Keeping the Human in Evaluation
Evaluation by Dr Marion Lynch and Art of Nursing CIC: person-centred and equity-led, combining critical thinking, relational intelligence, storytelling and data analysis.
My approach
My evaluation always looks at the context in which the intervention is happening, the mechanisms that help or hinder, and the outcomes for the individual, the service and the wider system. That is the realist tradition in which I took my doctorate in health science, and it shapes every evaluation I lead. Numbers tell you whether something moved; they rarely tell you why, or for whom it did not move. I go after both.
My lens on the world is person-centred and equity-led. I look for the people a programme was designed around as well as the people it was designed for, and I ask who holds power, whose knowledge counts, who leads and who benefits. Lived experience is treated as expertise. I bring four capabilities to every commission: critical thinking, relational intelligence, storytelling and data analysis. The first three decide whether anyone in a boardroom acts on the fourth.
Storytelling is not the decorative chapter at the end of the report: an evaluation that cannot be retold will not be reused. And I report limitations and disappointing findings alongside successes. An evaluation that only ever finds success is not an evaluation; it is a brochure.
“What works, for whom, in what circumstances, and why?”
THE QUESTION BEHIND EVERY EVALUATION
Qualitative, quantitative — and beyond
Whilst I work from both qualitative and quantitative data, I bring more insight than either alone: a sort of radical evaluation. Radical here does not mean unrigorous. It means going to the root: asking not only whether a programme worked, but who defined success, whose knowledge counted, and what the system made possible or impossible.
Selected evaluation work
Headstart Milton Keynes (2026)
Arts for Health Milton Keynes commissioned me to evaluate Headstart, an arts-on-prescription programme for children and young people aged 8 to 17, funded by the Big Lottery Community Fund. The evaluation identified positive impact on wellbeing, five conditions that make participation possible, and three processes through which change develops: moving from individual to collective action, identity development, and communication beyond words.
Thrive Through Menopause (2026)
A realist evaluation of a Burdett Trust-funded pilot for primary care nurses, with 50 places combining resilience training, a menopause circle, expert support, group coaching and personal action planning. Every participant who completed the measures increased their activation score, and the conclusion reached beyond the workshop room: sustainable impact requires organisational as well as individual change.
CHAT and TREAT, Cornwall (underway)
Cornwall Partnership NHS Foundation Trust and the Arbennek and St Austell Primary Care Networks are piloting CHAT and TREAT: daily nurse-led clinics in community venues, combining planned and drop-in treatment with peer support and social connection. With Experience Led Care, I am evaluating the pilot, with a strong data element alongside what the model changes for people, carers and community nursing staff. Evaluation funding is secured and commissioning is underway; findings are still to come.
DRY, with Human Story Theatre (2025)
Gaye Poole’s DRY toured libraries, community venues and arts centres before a final performance at the House of Lords, with an expert-led discussion after every show. I evaluated the work, and as Alison Bentley’s summary for the NHS Thames Valley and Wessex Leadership Academy records, ‘word of mouth was the most popular method of hearing about the performance’, and the ‘consistent message’ from audiences was that ‘DRY needs to reach a national audience’. The evaluation looked at services as well as audiences: self-referrals to addiction services surged, and Turning Point expanded its support hours with a new after-work drop-in for busy professionals. With Amy Enticknap and Gaye Poole, I later brought Human Story Theatre’s stories and evaluation data together in The Story of Human Story Theatre: across all its productions since 2016, HST’s cumulative totals stand at more than 168 performances reaching over 13,440 audience members.
An evaluation framework for arts in health, with Human Story Theatre
Human Story Theatre’s Evaluation and Recommendations sets out the framework I built to answer a deceptively simple question: does the drama work? It layers Kirkpatrick’s reaction, learning and behaviour change with the INNATE framework’s active ingredients of arts in health, and reads the wider system through the Ottawa Charter for Health Promotion. It is honest about what it cannot yet evidence, including social return on investment, and it gives HST evidence for funders, validation for partners and direction for future programmes. The framework underpins The Story of Human Story Theatre chapter.
The Nursing Now Challenge Fellowship
A realist evaluation of a global fellowship programme for early-career nurses and midwives, run through health partnerships between the UK and low- and middle-income countries. The evaluation looked through the lens of power and gender: who holds the funds, whose knowledge counts, and what decolonising global health asks of such programmes.
Menopause Circles learning review (2022)
A learning review of menopause circles, undertaken with Experience Led Care.
Video group clinics for outpatients in Wales (2022)
With Experience Led Care, I evaluated the national programme that took video group clinics into outpatient care across Wales, from the first 30 pioneer teams to more than 1,100 people engaged across up to 15 settings. The evaluation drew on a desktop review of the evidence, 15 hours of clinician interviews, four observed training events, and conversations with providers and commissioners. Clinicians described patients moving from passive recipients to active participants, finding peer support, shared experience and the relief of ‘I am not alone’, and they reported gains of their own: joy in work, greater autonomy and closer team working. The central finding was about time: these benefits are real to the people in the room, but they are not instant - the system has to invest time in training and in permission to change now, to save time later.
Read more: Welsh Government: virtual group clinics · The role of outpatients · Experience Led Care: video group clinics
Centres of Excellence
Evaluation has started on Centres of Excellence. Across 16 programmes in Women’s Health and Primary and Community Care, we are exploring how group clinics work, for whom and under what conditions. Combining outcome data with patient and staff stories, interviews and case studies, the evaluation examines approaches to co-production, the wellbeing of staff and participants, workforce development, equitable access and service productivity. We are using the Cultural Web to explore cultural change within organisations. Following teams through two clinical pathways will reveal how learning and adaptation shape delivery, generating practical evidence to support sustainable care and wider adoption.
How I think about evaluation
My work draws on the evaluation resources in the Art of Nursing library, alongside my experience in nursing, research and practice. I want an evaluation to help people understand what is happening, whose experience is missing and what needs to change.
Commission an evaluation
Every evaluation I run is built around the programme and the people in it, not a fixed battery of measures. I choose a proportionate set for each piece of work: validated instruments where they fit, bespoke questions where they catch what standard measures miss, with permissions and licensing checked before anything is fielded. Numbers track change; stories, relationships and open questions explain it, and I read both through a realist lens. I report only what the evidence supports: no causal claims the data cannot carry, and no savings figures borrowed from someone else’s benchmarks.
If you want evidence your board will read, and your participants will recognise themselves in, talk to me.