Public evidence summary · October 2026

Pilot: what we found

Inside a leading healthcare system, more than half of nursing staff used a 60-second pre-shift check-in voluntarily. On over a third of check-in days, they arrived for work tired or exhausted.

Setting	Acute hospital care, England
Participants	122 nursing staff enrolled, across every major specialty
Duration	19 weeks of check-in data, February to May 2026 (enrolment opened in late January)
Voluntary uptake	55% of enrolled staff (67 of 122) used the check-in at least once, giving 700 check-in responses
Arriving depleted	On 36% of check-in days, staff reported arriving tired or exhausted
Enrolment speed	112 staff enrolled in eight weeks with leadership backing
Specialty gap	0.62 points between the best- and worst-scoring specialty

Why we ran it

Nursing leaders can see who stays home, but not who comes in running on empty. Sickness absence records only the days people are off. Annual staff surveys look back a year, and occupational health sees people after the damage is done.

The pilot tested one question: will nurses tell us, shift by shift, how they are arriving for work, and does that signal show leaders something they can't see today?

How it worked

Check in. Before a shift, staff answered four questions on physical, emotional, sleep and nutritional health. It took about sixty seconds.
Support the nurse. Each nurse received targeted guidance built on the WHIP^® framework, matched to how they were arriving.
Show the pattern. Results were combined and de-identified by specialty, band and experience, so leaders saw trends rather than individuals.

Enrolment was led by the trust's nursing leadership. Participation was voluntary throughout.

What we found

1. Nurses will use it. 55% of enrolled staff used the check-in without being required to. Leadership backing mattered: 112 of the 122 enrolments came in the first eight weeks.

2. It sees what absence data misses. On 36% of check-in days, staff reported arriving tired or exhausted. These nurses were at work, so none of this strain would appear in sickness absence figures.

3. It pinpoints where strain sits. Paediatrics, Midwifery and Critical Care scored markedly lower than other specialties. On a 1–5 scale, Paediatrics averaged 2.55, Midwifery 2.70 and Critical Care 2.72, against 3.17 in Medical and 3.28 across the cohort. Band 5 registered nurses scored below the Band 2 healthcare assistants they supervise.

What we learned

People try it, but building the habit is the hard part. The pilot ran without scheduled reminders or active onboarding. Monthly active users fell from 39 to 26, then 6, then 3, and the average active user checked in 2.5 times. Phase 2 is designed around that lesson:

scheduled pre-shift reminders
active onboarding through ward managers
check-in frequency written into every contract as a success measure

Limitations and privacy

Specialty and band samples were small, so those findings are directional rather than conclusive. Phase 2 is designed to make them robust at larger scale.

No individual's data was shared with line managers or used for performance management. All results in this summary are combined and de-identified.

Next steps

MACH Health is now selecting Phase 2 partners for a 12-month, two-phase programme with success measures agreed up front. The full pilot report, with methodology and specialty and band breakdowns, is available on request.