Britain’s railway is one of the safest in the world and has continued to improve over the past 10 years. The industry now wants to create a matching step change in how we manage risk to workforce health and wellbeing. Across the rail sector, sickness has been found to be more than twice the national rate (ONS, 2019), translating into 1,346,659 days lost to sickness each year. The total costs of impaired health are estimated to be about £889m each year.