competition.
- The basics matter: pay, welfare, good work design, risk control and respectful treatment are all part of wellbeing.
Listen or watch the full episode of Build & Thrive to hear the complete conversation with Rob Cheeseman and host Jennie Armstrong.
🎧 https://www.buzzsprout.com/2431164
📺 https://www.youtube.com/playlist?list=PLEoibJLDuFnnT3qSQw37LKPG6xlyvCj7B
Join the Conversation!
Do you have experiences or thoughts on addiction and recovery in construction?
Drop a comment below or share this post to help break the stigma. Together, we can make wellbeing part of the culture – not just the policy.
Thank you to GKR Scaffolding for sponsoring the Build & Thrive podcast and supporting our mission to improve health and wellbeing across the construction industry.
At Construction Health & Wellbeing, we help organisations create healthier, happier, and more sustainable workplaces.
Contact us today to learn how we can support your strategy.
Learn more about the people and organisations mentioned in this episode:
Jennie Armstrong: https://www.linkedin.com/in/jenniearmstrong/
Construction Health & Wellbeing: https://constructionhealth.co.uk/
GKR Scaffolding (sponsor): https://gkrscaffolding.co.uk/
Rob Cheeseman:
Balfour Beatty:
