Policy paper

DHSC evaluation strategy 2026

Published 29 June 2026

Applies to England

Foreword

Evaluation is essential to our ability to:

• produce evidence-informed policymaking
• evaluate new and innovative policy solutions to learn what works and what doesn’t
• ensure policies and programmes maximise value for money

The Department of Health and Social Care (DHSC) published its first evaluation strategy in 2022. The strategy established a strong focus on learning and development and committed to extending our coverage of high-quality evaluation. Since then, we have developed our approach to evaluation further, including:

• strengthening departmental guidance on impact assessments, monitoring and evaluation plans
• delivering training in-house through our internal evaluation academy
• continuing our transparent approach to sharing evaluation activity on the cross-government Evaluation Registry
• publishing evaluation reports

DHSC has the privilege of access and strong links to the National Institute for Health and Care Research (NIHR). NIHR is one of the nation’s major funders of health and care research. NIHR has transformed research in and for the NHS and social care and has helped to shape the research landscape more broadly. This enables DHSC to produce the best possible evidence and evaluation.

Our work is, however, not complete. This updated evaluation strategy reaffirms our commitment to producing and using the best possible evidence and evaluation to inform our decision making to deliver the UK government’s 10 Year Health Plan for England and the health mission to build a health service fit for the future.

Professor Lucy Chappell, Chief Scientific Adviser

Introduction

Evaluation, and the evidence it creates, is fundamental to ensuring that the activity of DHSC is informed by the best available evidence to improve the health and care of the nation. As the department changes with the current restructuring, it is important to reaffirm our commitment to evidence-informed decision making. This evaluation strategy sets out an updated and renewed vision for high-quality evaluation for the department. It builds on our first evaluation strategy published in 2022.

A restructured DHSC would take on many current functions and teams from NHS England, if the Health Bill is approved by Parliament. We will review how we implement the strategy from April 2027 to reflect the needs of the restructured organisation. This will include any further iteration needed to embed the principles below and further develop the evidence base to deliver the department’s strategic vision.

DHSC’s strategic vision

DHSC supports its ministers in leading the nation’s health and care system. Our departmental vision is to enable everyone to live more independent, healthier lives for longer by supporting healthy behaviours, improving our health and care system, and creating healthy environments.

The UK government’s 10 Year Health Plan and the health mission to build a health service fit for the future outline the proposed plans to reform the health system and encourage opportunities for innovation.

The 10 Year Health Plan sets out 3 shifts:

Hospital to community

This shift will bring healthcare closer to home and includes launching a neighbourhood health service. Neighbourhood health will offer easier and more convenient access to a full range of healthcare services on people’s doorsteps, open 12 hours a day, 6 days a week.

Analogue to digital

This shift will make managing healthcare as easy as online banking, with a transformed NHS App. The NHS App will become the digital front door to the NHS, where patients book appointments, manage medicines and view their medical records.

Sickness to prevention

This shift will create a more active health and care system that works with partners to make the healthy choice the easy choice. It will transition the NHS from a sickness service to a prevention service, reaching patients earlier, catching illness before it spreads and preventing it in the first place.

The 10 Year Health Plan and health mission have set the direction to achieving the department’s vision. Evidence and learning generated from robust, high-quality evaluation will be vital to this.

Defining evaluation

Evaluation is central to our understanding of what works and what does not, for whom and why. It supports the delivery of better outcomes and value for money and enables evidence-informed decision making and good practice. This strengthens the evidence base for future spending decisions and results in the better delivery of policies and programmes.

For more information on evaluation in government, read the Magenta Book.

Vision and principles for the evaluation strategy

Our vision for evaluation is to continue to create the conditions for evidence to inform our strategic objectives and to strengthen a culture of evaluation across the department. As the restructured DHSC takes shape, we will build on these foundations to enhance our evaluation activity and deepen a culture of learning from the best available evidence.

Our vision is underpinned by 4 core principles of evaluation. These principles build on the best of the evaluation cultures from DHSC and NHS England. They provide a strong basis for evaluation to be built into our activity, processes and structures as we move to the restructured organisation.

The 4 core principles are:

• purposeful and proportionate evaluation throughout DHSC
• rigorous, independent evaluation, underpinned by robust analytical standards and methodology
• continuous and active learning from evaluation
• enabling and enhancing evaluation capabilities

Across all 4 principles it is essential that evaluation design, delivery and interpretation is inclusive and ethical, so that the evidence is representative of the communities and nation we serve.

Purposeful and proportionate evaluation throughout DHSC

To achieve our vision and ensure that evidence supports delivery of our strategic objectives, evaluation must proportionately cover the full range of departmental activity. This includes local interventions supported by regional teams and national strategic policy programmes.

Evaluation is central to our processes and structures. Evaluations can be used for a range of purposes including:

• understanding short-term outcomes, implementation or the early stages of delivery to inform learning and adaptation
• long-term outcomes, including inequalities and any unintended consequences

Our evaluation activity must therefore be purposeful, with clear remits, specific and meaningful questions, and underpinned by theories of change illustrating the range of outcomes. By starting with purposeful evaluation, we ensure we are asking the right questions and subsequently developing the evidence needed for decision making and future development.

We must be proportionate in our evaluation activity, matching methodological approach, data and evidence availability, and ambition to the context and constraints we are working within. When determining the scale of evaluation activity that should be undertaken, important factors to consider are:

• current available evidence
• amount of spend
• applicability to the wider health and care context
• priority

All evaluations should have clear governance arrangements and a named senior responsible owner (SRO) to ensure they remain purposeful and proportionate. Through clear governance arrangements and sharing findings, we will continue to emphasise the role evaluation has in providing timely, relevant and robust evidence to inform decision making and delivery.

Case study: how evaluation can be purposeful - the targeted lung health check programme

The targeted lung health check programme is an ambitious pilot, aiming to translate the promising outcomes from preceding clinical trials and pilots of lung cancer screening into realised benefits within the NHS. The overarching ambition is to diagnose lung cancers at an earlier and therefore more treatable stage.

Initially starting as a 5-year pilot programme, the programme since transitioned to a national rollout of lung cancer screening. The programme sought to confirm whether the promising outcomes in the earlier studies could be achieved on a population basis, working across a wider geography and in ‘real world’ (not trial) conditions. The evaluation of the programme questions prioritised themes relating to implementation in non-trial environments and builds on the existing evidence base by exploring strengths and weaknesses of delivery model variations.

Case study: how evaluation can be proportionate - the Better Care Fund

The Better Care Fund (BCF) promotes person-centred care that is closer to home and focuses on prevention so that people are living healthier and more independent lives. The evaluation of the fund explores whether the level of BCF activity is associated with changes in system-level outcome indicators.

Local authority level data from 2013 to 2023 was analysed using quasi-experimental approaches, to evaluate the associated effect of the BCF using indicators such as delayed transfers of care, hospital readmissions and admissions to residential or nursing care. Qualitative research will supplement the analysis by:

• exploring local and national perceptions of the effectiveness of the BCF in driving integration within systems
• delivering targeted and universal support through the BCF Support Programme from the Local Government Association

Rigorous, independent evaluation, underpinned by robust analytical standards and methodology

Our evaluation activity will be underpinned by robust analytical standards and methodology. Continued emphasis and adherence to government analytical standards, including the Magenta Book and Green Book, will provide the benchmark for evaluation activity. Working with internal analysts and external experts, we will continue to consider critically the best methodologies for each circumstance and advocate for the most rigorous methods, such as experimental approaches where appropriate.

We will ensure evaluations have some independence from the policy or programme delivery team. This could be through:

• involvement of internal analysts
• independent individuals steering or peer reviewing the evaluation design and reports
• an independent team of evaluators

Where possible and appropriate, expert analytical input should be used at early stages to scope and inform evaluation planning. Drawing on the breadth of the analytical community and our external resources across NIHR will ensure robust, proportionate approaches are being adopted.

Case study: how evaluation can be rigorous - the Start for Life programme

The Start for Life programme (now Healthy Babies) provides universal support to parents and carers with a child aged 0 to 2 in Family Hubs in 75 English local authorities, selected due to higher levels of deprivation. This ongoing evaluation aims to identify the impact of the programme.

A randomised controlled trial was not appropriate or practical because the programme was designed to support all families in the intervention areas. As the programme was only rolled out in more deprived areas, it was not possible to create a strong comparison group using local authorities outside the programme.

Due to this complexity, the evaluation is using a quasi-experimental synthetic control method and dosage approach to evaluate the programme’s impact.

We will also look to expand how we use adaptive evaluation methodologies to ‘test, learn and grow’ our understanding and evidence quickly and robustly. This approach will be particularly important for operational and programme delivery and policy development, so we can rapidly gather evidence and implement what we have learned in an adaptive, agile way.

Similarly, we will continue to promote new analytical guidance and approaches. The Evaluation Task Force (ETF) ‘guidance on the impact evaluation of AI interventions’ (part of the Magenta Book) highlights the unique challenges and opportunities of evaluating AI interventions. This new guidance will directly support DHSC’s approach to evaluating AI and other emerging technologies.

We will also continue to explore opportunities for evaluation activity, such as AI tools, while maintaining research integrity. DHSC is committed to the responsible and ethical use of artificial intelligence (AI), including when using it as a tool within research and evaluations. We will develop internal policies to support the department’s use of AI tools for evaluations, to supplement wider government guidance such as the Government Digital Service AI playbook for the UK government.

Improvements in the quality of, and ability to link, data across health, social care and wider public services creates an opportunity to capture a fuller picture of the longer-term impacts of health and care interventions. For example, linking several administrative data sets allows us to consider the longer-term impacts of prevention initiatives, as well as benefits to wider society from health interventions such as reducing economic inactivity and contributing to social cohesion. This supports better decisions about what improves outcomes and where to invest for the greatest value.

Case study: how linked data can support evaluation - NHS Health and Growth Accelerators

The Health and Growth Accelerators programme is piloting health interventions to support people with health conditions historically associated with leaving employment to stay in employment. National and local level evaluations will provide robust evidence on implementation and outcomes that will inform future rollout of similar schemes across England.

The national impact evaluation of the programme focuses on the long-term employment status of people who have been through the programme. To do this, an innovative linked person-level data set has been created by the Office for National Statistics (ONS) and includes data from:

• hospital episode statistics (HES)
• HM Revenue and Customs (HMRC)
• the census
• Department for Work and Pensions (DWP)

This analysis is complex, as it’s assessing an outcome that did not happen, in this case unemployment. This will involve person-level analysis (intervention compared with no intervention) plus site-level analysis to capture wider system effects, with economic activity outcomes providing the most rigorous measure of policy impact.

To continue delivering independent, robust evaluation activities, we will work as an analytical community and in partnership with researchers funded by DHSC through NIHR and other external partners. Across this partnership, analytical standards and a shared aim to produce high-quality, meaningful evidence is fundamental.

DHSC invests significantly in research and development through NIHR. NIHR enables and delivers world-leading health and social care research that improves people’s health and wellbeing and promotes economic growth by working in partnership with:

• the NHS
• universities
• local government
• other research funders
• patients and the public

Working with DHSC and other stakeholders across this system, NIHR seeks to address the challenges they face and is responsive to research needs. This includes funding evaluation research through:

• bespoke commissions
• national, regional and local support
• rapid and national evaluation teams
• dedicated policy research units
• evidence synthesis teams

For example, since 2024, the NIHR Policy Research Programme has invested and committed to over £16 million in evaluation activity. This is supplemented by an NIHR Health and Social Care Delivery Research investment of £21.7 million (since 2022) in rapid and national evaluation teams to support:

• policy development
• health and social care services
• patients, staff and service users

See more details on NIHR funding and awards.

Case study: how the NIHR Policy Innovation and Evaluation Research Unit supports evaluation - the 10 Year Health Plan evaluability assessment

In July 2025, the 10 Year Health Plan was published and set out how we will reinvent the NHS through 3 radical shifts - hospital to community, analogue to digital and sickness to prevention.

The Policy Innovation and Evaluation Research Unit (PIRU), funded by NIHR, was used to rapidly commission an evaluability assessment following the publication of the 10 Year Health Plan. The evaluability assessment aimed to understand whether and how the plan could be evaluated.

To do this, the evaluability assessment analysed the 10 Year Health Plan and related policy documents by theme and ran a rapid literature review of previous major NHS reform evaluations. The evaluability assessment also used stakeholder workshops and interviews to identify priorities for evaluation and the evaluation approaches that could be used.

Case study: how the NIHR Economic Methods of Evaluation of Health and Care Interventions Policy Research Unit supports evaluation - the Public Health Grant feasibility study

This used a feasibility study to explore if it was possible to estimate unmet need, to inform future research.

Upper tier local authorities in England have a statutory duty to take action to improve the health of their population. Under this duty, local authorities commission or provide a range of health services that provide direct patient care, funded through the Public Health Grant which is issued by DHSC (£4.4 billion in 2026 to 2027). The funding streams which form the newly consolidated Public Health Grant have fallen by 20% in real per capita terms since 2015 to 2016 and the scale of unmet need for these services is unclear.

The joint DHSC policy and analytical team worked with the Economic Methods of Evaluation of Health and Care Interventions Policy Research Unit (EEPRU) to commission a feasibility study, funded through NIHR. This estimated the unmet need that exists in populations receiving services funded by the Public Health Grant.

This research project is currently in its final stages and aims to provide the best possible evidence to inform spending decisions.

Continuous and active learning from evaluation

It is not sufficient to simply produce the best evaluation research. To make a difference, the results need to be shared and actively incorporated into future policy development, decision making and service development. Our continuous learning from evaluation, research and analysis is central to improving how we operate, achieve our objectives and deliver value for money as a department.

Case study: how evaluation findings were used for improvement - the Fleming Fund

The Fleming Fund is a UK aid programme that supports low and middle income countries to develop surveillance systems to generate, use and share data on antimicrobial resistance (AMR). The Fleming Fund has contracted an independent evaluator for the lifetime of the programme, which allowed regular input into programme effectiveness. The economic evaluation used a value-for-money approach using metrics on economy, efficiency, effectiveness and equity to understand the value for money of the programme both at country and regional levels.

The evaluation of the first phase of the programme found that value for money had been achieved when looking at economy and efficiency. However, when looking at effectiveness, the evidence was less clear. This finding, alongside broader conclusions from the evaluation, led the programme to develop several new workstreams for the second phase of the programme, improving programme effectiveness. The findings from the first phase of evaluation were also used to inform the design of the second phase evaluation.

Case study: how evaluation findings can improve delivery - the Oliver McGowan Mandatory Training on Learning Disability and Autism

The Oliver McGowan Mandatory Training (OMMT) on Learning Disability and Autism is a training package co-developed and co-delivered by people with a learning disability and autistic people. The training package aims to improve staff knowledge, confidence and practice and the first evaluation of the 2022 training found strong evidence of improved knowledge, confidence and skills, alongside some positive behaviour change.

The findings were used to strengthen the training offer. The evaluation recommended a standardised delivery of the tier 1 package, combining 90 minutes of e-learning with a session led by experts by experience. For the tier 2 package, the evaluation suggested combining the strongest parts into a single, standardised offer.

The findings also shaped the next phase. A second, larger evaluation, funded by NIHR and led by the University of Leicester, is now assessing the process and impact of OMMT. This will support further improvement and future policy decisions.

To build continuous and active learning, evaluation activity should have a clear plan on how interim and final findings will be shared from the start. Findings should be promoted not just with commissioning teams, but widely across the department, the health and care community and across government. Importantly, we recognise the valuable learning that can be gained when evaluation activity findings are unexpected or reflect negative outcomes. Evaluation is about learning what does not work as much as what does.

We will strive for evidence to not only be produced but also used and translated into decision making. Governance processes should include a regular review of how end users will be updated throughout the evaluation and how findings will be shared and used. SROs should ensure that all evaluation learning is shared widely, transparently and embedded clearly in decision-making processes.

As standard, we will continue to share our evaluation activity transparently through the Evaluation Registry and publish findings in a timely manner, according to the UK Committee on Research Integrity’s (UKCORI) Concordat to Support Research Integrity.

Across its commissioned activity, NIHR has adopted an open access approach to publications. Open access makes published academic research freely, immediately and permanently available online for anyone to read, share and reuse. This maximises the societal, academic and economic impact of publicly funded research and enhances the integrity and rigour of research through greater openness and transparency.

Enabling and enhancing evaluation capabilities

We continue to invest in and build our evaluation capability. This includes delivering the ETF Evaluation Academy training and tailoring it to consider the specific context of our health and adult social care system. We will continue to offer a range of training delivered in a variety of formats. This includes:

• bite-sized, standalone videos that are always accessible
• bespoke sessions that share advice from relevant case studies regularly throughout the year

Wider training for analysts, policy and other departmental professions will also focus on the value of evaluation, core analytical concepts and use of evidence.

Training, resources and guidance are readily available to all DHSC staff and colleagues in arm’s length bodies through the centrally managed, internal Evaluation Hub.

Case study: sharing learning across organisations - our evaluation festival in October 2025

DHSC hosted a virtual evaluation festival in October 2025. Over the course of the week, the festival welcomed 233 attendees, including colleagues from DHSC, UK Health Security Agency (UKHSA) and NHS England. There were 21 online sessions, including networking sessions, ‘evaluation in action’ seminars, spotlight discussions and learning and development focused sessions.

The events were positively received and succeeded in sharing knowledge and good practice. The festival also promoted evaluation methodologies and strengthened our internal community relationships.

Building on this success, we launched an evaluation community of practice, bringing more colleagues together than ever before from across DHSC and NHS England. We will continue to look for opportunities to enable and enhance evaluation capabilities throughout government and across the health and social care system, nationally and locally.

Building the capability of all DHSC colleagues, irrespective of grade or profession or role, continues to be central to ensuring we are equipped to deliver high-quality evaluation activity with impact. This is because building evaluation capability will improve and strengthen the everyday judgements on evidence we all make to inform decision making and delivery.

Principles in practice

The 4 core principles outlined in this strategy are already in action and will continue to strengthen as the restructured DHSC takes shape.

The 2 case studies below highlight how we are already using evaluation to improve the quality of health and care policies.

Case study: NHS AI Lab

The NHS AI Laboratory programme (the AI Lab) was established to accelerate the safe, ethical and effective adoption of AI technologies across health and care. The evaluation of the NHS AI Lab examined how the programme was implemented, the impact it achieved and its overall value for money.

The evaluation found that the AI Lab made strong progress in enabling experimentation with AI technologies and in systematically capturing lessons learned. Some AI technologies supported through the programme are already fully integrated into NHS systems and services.

However, the evaluation also highlighted that many of the AI Lab’s longer-term benefits will take more time to materialise. Scaling AI across the NHS remains challenging, reflecting the need for further development of:

• enabling infrastructure
• clearer procurement and commissioning pathways
• more mature governance and assurance arrangements

Since the evaluation was published, the AI Lab has taken forward several recommendations. This includes publishing learning resources that consolidate lessons learned and provide practical guidance for organisations on how to buy, deploy and manage AI technologies safely in health and care settings.

The AI Lab has also established the AI Ambassador Network, a national community of practice designed to support real world adoption of AI. The network connects clinicians, digital leaders, analysts and policy professionals across the system to share practical experience, challenges and insights from using AI in day-to-day settings.

Case study: adult social care workforce fair pay agreement

The adult social care workforce fair pay agreement aims to address historic issues of low pay for workers providing vital adult social care and support in England. The agreement aims to establish legally enforceable minimum standards for pay and terms and conditions, ensuring care workers receive the recognition and reward they deserve. It will also help tackle the recruitment and retention crisis in the sector.

The evaluation supports ongoing policy development of the fair pay agreement by examining feasibility, implementation considerations and anticipated impacts. The evaluation spans the pre-implementation period and up to 2 years following introduction of the first fair pay agreement.

It uses mixed methods to assess workforce outcomes, labour market effects and system level responses, using existing administrative and survey data where possible. Qualitative research with stakeholders across the sector explores:

• perceptions of the fair pay agreement
• potential behavioural and workforce impacts
• risks and opportunities associated with different implementation approaches

Conclusion

Evaluation, and the evidence it creates, is fundamental to ensuring that the department’s activity is informed by the best available evidence to improve the health and care of the nation.

We will use our evaluation strategy and the principles put forward as a platform for engaging with and learning from our colleagues in the restructured DHSC, across the health and care system (locally and nationally), across government and with wider stakeholders.