With an ageing population, a rise in long-term conditions, growing health inequalities and a lack of political will to ensure that funding is increased in line with demand, the UK’s National Health Service has been brought to breaking point. In this context, there is an urgent need to put in place policies that reduce healthcare need and make much better use of the resources available.
The problem will not be solved by new drugs or expensive high-tech equipment, important though these are. It will only be solved by large-scale behaviour change and this will not be achieved by continuing to rely on “common sense”. That is the key message from a new report from the Campaign for Social Science, The Health of People (pdf).
Four key areas are covered in the report. In all of these, there is clear evidence that we can and must do better to promote health and reduce health inequalities:
1. encouraging and supporting the population to adopt healthier behaviours;
2. improving the self-management of long-term conditions;
3. improving the effectiveness of our healthcare systems; and
4. making better use of “big data”.
Behaviour change lies at the heart of all of these. Relying on common sense when developing policies has led to a litany of failure, and is no more likely to achieve our goals than it was to develop manned flight. We laugh at pictures of men in Victorian times jumping off piers attached to naively constructed flying machines; yet we too often continue with similarly naive attempts to achieve large-scale behaviour change. There is a science and technology of behaviour change and this must be developed and used.
The Health of People report shows how the use of social and behavioural sciences in the past has led to substantial gains in population health, but that much more can be achieved by creating better systems for putting research into practice, and building research capacity. For example, there is abundant high-quality evidence that when GPs take just a few minutes to discuss smoking with patients in a particular way, it can lead to increased attempts to quit and an uplift in population quitting rates.