Article

Evaluating your health and wellbeing programme

Guidance for health and wellbeing leads about how they can measure feedback from their health and wellbeing strategies and/or initiatives.

1 April 2022

NHS organisations offer a range of staff health and wellbeing initiatives, but how do you demonstrate whether they have created the intended impact?

An important starting point is to think about evaluation right from the beginning of an initiative – even before it has been implemented if possible. This will allow you to clearly prioritise your goals and outcomes, gather internal support and develop a clear evaluation strategy. A logic model may be a good way to help you with this.

In terms of practically measuring impact, many organisations use feedback forms, which give a snapshot in time about how people feel and whether they enjoyed and valued the intervention. What this doesn’t measure, is the impact it had on the individual's behaviour, and if they have made a positive shift as a result of taking part. Measuring behaviour change can help you to demonstrate where your health and wellbeing strategy was effective and help you to improve your initiatives as a result.

Evaluation can show where things are working well and where there is room for improvement. It can help to move from providing a good service to an excellent one. Robust evaluation can help to make a difference, demonstrate impact, improve your work, and demonstrate value for money.

When you are starting to plan your evaluation, consider the following steps.

 

Define your objectives

Objectives should set out in your evaluation plan what your overall health and wellbeing programme/initiative aims to achieve, and the overall goals that will be used to measure performance. The objectives should always be clear, provable (if you will not be able to prove an objective has been met, then think about revising it) and relevant to your role and the remit of your strategy.

Health and wellbeing programmes/initiatives often involve partners or participation from staff, and success can be dependent upon a number of external factors beyond your control. Make sure that your objectives are not impossible for you and your team to achieve. You may find the following questions and points helpful or thought provoking when setting objectives:

  • What will success look like? Make sure this is definable and achievable.
  • How will you measure the impact of this intervention/programme? For example, via surveys or interviews.
  • What would you ideally like the outcome to be? This could be improved mental health, reduced absenteeism or fewer occupational health referrals.
  • Have you built in opportunity for staff to feedback in the overall process? Ensuring staff are engaged is essential and incorporating feedback could help improve the effectiveness of an intervention.
  • Have you considered measuring the impact both quantitatively and qualitatively? A range of different metrics may offer a more robust measure.
  • Do you have the resource within your role/team to be able to do this effectively? Make sure you are mapping out your evaluation activity relative to your capacity.


Your health and wellbeing strategy/initiative may involve a range of tasks, activities, or initiatives, for example, a toolkit, a staff physiotherapy service and a health and wellbeing roadshow. Together these contribute to the overall objectives of the programme. You may choose to define specific initiative objectives within your programme evaluation plan or for large programmes, you may have individual evaluation plans for specific activities within the overall programme evaluation plan.

When setting activity objectives, the same rules apply as for programme objectives. You should make sure they fit within the context of the overall programme objectives and ensure that you aim for consistency for similar types of activity or product.

 

Identify target audiences

It is really important to identify all of your target audiences. Are you trying to engage all staff or specific staff groups? Do you have different audiences for different interventions? Identifying your audiences will help you tailor your interventions and measure how successful they have been.

 

Mapping tasks and activities

The next stage in creating your evaluation plan is to map your tasks and activities. This will help you demonstrate the full impact of your work by ensuring you choose the right performance measures to track and evidence impact. This is useful as we don’t often include everything we do and the time that it takes to run a health and wellbeing programme.

Begin to think about how to collect evaluation data and information as activities proceed.

  1. List everything you have done so far and how it has contributed towards your overall strategy.
  2. Develop a logic model or theory of change to help you clearly map out your future activities and intended impact.
  3. Consider how your objectives and activities are likely to influence behaviour.
     

Define performance measures

When looking at what to measure in order to build your evaluation, it is helpful to think about the following:

  • Inputs – these are the activities that you will be doing for instance, how many roadshows are you running?
  • Outputs - these are the number of people who have engaged in or been exposed to your intervention for instance, web hits on your intranet or attendees.
  • Out-takes – this means the immediate impact on the audience after your intervention, this could be a happy sheet or the number of people who intend to change as a result of your intervention for instance, a health check or a mindfulness session.
  • Changed behaviours – this is how many people have changed something as a result of the intervention for instance, in the health check example, has the person made changes to their lifestyle as a result of the conversation?

The NHS Health and Wellbeing Framework implementation guide demonstrates the factors that you may want to consider as part of your evaluation framework.

 

Identify data sources

How will you gather data? Will you create a survey? Do you already have this data elsewhere? You may already have collected most of the data in one way or another, so think about what data your organisation already collects. Some key places to look for data are:

  • the NHS Staff Survey
  • the NHS people pulse survey
  • patient satisfaction rates
  • sickness absence
  • staff performance evaluations
  • data dashboards - such as the NHS health & wellbeing framework diagnostic tool
  • occupational health referrals
  • employee assistance programmes
  • agency spend.

You could also try and collect your own data where resource and capacity allows from interviews and/or focus groups.

You could also get external support to get deeper expertise from pre-existing resources for example, more extensive data collection techniques such as in-depth health and wellbeing surveys like Britain’s Healthiest Workplace which is used by some NHS trusts. External support can offer a level of expertise (expert data analysis techniques) and independence that internal support may not be able to.
 

Consider the use of real-time data

A key finding from the 2021 NHS England and NHS Improvement report The Future of NHS Human Resources and Organisational Development highlights the need for real-time data. The findings suggest that whilst the NHS Staff Survey is very good for benchmarking scores and data, it does not provide a real-time, truly representative reflection. Capturing frequent snapshots of health and wellbeing data could be hugely beneficial to help identify key individuals, teams, departments, or cohorts that may be needing additional health and wellbeing support.

Examples include regular NHS People Pulse surveys (to capture regular changes over time) or real-time health trackers for example, smart devices that measure steps, heart rate and physical activity levels.

In addition to assessing whether things work, it is equally important to learn lessons. Your evaluation process should occur regularly so that you can adjust and renew your programmes and interventions if you need to and achieve desired impacts. Real time insight can help this process occur more smoothly.

 

Risks and constraints

Things to consider:

  • Will budget be a problem?
  • Do you have all the resources you need?
  • Will people get survey fatigue?
  • Do you have enough time to do everything?
  • What do you need to prioritise?

You can then start to implement your evaluation plan. Once you have gathered your findings, it’s important to share these with your colleagues and act on them. It can be a great way of demonstrating the value of your interventions and deciding where to invest money in new initiatives. Furthermore, demonstrating that you have taken into consideration the feedback from your sources can motivate them to give more feedback in the future.

 

Resources to help guide your evaluation

  • In partnership with RAND Europe, we ran evaluation workshops to support health and wellbeing leads in their roles. These events were designed to help them understand how to effectively evaluate their health and wellbeing strategy and/or initiatives. See the recording from a workshop and view the slides
  • Evolve Workplace Wellbeing website has free, evidence-informed workplace wellbeing resources developed and curated by the Workplace Wellbeing team at the University
    of East Anglia and RAND Europe.  The website also includes a free cost effectiveness calculator
    to help you make a business case for wellbeing initiatives in the workplace. 

  • The developing and evaluating workplace health interventions: employer toolkit, developed by Public Health England and Northumbria Healthcare NHS Foundation Trust, sets out a four-stage strategy for developing and evaluating workplace interventions: analyse, plan, implement and evaluate.
     
  • The What Works Centre for Wellbeing provides a practical eight-step guide for how to evaluate wellbeing interventions. Their guide was designed for people who may have lots of different functions in an organisation, with very busy working days. The guide allows you to dip in and out of the content as needed, and work at your own pace.
     
  • The What Works Centre for Wellbeing in partnership with the Economic and Social Research Council , the University of East Anglia and the University of Sheffield have created a free cost effective calculator and how to guide. Used alongside their detailed user manual, these resources will help you evaluate and compare the cost effectiveness of wellbeing activities in the workplace.