Transcript Document

Influencing healthy behaviour
change in the new world
James Farnham
6 October 2010
The case for change
•
The current system is unsustainable
•
The health system in which marketing
operates is changing
•
The new government marketing agenda
•
Some implications for health marketers
The current system is unsustainable……
DH/NHS Social Marketing Review
Oxford Strategic Marketing
Hear
Expert
Views
Investigat
e Local
Practice
Gather
Core
Data
C.50 Expert
Interviews
Stakeholder
Engagement –
c. 150 people
Detailed
3 Day
Questionnaire ‘Deep Dives’
– 75 PCT
– 4 PCTs
responses
spend/ MO
Analysis of
c.200 Seminal
Documents
Worldwide
Review of
Social
Marketing
100
Exemplar
Case Studies
‘System’
Spend and
Media Shareof-voice
Duplication in the system
Chlamydia
Health Trainers
Source: Oxford Strategic Marketing DH/NHS Social Marketing Review 2010
A complex, loosely coordinated ‘system’
‘System’
has 3 levels
generating
options . . .
Generating up to 70
competing ‘calls to
action’ across 35+
issues . . .
National
DH /NHS/
OGDs
Many
developers
of new
brands etc
...
Public
Health
18-20
National
per month
+7
extra
7
Regional
Priorities
+5
extra
Comms
Regional
SHAs,
RAs etc
Local
PCTs,
LAs etc.
31
Local
Priorities
+12
extra
Social
Marketing
. . . and
limited
capacity to
deliver
HCPs
pharmacists
etc.
Work
forces
WCC
LAs and
public
partners
HCPs
Private
partners
RESULT- A
bemused,
bombarded
public
Receiving
thousands
of messages
across
hundreds
of media
Source: Oxford Strategic Marketing DH/NHS Social Marketing Review 2010
The health system in which marketing
operates is changing……
Health White paper summary
A system focused on
improving outcomes
Robust economic regulation
and quality inspection
Clinically-led
commissioning &
payment for results
Enhanced
local voice
Empowered
professionals working in
autonomous providers
Informed patients
exercising choice
The new health system
Parliament
DH
Funding
Accountability
NHS
Commissioning
Board
Monitor
CQC
licensing
Local
authorities
local partnership
GP
commissioning
consortia
contract
accountability for results
Local
HealthWatch
Patients and public
Source: Equity and excellence: Liberating the NHS
Providers
Targets are dead! but the outcomes
framework may shape future marketing
in much the same way as PSAs
SoS
NHSCB
SoS holds to
account
through
achievement of
outcomes
Determines how
best to achieve the
outcomes through
consortia eg
commission
Quality Standards
from NICE to drive
CQIN
Consortia
Outcomes framework – DOMAIN 1:
preventing early death
Overarching Indicator
Frames NHS
Commissioning Board’s
broader responsibilities
Improvement Areas
Outcome Indicators
Supporting Quality
Standards
SofS holds NHS Commissioning
Board to account for progress
Support commissioning of
high quality service
Heart disease
e.g. premature mortality
Cancer
e.g. 1 and 5 yr survival
e.g. Mortality
amenable to
Healthcare
Stroke
e.g. premature mortality
e.g. Children
e.g. infant mortality; respiratory
disease
e.g. Older people
e.g. healthy life expectancy age 65
A suite of quality
standards will
support the
delivery
of improved
outcomes in this
domain
The relevance of poly behaviours
Smoking 22%
9%
High BMI 49%
7%
4%
3%
8%
10%
30%
Increasing/high
risk drinker 24%
Base: Healthy Foundations - All respondents who do at least one negative health
behaviour (unwtd 4909, wtd 4895)
The new government marketing
agenda……
A new paradigm
Big Government
The Big Society is one in which we
all try and do more. We don’t just
look to Government to solve the
many problems that we have, we
actually look to ourselves, to
voluntary bodies, to companies, to
charities, to all of those things to
build a bigger, richer country
Big Society
A changing role of Gov't marketing across a
broader spectrum of needs and across time
Responsibility:
Central Government
(National)
Responsibility:
Big Society
(Community)
Responsibility:
Individual
(Personal)
To direct
(Necessary)
To enable
(Valuable)
To inform
(Your choice)
Government led objectives
Government as author
VFM scrutiny
Fewer, well-branded, coordinated programmes
focusing on fewer strategic themes
Devolved responsibility
Citizen/partner led objectives
Collaborative, co-produced, flexible, transparent
Government facilitates, coordinates, partners and seed funds
TIME
A new paradigm for relationships
From
To
Command and
control
Collaboration
The passive citizen
Active participation
I invent
I direct
I do
I invite
We invent
We or you do
But how will society expand
as government withdraws?
A new collaborative model to make
Big Society happen
Collaboration starts
here
Problem
•
•
•
•
•
Policy
Not here!
Development
Delivery
Do more with less
New incentives
Using more subtle “levers”
Tackling greater complexity
Unproven
How can Marketing help?
Outcome
Marketing has evolved to become a
process of empowering the consumer
Conversation
Marketing is about creating,
communicating, delivering, and
exchanging offerings that have
value for customers, clients,
partners, and society at large
American Marketing Association
Control
Early 20C
Marketing is
about providing
products people
need
Provider
Now and the future ~
Marketing is about engaging
with and mobilising
audiences as an equal
1980s-2000s
Marketing is about
making people feel
one to one
relationship
1960s-80s
Marketing is about
persuading people
through messages
Persuader
Partner
A new opportunity for Government
Marketing
“The last government thought
the answer to everything was to
launch an advertising
campaign…we will look at new,
more efficient ways of delivering
government communications”
(Francis Maude, July 27th 2010)
•
•
•
•
Much less spend
Broadcast to narrowcast
Supporting and enabling
More focussed, cogent and sparing
•
•
•
•
More disciplined planning
More targeted objectives
New model assumptions
VFM driven
LESS MARKETING £
BUT
MORE MARKETING SKILLS
Four pillars for new outcomes
from Government marketing
•
•
•
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Behavioural insights
Partnerships
Channel balance
Value and evaluation
Transforming capabilities
Changing channel balance……
More
control
Outcomes and expenditure
Earned
Less
control
?
Outcome gap
Owned
?
?
Earned
?
Outcome
gap
?
?
Owned
Purchased
Earned
Purchased
Owned
Current
Reduce paid and
increase owned &
earned
Finite capability of owned
and earned, leading to
outcome shortfall ?
Some implications for health
marketers……
1. A co-ordinated approach to
marketing planning
•
•
An annual cycle that is co-created between central and local teams, with robust,
transparent planning, and is co-ordinated and cascaded out effectively
All activities to be based on established segmentation and insight, and drawing
from a wide range of levers to best deliver behaviour change
‘Blueprinting’ - horizontal as well
as vertical models
Scoping
Learning
Strategy
Formulation
‘Do it once’ - making it quicker and
easier to adopt and adapt than re-invent
Evaluation
Implementation
Plans
Activation Roles
• Lead and pioneer
• or Steal with pride
• or borrow and adapt to suit local needs
Source: Based on OSM DH/NHS Social Marketing Review 2010
2. Ensure hypothetical behaviour change models
drive the planning and evaluation process
3. Connect theory to reality in behaviour change
In OSM’s
analysis, the
most
successful
interventions
clearly
operated at
least 5-6 of
these
principles
OSM behaviour change principles
1
Make it as easy and pleasant for people to act
2
Create/restate the social norm so people ‘follow the herd’
3
Create fast benefits & reward ‘good’ behaviour instantly
4
Make it interesting to gain momentum and ‘viral spread’
5
Avoid fear /recrimination unless people resist the positive
6
Get tangible commitment – don’t let people delay acting
7
Chunk up action in easy steps -make success achievable
8
Give alternatives not big sacrifices – swaps not costs
9
Use insight into how people think to engage emotionally
10
Remove excuses – erect barriers to back-sliding
11
Build coalitions for impact and credibility
Source: Oxford Strategic Marketing DH/NHS Social Marketing Review 2010
4. Step-change in intermediary marketing,
emphasising partnerships with co-authored delivery
Health & Wellbeing Boards
LAs
GPs
Internal workforce Regulators
PH Observatories
HCPs
Professional associations
Think tanks
ALBs
Commercial partnerships
Social enterprises
DPHs
Third sector
lobbyists
Media partnerships
Employers
Third sector partnerships
Royal colleges
OGDs
Health Media (BMJ, HSJ,
Pulse, Doctors.net
4. Step-change in intermediary marketing,
emphasising partnerships with co-authored delivery
KEY TASKS
• Strategy formulation
including objectives
• Identification of appropriate
partners at both a national
and local level
• Negotiation with partners
• Co-creation
• Plan development and
monitoring
• Oversight of effective
delivery of partnership to
achieve objectives
• Evaluation of partnership
effectiveness
• Ensure partnership
synergies across the health
sector, avoiding unhelpful
duplication
“Wherever possible, we want people to
call the shots over the decisions that
affect their lives”. Coalition Document
KEY CHALLENGES
• Joining up national/regional/local
• Robust evaluation
• Trade off between control and energy
• Co-ordination
CSFs
• Supreme account management,
brokering and negotiation skills
• Planned, co-ordinated approach
• Reaching agreement on price and
other terms of the offer
5. Catalysing and facilitating
the Big Society
Give communities
more powers
Encourage people to take an
active role in their communities
Transfer power from central
to local government
Support co-ops, mutuals,
charities and social enterprises
Publish
government data
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•
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Nurturing the early shoots
of emerging big society groups or interested
individuals
Identify topics of mutual
interest, make contacts,
share ideas and provide
support
Supporting volunteers and
activists attempting to run
new projects
Bringing alive usergenerated content
6. Capturing and sharing knowledge,
then reapplying it effectively
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Incentivise the knowledge culture
Reduce duplication
Identify and link ‘statistical neighbours’
Flexible, searchable interactive
Encouraging ‘horizontal’ models
Many uncertainties………..
•
Inherent tension between the thirst for
efficiency (eg avoiding duplication) and the
devolved model
•
Will the serious appetite for innovation
become a reality in tough times?
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Will providing information be enough?
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Which metrics need to be developed for the
new world marketing?
•
Is the Big Society a social movement or a
collection of social movements?
COI white paper discussion
seminars
What Patients Want
Making Sense of Data
Accountable start-ups
Public health Effectiveness and Efficiency
Social Care and Disability
How to engage GPs
 if you are interested in attending please email [email protected]