Most university-age musicians experience physical and psychological symptoms that are directly related to the practice and performance of music, with up to 61% of tertiary music students reporting poor mental health, and 65% of tertiary students in a large European study reporting physical performance-related problems in the 12 months prior to the study. Despite forty years of research and advocacy, these figures remain persistently high. Health information and education are increasingly being adopted into music education courses, however, these tend to be peripheral to the main curriculum, are seldom regarded as integral to musical excellence, and do not address cultural and institutional policies and expectations that are powerful drivers of health behaviour.The aim of this discussion is to present strengths, weaknesses, opportunities, and threats to student musicians’ health and wellbeing, using a SWOT analysis of four different approaches to health and wellbeing across the Faculty of Music. Strengths include the daily presence of a musicians’ health specialist/Alexander Technique teacher/healthcare practitioner teaching in classes alongside instrumental teachers; accessibility of in-house advice and services, and frequent opportunities for formal and informal collaboration between the musicians’ health specialist and other staff, including administrative and maintenance personnel. Weaknesses include the lack of a faculty-wide policy to support healthy environments and behaviours; inconsistent leadership attitudes towards the inclusion of health and wellbeing as part of musical training, and health and wellbeing programs being dependent on department heads' preferences and on one casual individual practitioner. Opportunities include the availability of extensive advice on building sustainable health policy using occupational and public health principles, now tailored for music contexts in outputs from the Global Summit for Occupational Health in Music 2025; mutually beneficial collaborations with other university faculties and other institutions, and the potential to benefit the wider musician community through health data collection and analysis. Threats include expectations of costs in formalising musicians’ health as part of faculty policy; lack of suitably trained practitioners; a performance culture that is highly competitive and underpaid, and where the costs to musicians of over-practicing and unmanageable scheduling have largely been overlooked. The key recommendation is to design and implement a context-specific multi-level strategy according to occupational and public health principles that aims to create healthy playing environments and improve health literacy among staff and students.