Since the industrial revolution a chief concern of business organizations has been how best to organise work to maximise productivity and minimise costs. Securing and maintaining competitive advantage through new methods of work organization and systems of operation have largely centred around commercial and financial concerns rather than on the well-being of employees. Issues of occupational health and safety (OHS) have arisen in a range of working environments and legislative change has sought to ensure that safe and secure working conditions are a mandatory requirement of modern business. However, implementation of these mandates generally rests with management and whilst procedural regulations are broadly adhered to, more innovative solutions to OHS issues at work have been largely absent. The main argument of this paper is that traditional thinking and reactive policies to health issues at work have limited the development of innovative solutions to improve the well-being of people at work. We contend that the more recent interest in notions of social innovation, social entrepreneurship and social business, provide an opportunity to rethink approaches to, and our understanding of, occupational health and safety management in organizations. We commence our discussion by considering the emphasis in industrial production on the organization and control of work in the push for ever greater performance (and profits), often at the expense of the well-being of employees at work. We then turn attention to studies that have considered the social aspects of work and we consider the new and emerging concept of social innovation. In the final section, we forward a more holistic model of OHS for improving the conditions and well-being of employees in work settings. We conclude by calling for further research on social innovation and the management of OHS in the pursuit of sustainable healthy work environments.