Health Biography
Source:- Google.com.pkProfessor Mike Kelly, director of the Centre for Public Health Excellence at NICE, said the concept of nudging was not new but had been shown to work in other settings.
The tactic involves encouraging people to be healthier through positive advice without restricting choice through legislation.
Evidence for health-related nudging is ‘limited but improving’, Professor Kelly told attendees at the UK Faculty of Public Health annual conference in Birmingham on Monday.
But Professor Kelly warned: ‘I think there is still the question of what the unintended consequences of the nudge approach might be, not least the ethics of keeping people aware of what [public health] is doing.’
He said any nudge tactics must be specific about the behaviour they are attempting to change. The complex interaction with other aspects of behaviour must be considered too.
‘It isn’t good enough to talk about behaviour change in general – you have to be specific about what you are trying to do,’ he said.
‘The operation problem of only thinking of nudge in a small way is where the causal relation between the nudge and the outcome is distal, where some sort of lengthy process is at work. Does nudge still work then?’ he said.
‘We are by definition dealing with complex definitions, settings and behaviours, necessarily easily amenable to bite size ways of describing the problem.’
The BMA has been vocal in its dissent of the policy.
In February, Cambridge University researchers argued that, while nudging can alter behaviour, it often moves people towards unhealthy choices.
There is little evidence to support the effectiveness of nudging improving population health and reduce health inequalities, they said.
Primary care must make better use of the ‘untapped resource’ of patients themselves, according to Angela Coulter, a health policy analyst from the University of Oxford and honorary fellow of the RCGP.
Speaking at the RCGP annual conference 2013 on Friday she added that the NHS was ‘failing’ patients with chronic conditions.
Click here to watch a video of Ms Coulter's conference address
The number of people with multiple health conditions is likely to rise from 1.9m in 2008 to 2.9m by 2018, according to the DH.
Ms Coulter said multimorbidity was the biggest issue facing primary care with respect to long-term conditions.
An analysis of data from the CQC’s annual adult inpatient survey by Ms Coulter’s group found patients with multiple long-term conditions are less likely to feel involved in their care than patients with one or no chronic conditions. These patients’ families less frequently received information to help them with support and recovery.
Click here to read more from the RCGP annual conference 2013
In her speech to the RCGP conference yesterday, Ms Coulter said: ‘We are failing people with long-term conditions. We’re not doing as well with them as we probably need to.’
She said the GP contract and the QOF ‘encourages GPs to think along disease silos’. ‘In fact, what patients are saying is: "We’re not a collection of diseases, we are [people] trying to live with these conditions, and we need co-ordinated support to help us do that".’
‘Even if all those extra GPs that we’ve been promised are going to be recruited, even if there is more money going into general practice instead of less, I still think that it won’t be possible to keep up with demand, unless this untapped resource of the patient is really the starting point for planning a new way of working.’
Dr Sue Roberts, former national clinical director for diabetes, urged GPs to change how they conduct consultations to incorporate more care planning for patients so they feel more involved in their care.
She said this should include routinely choosing health goals with patients and setting out the actions they can do to achieve them. ‘It needs some new skills, thinking about supporting people to become problem-solvers in their daily life, rather than just with you in the consulting room.’
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