Impact Framework

The NHS England Sustainable Improvement team
Impact Framework

Beyond measurement for improvement to your impact story

In today’s challenging health and care landscape, it is more important than ever to evidence the value of our work. Yet traditional approaches to evaluation can often underestimate the impact and value of improvement work.

Drawing from traditional and more innovative evaluation approaches, NHS England’s Sustainable Improvement team has developed an Impact Framework designed to capture the full value of improvement work. It uses theory of change and a narrative approach to bring rich sources of evidence to life.

The framework is applicable to quality improvement and transformational change programmes where evidence is harder to capture.

Sustainable Improvement team Impact Framework

The framework is based on eight underpinning principles:

  1. Be clear about what you are trying to achieve, and understand what changes (intended and unintended)
  2. There is no one absolute measure of value- focus on creating a  ‘good enough’ account of value at a point in time
  3. Judgements of value can (and should) be made by those involved, not only by ‘objective’ third party evaluators
  4. Involve stakeholders in defining and evaluating value at meaningful intervals
  5. Be honest about contribution and attribution
  6. Don’t dismiss the elements of value that are harder to capture
  7. Keep it simple and transparent
  8. Focus on learning, not just accountability

For more information on the Impact Framework, please contact