Step Up Trial formative and process evaluation

Step Up Trial Formative and Process Evaluation
01 Nov 2019


The Step Up Trial formative and process evaluation covers the first eight months of the Step Up Trial, which started in November 2018. Results from the evaluation contributed to the development of Here Toitū which replaced Step Up in 2020.

In November 2018, MSD implemented the Step Up Trial in partnership with Canterbury District Health Board and Pegasus Health.

Local and international evidence had suggested that using navigators/co-ordinators in health and employment settings can help clients engage with health and social services and improve their employment outcomes. A key feature of Step Up was the use of Health Navigators. The Navigator role was to facilitate and support clients’ connections with services to help them toward work readiness.

The Step Up Trial was offered by General Practitioners to MSD clients who met the eligibility criteria and who wanted to work. Eligible clients were receiving a main benefit, had a medical deferral from work obligations, and were enrolled with a participating General Practice.

The Ministry of Social Development (MSD) commissioned the Step Up Trial formative and process evaluation to assess the implementation and how well it was working overall in the trial phase. The evaluation was intended to inform decisions about future implementation of the Health Navigator model.


In May 2019 MSD contracted an external evaluation provider to conduct an evaluation using evidence from interviews, a document review, and provider monitoring data. Interviews were conducted with clients (35), GPs (8), general practice staff (7), Health Navigators (6), the Step Up team leader and service manager, Canterbury District Health Board managers (3), MSD Service Centre Managers (2), MSD Regional Director (1), Case Managers (4), Work Brokers (2), and Employment Co-ordinators (2).

Key Results

Evaluation findings indicated that overall Step Up worked well at an operational level. Clients reported feeling supported by Health Navigators and Case Managers to progress toward work readiness. General practice staff believed the service had the potential to make a positive difference to clients lives. Areas for further refinement included processes relating to client identification, client referral and engagement, and communication and collaboration across agencies.

The evaluation contributed to the development of the Here Toitū dedicated support team model which includes health navigators. Here Toitū replaced Step Up in Canterbury in August 2020.

Page last modified: 05 Sep 2023