Funded Project Evaluation Form

1Data Protection Info

2Project Detail

3Wider impact

4Environmental Sustainability

5Project Learnings

6Overall Experience

Phone

This field is for validation purposes and should be left unchanged.

Data protection

We ask that you do not share any sensitive patient information or information that could be traced back to an individual or business. We also ask that, in the free text boxes, you do not enter any information that could identify you or anyone else. NHS Lothian Charity may use the information provided to showcase the impact of the funding and support that we provide. Any personal details will not be disclosed by us to any third parties without your prior consent.

If you have any questions about how your data will be used, stored and retained, get in touch by emailing [email protected] or you can read our Privacy Policy. Data will also be held in compliance with the NHS Lothian Data Protection Notice

Reference Number(Required)

Please refer to email requesting you provide evaluation feedback if you are unsure

When did the project go live?(Required)

By live we mean what date did/could people start benefitting from the project e.g. when was the equipment purchased, installed and ready to go or when a group activity started

Day

Month

Year

Please tell us all who benefitted from the project?(Required)

Please select all that apply

Patients

Families, Carers, Visitors

Staff

Other

As you ticked other please provide more information on who else benefitted

We may contact you for further information

Will your project support the group(s) you have identified above indefinitely?(Required)

By this we mean will these groups continue to benefit/be supported by the project after you have completed this form for years to come. If your project will stop supporting these groups in a known time frame please select no.

Yes

As you have selected no, please provide a project end date(Required)

Day

Month

Year

Benefit to patients

How did the project impact patient experience?(Required)

Please select all that apply

Patients had more opportunities outside of clinical care

Patients more active

Patients more engaged with staff

Patients more engaged with each other

Patients more engaged with their community

Patients more engaged with their care

Patients happier

Patients more motivated

Patients less isolated

Patients waited less time for support

Patients exhibited less signs of stress and /or distress

Patients exhibited less signs of aggression

Patients exhibited less signs of boredom

Patients gave more positive feedback

Care provided closer to home

Patients less worried

Other

You selected other please let us know about the other benefits to patient experience

Please provide examples of how the project benefitted patient experience

Do not provide patient identifiable information but be as specific as possible.

How did the project impact on clinical or wellbeing outcomes?(Required)

Please select all that apply

Less medication prescribed

Patients had a shorter stay in hospital

Less appointments required

Patients had better nutritional intake

Patients slept better

Patients had less falls or trips

Patients better able to engage with treatment

Patients received an improved prognosis

Patients received a quicker diagnosis

Patients more informed about their care

Improved the physical wellbeing of patients

Improved the social wellbeing of patients

Improved the mental wellbeing of patients

Improved the financial wellbeing of patients

Other

You selected other please let us know about the other benefits to clinical or wellbeing outcomes

Please provide examples of how the project benefitted clinical or wellbeing outcomes

Do not provide patient identifiable information but be as specific as possible.

Approximately how many patients per month did the project support in the last month?(Required)

e.g. how many people used the equipment, or sat in the waiting room that has been enhanced or attended a group. Even if you are not sure, please try to provide an estimate.

Please enter a number greater than or equal to 0.

Approximately how many patients experiencing health inequalities did the project support in the last month?(Required)

WHO define health inequality as systematic differences in health status of different population groups. Health inequality affect people from disadvantaged or historically oppressed groups most severely. Even if you are not sure, please try to provide an estimate.

Please enter a number greater than or equal to 0.

Benefits to families/carers/visitors

How did the project support families/carers/visitors?(Required)

Please select all that apply

Provided a break for families/carers/visitors

Reduced stress for families/carers/visitors

Families/carers/visitors are more informed about patients’ care

Enabled them to provide support to patient

Improved communication with professionals

Improved family dynamics

Families/carers/visitors had a better experience

Acknowledged the role of families/carers/visitors

Improved the physical wellbeing of families/carers/visitors

Improved the social wellbeing of families/carers/visitors

Improved the mental wellbeing of families/carers/visitors

Improved the financial wellbeing of families/carers/visitors

Reduced isolation of families/carers/visitors

Families/carers/visitors felt less worried

Other

You selected other please let us know about the other benefits to families/carers/visitors

Please provide examples of the benefits to families/carers/visitors

Do not provide patient identifiable information but be as specific as possible.

How many individuals who are family members/visitors/carers were supported by the project in a month?

Even if you are not sure, please try to provide an estimate.

Please enter a number greater than or equal to 0.

Benefits to staff

How did the project benefit staff?(Required)

Please select all that apply

Staff feel more valued

Staff’s physical wellbeing is improved

Staff’s mental wellbeing is improved

Staff’s social wellbeing is improved

Staff’s financial wellbeing is improved

Staff feel less stressed

Staff feel more motivated

Staff have gained more knowledge

Staff have developed existing skills

Staff have acquired new skills

Staff are at less risk of injury

Staff have increased confidence

Staff have increased resilience levels

Staff feel less isolated

Staff are more able to communicate better with patients and families

Staff are more able to communicate better with colleagues

Staff are taking longer and more frequent rest breaks (as appropriate)

Other

You selected other please tell us more about other benefits to staff

Please provide examples of benefits to staff

Please do not provide identifiable data but be as specific as possible

How many individual staff members were supported by the project in a month?(Required)

Even if you are not sure, please try to provide an estimate.

Please enter a number greater than or equal to 0.

Has the project had any impact on staff absence or retention?(Required)

Yes

Please explain how the project had an impact on staff absence/retention

Has the project had an impact on career progression/promotion for yourself or team members?(Required)

Yes

Please explain how the project impacted on career progression/promotion?

Has the project saved NHS Lothian money?(Required)

Yes

Please explain how the project saved NHS Lothian money?(Required)

Does the project contribute to environmental sustainability?(Required)

Yes

Have your behaviours relating to environmental sustainability/mitigating climate change changed as a result of the project?(Required)

Yes

What are you doing differently at work and/or home in relation to environmental sustainability?

Have your colleagues behaviours in relation to environmental sustainability changed as a result as a result of the project?(Required)

Yes

What are you colleagues doing differently in relation to climate change?

Have patients/or their families behaviours in relation to environmental sustainability changed as a result of the project?(Required)

Yes

How have your patients and/or their families behaviours in relation to environmental sustainability changed as a result of the project?

Have your shared your learning from the project?(Required)

Yes

How did you share the learning of the project?

Is there anything else you would like to tell us about the project?

Please tell us about benefits, impacts, challenges, barriers.

The next questions are about your experience working with NHS Lothian Charity. Please select the option that best reflects this experience.

Finding information about the support available (1 is poor, 9 is excellent)

1	2	3	4	5	6	7	8	9	Don’t know

The application process (1 is poor, 9 is excellent)

1	2	3	4	5	6	7	8	9	Don’t know

Support received during the application process (1 is poor, 9 is excellent)

1	2	3	4	5	6	7	8	9	Don’t know

Ongoing support received after securing the funding (1 is poor, 9 is excellent)

1	2	3	4	5	6	7	8	9	Don’t know

Approved funding was received in a timely fashion (1 is slow, 9 is fast)

1	2	3	4	5	6	7	8	9	Don’t know

I would apply for funding from the Charity in future (1 is no, 9 is definitely)

1	2	3	4	5	6	7	8	9	Don’t know

Do you have any other comments regarding your interaction with the Charity/the application process?

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