It has been suggested that nudges – approaches that steer people in certain directions while maintaining their freedom of choice – might offer an effective way to change behaviour and improve outcomes at lower cost than traditional policy tools.
Nudges have been applied across a wide range of areas in the UK and globally. However, there is relatively little in the way of coverage of nudge-type behaviour change interventions to health care specifically and some uncertainty about how effective nudges are in bringing about desirable behaviour change.
This review begins to address this gap by:
providing a map of the evidence of the application of nudge-type interventions in health care
considering opportunities for reducing inefficiency and waste in health care.
The review identifies:
nudge-type interventions with potential to increase efficiency and reduce waste in health care
areas of inefficiency and waste to which nudge-type interventions might be productively applied
opportunities and considerations for those looking to introduce nudge-type interventions
The annual number of adults and children newly infected with HIV fell from 3.1 million in 2000 to 2.1 million in 2014, show new figures released by the World Health Organization for world AIDS day on 1 December.1
The decline in the number of new infections was even steeper in Africa, which saw a 40% drop (from 2.3 million to 1.4 million) over the same period.
The number of people receiving treatment has also increased substantially, with an estimated 16 million taking antiretrovirals in 2014, 11 million of whom were in Africa. In 2000 just 11 000 people in Africa received antiretrovirals.
WHO’s report describes how the increase in treatment has had a big effect on life expectancy in Africa, which in most countries plummeted between 2000 and 2005. In Zimbabwe, for example, average life expectancy between 1985 and 1990 was around 63 years. This fell to just over 40 years between 2000 and 2005 but has started to rise again, and between 2010 and 2015 it was at around 55. Over the same period life expectancy in Namibia fell from around 62 to 53 years but is now about 64.
The PROTECT (Provider Responses, Treatment and Care for Trafficked People) research project recently published its independent findings in the ‘British Medical Journal Open’ journal. Sponsored by DH, the research shows that up to 1 in 8 NHS professionals reported having contact with a patient they suspected may have been trafficked.
Further findings published by the Lancet Psychiatry show that hospital mental health services are seeing trafficked people with a range of diagnoses, including depression, post-traumatic stress disorder and schizophrenia.
Many trafficking survivors talk of experiencing physical violence and psychological abuse. Research evidence shows they have poor mental health and many, especially women, are sexually abused and may acquire sexually transmitted infections as well as having to cope with unwanted pregnancies and abortions.
The research highlights how important it is that the health system has an understanding of modern slavery and the need for training tools to support health professionals in identifying and providing support for victims. The DH e-learning tool for staff on identifying and responding to modern slavery has been updated and is available on the largest e-learning portal for NHS staff: e-Learning for Healthcare.
The Royal College of General Practitioners and the Nuffield Trust have published Collaboration in general practice: surveys of GPs and CCGs. Commissioned by NHS England, this slide pack presents the results of two online surveys which aimed to examine the landscape of collaboration in general practice: one distributed to GPs; and the other distributed to clinical commissioning groups.
The surveys were undertaken from July to November 2015 and aimed to provide a snapshot of the pace and scale of large-scale collaboration in general practice in England. They include responses from 94 CCGs and 982 GPs and practice representatives.
This report synthesises the lessons from the Health Foundation’s work on improving patient safety. Part I illustrates why improving safety is so difficult and complex, and why current approaches need to change. Part II looks at some of the work being done to improve safety and offers examples and insights to support practical improvements in patient safety. In Part III, the report explains why the system needs to think differently about safety.
The report includes specific resources to contribute to the next phase of safety improvement in the NHS:
For leaders of provider organisations, three practical steps are given that need to be taken to build an organisation-wide approach to continually improving safety. We have also brought together ten Health Foundation resources to support leaders to do this.
For government, quality regulators and national bodies with a remit for patient safety, The Health Foundation sets out its vision for an effective safety system, which current activities and ambitions should be assessed against.
This guideline covers the transition between inpatient hospital settings and community or care homes for adults with social care needs. It aims to improve people’s experience of admission to, and discharge from, hospital by better coordination of health and social care services.
This paper launches a series of reviews which will examine prevention activity at different stages of the life course and pay particular attention to pressure points such as transitions and particular vulnerability and exposure to adversity associated with this life stage
Prevention operates at different levels:
1. Primary prevention – Stopping mental health problems from occurring in the first place by using ‘upstream’ approaches.
2. Secondary prevention – Identifying the earliest signs that mental health is being undermined and ensuring early intervention is available to minimise progression into a more serious mental health problem.
3. Tertiary prevention – Working with people with established mental health problems to ensure the earliest path to sustainable recovery and to reduce the social, economic and health losses often resulting from living with a mental health problem.