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Personal Wellbeing Score (PWS)—a short version of ONS4: development and validation in social prescribing
  1. Tim Benson1,2,
  2. Joe Sladen1,3,
  3. Andrew Liles4,5,
  4. Henry W W Potts2
  1. 1R-Outcomes Ltd, Thatcham, UK
  2. 2Institute of Health Informatics, UCL, London, UK
  3. 3Wessex AHSN, Southampton, UK
  4. 4R-Outcomes Ltd, Brighton, UK
  5. 5School of Management, Royal Holloway University of London, Egham, UK
  1. Correspondence to Dr Tim Benson; tim.benson{at}


Aims Our aim was to develop a short generic measure of subjective well-being for routine use in patient-centred care and healthcare quality improvement alongside other patient-reported outcome and experience measures.

Methods The Personal Wellbeing Score (PWS) is based on the Office of National Statistics (ONS) four subjective well-being questions (ONS4) and thresholds. PWS is short, easy to use and has the same look and feel as other measures in the same family of measures. Word length and reading age were compared with eight other measures.

Anonymous data sets from five social prescribing projects were analysed. Internal structure was examined using distributions, intra-item correlations, Cronbach’s α and exploratory factor analysis. Construct validity was assessed based on hypothesised associations with health status, health confidence, patient experience, age, gender and number of medications taken. Scores on referral and after referral were used to assess responsiveness.

Results Differences between PWS and ONS4 include brevity (42 vs 114 words), reading age (9 vs 12 years), response options (4 vs 11), positive wording throughout and a summary score. 1299 responses (60% female, average age 81 years) from people referred to social prescribing services were analysed; missing values were less than 2%. PWS showed good internal reliability (Cronbach’s α=0.90). Exploratory factor analysis suggested that all PWS items relate to a single dimension. PWS summary scores correlate positively with health confidence (r=0.60), health status (r=0.58), patient experience (r=0.30) and age group (r=0.24). PWS is responsive to social prescribing intervention.

Conclusions The PWS is a short variant of ONS4. It is easy to use with good psychometric properties, suitable for routine use in quality improvement and health services research.

  • healthcare quality improvement
  • patient-centred care
  • performance measures
  • quality measurement
  • surveys

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  • Contributors TB designed the questionnaire and wrote the first draft of the paper. TB, HWWP and JS performed the analyses. JS and AL were actively involved in the data collection. All authors contributed to the final text, read and approved the final manuscript.

  • Funding The data were collected as part of evaluations of social prescribing systems by Wessex AHSN (Academic Health Science Network).

  • Competing interests TB and AL are directors and shareholders in R-Outcomes Ltd, which provides quality improvement and evaluation services using the Personal Wellbeing Score. Please contact R-Outcomes Ltd if you wish to use it. HWWP has received consultancy fees from Crystallise, System Analytic and The HELP Trust and received funding from myownteam and, unrelated to the work reported herein. The authors declare that they have no other conflicting interests.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

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