NHS Change Day is a grassroots social movement led by staff and patients from across clinical and non-clinical areas of work in health and care. For one day each year, those involved harness their collective energy, creativity and ideas to help improve health and care. NHS Change Day is the single largest improvement event in the history of the NHS.

In January 2015, NHS IQ Horizons Team commissioned AD Research & Analysis to undertake an evaluation of NHS Change Day 2015.

The purpose of this evaluation is to:

  • Determine the impact of NHS Change Day on personal attitudes, positive deviance behaviours and the spread of innovation diffusion.
  • Develop a new understanding of grassroots social movements using a grounded theory of change.
  • Explore new thinking on organisational transformational change and the actions people use to galvanise, inspire and connect with others to realise their passion and ideas.
  • Contribute to the future design and delivery of Change Days.

What did the evaluation reveal?

  • In order to understand the impact of large scale social movements we need a new language, a new way of re-imagining evaluations and a space for innovative thinking and practice.
  • NHS Change Day 2015 was exponentially bigger than in previous years, becoming the largest social movement in the NHS. More than two thirds of Acute Trusts, Clinical Commissioning Groups and Mental Health Trusts were involved in NHS Change Day.
  • Over fifteen national, regional and local campaigns took place. They achieved almost six times as many Twitter mentions as the previous year. 209 organisations or settings undertook some sort of activity on NHS Change Day 2015.
  • NHS Change Day enables system-wide innovations to gain support and be adopted into use. It helps social innovations become more visible and celebrated. The results show an increasing recognition of social innovation, bottom-up forms of change, solidarity of staff across the system, organisational commitment to change and the power of networks.
  • NHS Change Day is worth what users make it worth. It is a platform: a website that links to other websites and its power lies in how it connects people and resources together, provides spaces for people to ‘meet’, makes their actions visible and makes valuations of them together.
  • NHS Change Day is a way of linking and connecting with others: a system of systems. This can be observed by the way networks link together, such as NHS Change Day volunteer networks coming together on NHS Change Day through the use of common platforms like the #NHSChangeDay or activists linking their campaigns to similar others and to Change Day itself.
  • Thousands of pledges were made on NHS Change Day but it is the patterns that are significant in terms of impact: celebrating change, using multimedia communication channels, campaigns, introducing quality improvements, turning ideas into actions, reaffirming positive working practices and behaviours and restating solidarity.
  • NHS Change Day volunteers are an important community of practice of talented professionals. They play a key role in supporting the spread of NHS Change Day through their social media communications, on the ground activities and presence.
  • The biggest impacts are generated in local systems where the existing culture is already sympathetic to NHS Change Day. Examples of this include improving maternity services, post-operative care, end of life care and mental health and dementia patient care.
  • The intangible value is greater than the visible, and the indirect benefits are greater than the direct.
  • The Re-evaluation introduces a new way of measuring the full value of NHS Change Day using Calibration, Calculation and Capacitation.
    – Calculate – summing numbers to arrive at a single figure, usually in pounds.
    – Calibrate – the cost/benefits of different actions and outcomes, based on individual decision making and socialised in groups.
    – Capacitate – measuring the capacity of a movement or network, plus the potential of that network to increase its capacity and the value it can generate in the future.
  • The re-valuation makes a strong case for the socialised value of NHS Change Day as a way of measuring impact. This relates to the way people talk about the Day, place a social value on their individual and collective contribution, or reach an agreement on what the value actually means.
  • If the full value is accounted for by monetising the previously indirect or intangible value (using third party data, e.g. sickness absence avoided and the knock on uplift in patient experience), the answer in pounds will be implausibly large.
  • Compared to that input, the cost of running NHS Change Day is trivial and the main cost of NHS Change Day is the time/effort put in.

Evaluation documents

If you have any questions regarding the NHS Change Day 2015 re-valuation, please email Janet Wildman.