Evaluation of the Wellbeing Premium Programme

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Good employee health and wellbeing is of key importance to employers and the economy. Yet, many businesses find it hard to invest in the health and wellbeing of their employees, or do not invest at all. These problems are especially true for small and medium size enterprises (SMEs). There has been considerable interest in the effect of financial incentives to stimulate change in the workplace environment but evidence is limited.

The West Midlands Combined Authority (WMCA) is running a randomised controlled trial of a financial incentive programme to improve employee health and wellbeing in SMEs in the West Midlands.


RAND Europe and the University of Warwick have been commissioned by the WMCA to conduct an evaluation of the Wellbeing Premium Programme. The primary aim of the study is to establish whether SMEs will improve their health and wellbeing and achieve higher employee awareness and participation in response to a financial incentive offer. The evaluation also aims to assess whether such premiums help and motivate SMEs to overcome barriers when aiming to improve the wellbeing of their employees.


This study includes:

  • A recruitment evaluation carried out by RAND Europe in order to better understand reasons behind companies’ decisions to participate in the programme, as well as barriers, motivators and enablers that influence the success or otherwise of recruitment to the programme. Data collection will involve short telephone interviews with non-participating organisations.
  • A process evaluation carried out by RAND Europe and the University of Warwick in order to explain how the programme was implemented and to understand why behavioural change did or did not take place as expected within participating SMEs. Data collection will involve telephone and face-to-face interviews with employers and employees participating in the trial.
  • An impact evaluation to be carried out by the University of Warwick in order to measure the efficacy of the programme.

Interim Findings

The evaluation of efforts to recruit SMEs to the Wellbeing Premium Programme run in the West Midlands resulted in the following findings:

Administrative burden

The views were split between SMEs in terms of viewing additional administrative burden as an obstacle to participate. Similarly, time required from staff to take up health and wellbeing activities was cited as an obstacle for some organisations.

Trial arm allocation and research design

Uncertainty related to random allocation to trial arms seemed to have played a role for some organisations in making their decision to participate. Most SMEs were unconcerned about access to data, confidentiality or consent processes.

Uncertainty on requirements

Uncertainty about what exactly was required and how the programme would work was one of the major factors that played a role in organisations' decision to not participate. In particular, SMEs wished that information about the programme was clearer about expected benefits, costs involved and requirements for taking part. A one-page summary of this information would be helpful for many.

Capacity and time

Nearly all interviewees cited capacity and time constraints as reason for not participating.

Participation in other schemes

Participation in another scheme (or satisfaction with the existing health and wellbeing offer) was cited by some SMEs as a reason for not taking part.


  • Conduct market research with SMEs to explore how to approach them and if and how they would like to participate in a future initiative.
  • Complete the design of the intervention and evaluation before starting the recruitment in order to formulate a clear business proposition.
  • Rely on pre-existing connections of your team and/or established business networks and personalise messages when speaking with SMEs, building on existing relations and trust.