Applying the science
of human behaviour
to the art of
communications
Dan Berry
@dan_berry79
[email protected]
16 March 2017
Judges are humans
2  © Hill+Knowlton Strategies
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11,000,000
bits per second
40
bits per second
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How our minds works
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Do we have a Sherlock Holmes bias?
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Applying behavioural
insights to NHS
communications
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Kunz, P. R., & Woolcott, M. (1976). Season's greetings: From my status to yours. Social Science Research, 5(3), 269-278.
8  © Hill+Knowlton Strategies
Reciprocity – the sense of give and take
Standard SMS reminder
New SMS reminder
12
11.1
%
Patients not attending
their appointment
10
8.4%
Appt at St Barts
Hospital on Sep 26 at
2.30. To cancel or
rearrange call the
number on your
appointment letter.
We are expecting you
at St Barts Hospital
on Sep 26 at 2.30.
Not attending costs
NHS £160 approx.
Call 02077673200 if
you need to cancel or
rearrange.
8
6
4
2
0
standard SMS
reminder
new SMS
reminder
N = 10,111
Hallsworth M, Berry D, et al (2015) Stating appointment costs in SMS
reminders reduces missed hospital appointments, PLOS One
 © Hill+Knowlton Strategies
We tested 7 messages in total
Appt at St Barts
Hospital on Sep 26
at 2.30. To cancel
or rearrange call
the number on your
appointment letter.
Appt at St Barts
Hospital on Sep 26
at 2.30. To cancel
or rearrange call
02077673200
We are expecting
you at St Barts
Hospital on Sep 26 at
2.30. 9 out of 10
people attend. Call
02077673200 if you
need to cancel or
rearrange.
We are expecting
you at St Barts
Hospital on Sep 26 at
2.30. Not attending
costs NHS £160
approx. Call
02077673200 if you
need to cancel or
rearrange.
Specific costs
Existing message
Easy call
Social norms
We are expecting
you at St Barts
Hospital on Sep 26 at
2.30. Not attending
wastes NHS money.
Call 02077673200 if
you need to cancel or
rearrange.
We are expecting
you at St Barts
Hospital on Sep 26 at
2.30. Please be fair
to others and call
02077673200 if you
need to cancel or
rearrange.
We are expecting
you at St Barts
Hospital on Sep 26 at
2.30. Please attend
or call 02077673200
to cancel/rearrange
or we will record as a
missed appt.
General costs
Fairness
Monitoring
 © Hill+Knowlton Strategies
Combining a range of message framing techniques
Standard NHS letter
New letter and accompanying SMS messages
35
30
attendance
rate
30%
25
PRIMER
REMINDER
20
18%
15
10
5
0
standard NHS
letter
new letter and
SMS
N = 13,800
Berry D, Bonus, A: Increase uptake of the NHS Health Check in
Southwark: results from an RCT:
https://www.gov.uk/government/publications/nhs-health-checksincreasing-uptake
 © Hill+Knowlton Strategies
Social norms – everybody’s doing it
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Social norms
“The great majority (80%)
of practices in Birmingham
prescribe fewer antibiotics
per head than yours”
Hallsworth, M., Chadborn, T., Sallis, A.,
Sanders, M., Berry, D. et al. (2016).
Provision of social norm feedback to high
prescribers of antibiotics in general practice:
a pragmatic national randomised controlled
trial. The Lancet, 387(10029), 1743-1752.
 © Hill+Knowlton Strategies
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We know less than
we think we do
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Social marketing campaign
“A fact about
antibiotics you may
find hard to swallow.
If you or your family
take antibiotics when
you don’t need them,
they’re less likely to
work when you do.
Don’t let bacteria build
up resistance. Follow
your doctor’s advice.
Keep antibiotics in
good health”
Hallsworth, M., Chadborn, T., Sallis, A.,
Sanders, M., Berry, D. et al. (2016).
Provision of social norm feedback to high
prescribers of antibiotics in general practice:
a pragmatic national randomised controlled
trial. The Lancet, 387(10029), 1743-1752.
 © Hill+Knowlton Strategies
Testing our assumptions
Change for Life: Family Information Pack
Croker, H, Lucas R, and Wardle J. (2012) "Cluster-randomised trial to evaluate the
‘Change for Life’ mass media/social marketing campaign in the UK." BMC Public Health
12, no. 1: 404.
 © Hill+Knowlton Strategies
Applying behavioural
insights back at your
day job
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Potential in the NHS
Helping people with their good intentions
• Attending screening checks or other medical appointments
• Medications adherence
• Clinicians making best use of NHS drugs and equipment
• Lifestyle change such as exercise and diet
Reducing error
• Reducing error in prescription costs
• ‘Human factors’
• Collecting patient charges e.g. from overseas visitors
Understanding risk
• Clinical risks
• Other issues that are risky or uncertain such as referrals to new providers,
or switching from A&E to alternatives
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Finding out more
• In-house team at PHE
• Behavioural Insights Team
• Academic departments at:
- Warwick
- UCL
- LSE
- Stirling
- Cambridge
• The Health Foundation
• H+K Strategies
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21Hill+Knowlton Strategies
Game
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An extra 96,000 organ donor registrations per year!
Social norm + picture
Harper, H., Sallis, A. et al. (2015). Driving up organ donation registrations: An RCT of message prompts to 1 million road-users.
Publication pending.
Reciprocity
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Twitter: dan_berry79
Email: [email protected]
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