Welsh Government
Developing Evidence-Enriched Practice

Developing Evidence-Enriched Practice

The popularity of the BBC programme, The Great British Bake Off is proof that everyone enjoys a piece of cake, especially when it has been made to perfection.

However, baking a good cake is more complicated than it seems.

It requires the careful selection of ingredients, which then have to be combined in the right amounts, in the right order and in right way. Careful attention also has to be paid to the cooking process, to avoid it being either burnt or soggy. It’s much the same when it comes to making good public services like health and social services.

The Developing Evidence-Enriched Practice (DEEP) approach to improving health and social services was developed and tried-out in five places in Wales and one place in Scotland, in partnership with the Joseph Rowntree Foundation during 2014/15.

In each place, a group of older people, carers, frontline staff and managers working in health and social services got together to explore a range of evidence, including research, and see if they could use it to improve the well-being of older people, carers and frontline staff. They chose to explore evidence in relation to the following topics:

  • Supporting people living with dementia to stay in their own homes, by taking a more positive approach to risk-taking, taking into account ‘what matters  most’ to people with dementia, rather than what everyone else thinks is best for them.
  • Developing meaningful activities for older people in care homes and day centred, which give them a sense of belonging, purpose and achievement.
  • Improving relationships between older people, carers and frontline staff in social care services to make services more friendly and ‘normal’.
  • Supporting inter-dependent caring relationships, through the provision of short breaks in ways that do not make carers feel guilt or upset the person being cared for.
  • Making better use of paperwork, so it is helpful and not burdensome.
  • Making community based services ‘a part of the local the community’, rather than ‘apart from the local community’, by having social events and sharing ideas on how to work together.

The project found that in order to make these things happen, they had to pay careful attention to five things, which had some similarities with baking a good cake! These were:

Thing 1:
Valuing and empowering all of the people involved in the project (the happy and creative chefs) – senior managers had to support participants to be creative and able to experiment with ideas. Trusting relationships needed to be developed between everyone involved, so people could be honest and feel safe. People needed to feel appreciated and their successes (even in little things) celebrated.

Thing 2:
Valuing and using a range of evidence (the ingredients) – it was important to consider ‘what mattered’ to everyone involved, which meant that four main types of evidence needed to be considered – research, the views and experiences of older people and carers, the expertise of frontline staff and organisational concerns including policy.

Thing 3: Preparing the evidence, so that it was interesting and relevant (preparing the ingredients) – participants were able to understand and use the evidence when it was presented in the form of short summaries, stories, pictures, poetry or even song. Some of the evidence could also be summed up in provocative statements, which got people thinking.

Thing 4: Facilitating the exploration and use of evidence (the careful measuring, mixing and baking) – this was perhaps the most important and complicated thing. Well-structured approaches to helping people think and talk together, enabled them to be better listeners and more open to learning. As a result, they came up with collective ideas and decisions and everyone felt that their contributions were welcomed. Different bits of evidence were weaved-in to discussions as they became relevant over time.  

Thing 5: Recognising and addressing national and local organisational circumstances and obstacles (making sure the equipment used, including the oven and baking trays is fit for purpose) – it was important to consider and tackle things that could get in the way of success. These included well-meaning national and local rules and regulations which did not always fit well with contextual decision making and what participants felt were the most important things in promoting well-being.

The project was very much a success and over the next three years, the aim is to further develop and refine the DEEP approach.

If you would like further information on the DEEP approach, you can contact Nick Andrews in Swansea University: N.D.Andrews@swansea.ac.uk (01792 606380)

Further details of the Developing Evidence-Enriched Practice (DEEP) project can be found at:



Health and Social Care Wales funded Nick Andrews' involvement as Project Co-ordinator and also the contribution of Martin O’Neill, Cardiff University.


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