Behaviour change in the Welsh NHS: insights from three programmes

Trying to change the way that the NHS operates can be usefully seen as an attempt to change the behaviours of the people within it. This report applies insights from behavioural science to analyse three national programmes in Wales seeking to do this: Making Every Contact Count; Choosing Wisely Wales; and Social Prescribing.

All three programmes aim, in different ways, to change the relationship between patients and the health service. Specifically, they aim to improve health outcomes by reorienting health service provision towards co-production and prevention as part of the Prudent Healthcare agenda.

The report brings together international evidence, which suggests that each programme has the potential to successfully change behaviours. However, for this to happen at any meaningful scale will be complicated by the significant structural and cultural barriers that reinforce current behaviours in the system. These include time and resource constraints, but also the way in which staff perceive their role and relationship with patients.

Each programme’s key mechanism for successful delivery is training, and this will be very important. Training should not just impart the necessary knowledge and skills, but also address perceptions of duty and identity of staff. This should be combined with support from Welsh Government, who can aim to address barriers to co-production and prevention as part of their response to the Parliamentary Review of Health and Social Care in Wales.