Case Study

University College London Hospitals (UCLH) NHS Foundation Trust is a leading NHS Foundation Trust in the London, renowned for providing first-class acute and specialist services. 

UCLH operates across multiple sites in North Central London, with its main hospital, University College Hospital, located on Euston Road. Other key locations include the National Hospital for Neurology and Neurosurgery, the UCH Macmillan Cancer Centre, the Royal National ENT and Eastman Dental Hospitals, Grafton Way, Westmoreland Street, the Hospital for Tropical Diseases, and the Royal London Hospital for Integrated Medicine. 

UCLH is a large organization with an annual turnover of approximately £1.6 million. It employs circa 11,500 staff. Each year, our hospitals care for over 1 million patients both as outpatient appointments and inpatient services. 

UCLH is engaged in providing a wide range of acute, as well as specialized and complex care. This includes: 

• Acute and Specialist Services: Covering a vast array of medical and surgical specialties, from general medicine to highly complex conditions including neurological disorders, Women’s Health Services, Cancer Services, Proton Beam therapy, ENT, Dental Services, amongst many others.  
• Major Teaching Centre: Its hospitals are significant teaching hubs, offering training for doctors, nurses, and other healthcare professionals in partnership with University College London (UCL) and other universities. 
• World-Class Research: UCLH collaborates closely with UCL in research. As one of the UK’s leading NHS hospitals and one of the world’s leading universities, our vision if to ensure that advances in medical science, led by our scientists and clinicians, are best used to improve care for patients, at UCLH and beyond. 
• The close partnership between UCLH and UCL in research is enabled by the National Institute for Health and Care Research UCLH Biomedical Research Centre (BRC), which invests in research at UCLH and UCL. 

Happy staff means well cared for patients. Exceptional care of staff, as is the vision at UCLH, enables the best care for patients. UCLH’s innovative, co-created Health and Wellbeing Programme (Be Well), launched in 2021, exemplifies staff engagement and experience through a holistic, whole-person approach. Grounded in the NHS England’s Health and Wellbeing Framework, and extensive engagement and feedback from staff, the programme addresses all aspects of wellbeing. Since 2021, feedback from staff has been overwhelmingly positive and, for some, Be Well has been life changing.  

Impact data shows consistent, widespread, improvements in all areas of Staff Engagement and Experience (NHS Staff Survey) with UCLH voted the ‘most recommended trust to work for’ (acute/community trusts) in the annual staff survey for the last 3 years. At UCLH, we know that staff experience goes hand in hand with patient experience and UCLH is the highest scoring acute trust in London for patient satisfaction (2023 National Inpatient Survey). 

Data from a recent Trust Wellbeing Survey also showed that almost all respondents (80%-95) were aware of our key wellbeing service providers and a large proportion (89%) engaged with at least one of these, suggesting benefits are being realised across the organisation.

During the Covid-19 Pandemic, NHS staff suffered unprecedented emotional burden, leading to the rise in depression, anxiety, alcohol use and suicide (Kevin Fong, 2022) posing a risk to patient care. In 2020, UCLH conducted numerous listening events, briefings, and surveys to feel the ‘pulse’ of the organisation, assess staff wellbeing needs and plan an appropriate support response. Results showed overwhelming need for support across all areas of wellbeing. Staff Wellbeing was rated High Risk within UCLH’s Board Assurance Framework, and a large-scale recovery programme began in 2021 which included:  

Being Well – To grow a culture of wellbeing (WB), led by a network of Wellbeing Champions (WBC) across UCLH  

Communicate Well – To embed a culture of kindness, civility and respect and improve communication skills of staff through training, mediation, and peer support services 

Eat/Hydrate Well – To improve the affordability, accessibility, diversity and quality of food and hydration at UCLH including the roll out of an all-new 27/4 out of hours food access 

Finance Well – To improve financial wellbeing though increased access to financial support services 

Relax Well /Joy at work: To enhance working relationships through access to funds for team-led activities and events 

Rest Well – To implement a ‘basic standard’ for rest spaces and funding for staff to improve their break spaces with equipment of their choice 

Feel Well – To improve psycho-emotional and social wellbeing through increased access to confidential mental health support services. 

Lead Well – To improve the wellbeing of line managers and teams through improved communication, training, and peer support 

Work Well Anywhere – To implement a flexible and remote working policy and improve wellbeing and support business sustainability 

Work Well Together – To deliver bespoke team development support to high-risk/low functioning teams in relation to productivity, wellbeing, and civility. 

As a large, highly diverse organisation, employing over 11,500+, from 120 nations, for UCLH to be able to deliver a programme that provides significant improvements in wellbeing, across such a broad range of needs, we needed to: 

1) engage the whole organisation, through a multitude of mediums, to hear ‘what wellbeing means’ to staff and give staff an opportunity to shape the Be Well Programme.  

2) extensively engage staff support functions and wellbeing champions to contribute to the planning, design, and delivery of the programme. 13 posts across 6 departments (see additional evidence) where recruited to and hundreds of professionals/staff groups fed their skills and experience into the design of Be Well. 

3) Co-create a collaborative, cross-discipline, holistic ‘no one size fits all’ Workforce Wellbeing Programme addressing whole-person (including physical, psychological, emotional, environmental, social, professional and spiritual) and organisational wellbeing, aligning with all elements of the NHS People Promise and UCLH’s Objective: ‘To invest in our diverse workforce’.  

4) Develop a robust, evidence-based evaluation process and ongoing feedback loop with staff to ensure the programme was, in real time, achieving its aims. In 2021, UCLH employed a Research Associate to undertake a comprehensive two-year evaluation to provide valuable insights about the benefits and challenges of Be Well. Measures for understanding both staff experience and patient-experience were established with results being fed directly into Be Well’s Project Planning This enable us to take an agile approach to programme delivery, adapting the programme to meet the changing needs of staff (and patients) and the organisation, within the context of the Covid-19 pandemic. 

Due to the complexity of the large -scale programme, and the need to ensure value, a comprehensive evaluation framework was implemented. This was based on NHS evaluation guidelines, CECAN complexity evaluation toolkit, and the UCLH Quality Improvement tools.  

Overarching outcomes measures of the programme include:  

UCLH is the ‘most recommended trust work’ (acute/community) 3 years running, the ‘most safe and healthy’ trust to work within the Shelford Group of Acute NHS Trust (NHS Staff Survey) and the highest scoring acute/acute combined trust in London in the 2023 National Inpatient Survey. 

Equity, Diversity, and Inclusion measures of the programme include:  

We have seen improvements in wellbeing for staff with protected characteristics such as 1.4% improvements in staff identifying as having a disability feeling that ‘their manager takes a positive interest in their wellbeing’ and 3.7% improvement in feelings that the ‘organisation takes positive action on health and wellbeing’ (2023-24 NHS Staff Survey). 

Highlights from the individual workstream impact measures, include:  

1. Being-Well: We have 600% (n=320) more WBC, representing 99% of divisions, leading a growing wellbeing culture. 1.5% improvement in staff reporting UCLH’s positive action on Health and Wellbeing (2023-24 NHS Staff Survey) 

1. Communicate-Well: Trained UCLH mediators and mediation leads, have increased mediation delivery by 250%. Thousands of staff attended difficult conversation skills practice, Active Bystander Training and 1:1 conflict coaching (n=256).  

1. Eat/Hydrate-Well: Twelve 24/7 smart fridges were rolled out. A pilot survey of two high-pressure areas showed a 74% improvement in out-of-hours food accessibility (compared to 2021), with 89% of respondents expressing a positive impact on their wellbeing. 

1. Finance-Well: 15 financial wellbeing interventions have been implemented. 125,000 50p hot drinks/meals have been provided. 83% of survey respondents reported an impact on their wellbeing – feeling valued, saving money, and supporting social interaction. 

1. Relax-Well: 217 teams involved, with feedback indicating a positive impact on Staff Experience (96%), Morale (98%) Wellbeing (97%) a sense of enhanced team bonding, wellbeing, and patient care. 

1. Rest-Well: 125 team requests, benefiting staff across multiple sites, showed an overwhelmingly positive impact on Staff Experience (96%), Morale (98%) and Wellbeing (97%) with staff expressing they now more likely to rest, eat well and socialise between shifts. 

1. Lead-Well: Piloted positively rated new wellbeing training and resources for managers with 5.3% improvement in staff ‘feeling that their immediate manager takes a positive interest in their Health and Wellbeing (2021 – 2024 NHS Staff Survey)’ 

1. Feel-Well: Supported UCLH SPWS to increase 1:1 clinical appointments by 50.4% and other clinical activities by 47.3%. Wait times reduced from 20 days to 4 with staff expressing the service to be “invaluable to the trust”. New 3-days a week Citizens Advice Camden Service for Staff, yet be evaluated, which is well used and received well. 

1. Work-Well-Anywhere: Since implementing the Flexible and Remote Working Policy and desk booking system, more staff feel that UCLH is ‘committed to helping staff balance work and home life’ (9.8%) and are satisfied with opportunities for flexible working patterns (4.51%) (2021-24 NHS Staff Survey).
2. Work-Well-Together: 68% of Divisions have benefitted from bespoke team development support. ‘We are a team’ people promise increased from 6.1 to 6.92. between 2021 and 2024 (NHS Staff Survey).

Ensuring the long-term sustainability of wellbeing is high on UCLH’s agenda, particularly considering the recent changes to the national NHS operating context. Sustainability has been embedded across Be Well Workstreams, an example being the Wellbeing Champion programmes focus on decentralising administration, and empowering divisions to take ownership of wellbeing. Also, workstreams such as Team Development, The Volunteer Spa/Therapy Services and Mediation now being established as ‘business as usual’ ensuring the benefits will continue to be observed beyond Be Well. 

Delivery of Be Well has strengthened existing relationships, increased collaboration, resource, and knowledge sharing across the organisation, resulting in new ways of working, policies, strategies and roles to work together more effectively. In 2025, UCLH launched a new Workforce and Organisational Development Strategy, which includes Health and Wellbeing objectives, which are overseen by the Trust’s Health and Wellbeing Stakeholder group, ensuring that the wellbeing continues to remain a priority. 

The success of Be Well is down to 7 key factors – senior leadership support, staff engagement/empowerment, collaboration, consistency, ensuring the basics (from food, hydration to respite space, and much more) and evaluation. Taking the time to listen to the unique needs of staff and building something unique, that goes beyond a ‘bolt on’ of ‘off the shelf’ wellbeing programmes, is fundamental to success. Focussing on ‘getting the basics right,’ before moving on to more advanced provision, ensures our staff needs are being met and they feel safe and supported. Staff have said many times that the basics like food and hydration support them to be able to continue to offer excellent patient care. 

UCLH’s wellbeing culture has been growing for 5 years and is now a consistent factor at UCLH. Be Well has been designed by staff, for staff and is led by staff (with support of key staff support teams) enabling us to create a workplace in which staff feel safe, happy, and cared for which in turn offers better quality care to our patients. 

As a large, complex organisation, our greatest challenge was balancing diverse needs/priorities and avoiding a ‘one size fits all’ approach. Considerable time and resource were invested into getting this right, developing relationships, building trust and strengthening communication. We continue to monitor both patient experience and staff experience, so we can learn and adapt as we go and we have an ever-growing number of staff engaging with wellbeing initiatives and becoming Wellbeing Champions.  

We would encourage other organisations to put time and care into listening/engagement, building unique communication channels to capture staff voices to create a whole person-programme that values ‘getting back to basics’. One where exceptional care for staff is paramount, and where you are prepared to be creative, try things out with staff, and make changes if things don’t work, so as to continue to improve patient care.