The Health of People: How the social sciences can improve population health
Publication Year: 2017
As Britain ages amid austerity, more and more people will suffer from long-term health conditions. Obesity and diabetes are on the rise. Mental health problems are widespread. Tobacco and addictions are well-known killers. Each condition brings high costs, both financial and social. Meanwhile, budgets for the NHS, social care and public health are being squeezed. Despite this potential crisis, new opportunities are emerging to support both healthcare providers and the population. Advances in understanding will change how behaviour can prevent and mitigate ill health. Our approach to health must become more ‘social’. The Health of People – a report compiled by the Campaign for Social Sciences – investigates a range of ways to cut the cost of health interventions and to improve patient outcomes as ...
- Front Matter
- Back Matter
- Healthy behaviour: Promoting population behaviour change
- Understanding behaviour change
- Strategies to encourage and support changes in health-related behaviours
- Self-management of illness and long-term conditions
- Behaviour change and implications for health service delivery
- Social science and new ways of configuring services
- Social science and data
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© Campaign for Social Science 2017
First published 2017
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This report is very welcome and timely. The contributions of modern science and technology to the quality of modern healthcare are everywhere visible. They include non-invasive imaging, minimalist surgery and new anaesthetics, stents and statins, genetic testing and new techniques and treatments for cancers. There is much more to come as we head into the era of personalised medicine in which diagnostics and treatments are moulded with much greater accuracy around the individual.
Less obvious, but equally as important, has been the contribution of the social sciences, as evidenced by the examples in this report. Healthcare is enormously expensive. Relatively few nations have even a basic model of universal healthcare coverage that provides equity of access to an entire population, let alone with the NHS promise of being free at the point of clinical need. And no such nation has a model that is economically sustainable well into the future, given demographic changes and rising costs, as science enables us to perform life-saving procedures that were previously impossible, and as public expectations rise accordingly. Across all of these domains lie the social sciences.
More importantly for healthcare systems across the world is the improvement of population health, primarily through the prevention of ill-health, but also through shifting presentation, diagnosis and treatment further upstream, so that healthy lives are prolonged and healthcare becomes more than simply a patch and repair service for acute and chronic conditions.
This report proposes a number of steps towards a more coherent and focused approach in linking the social and behavioural sciences to these ends, and is to be warmly welcomed and applauded. It’s a strong case and there is an urgent need.Chair, NHS England
[Page viii]The Campaign for Social Science was set up in 2011 to inform public policy, build coalitions and engage in measured advocacy. It sprang from the Academy of Social Sciences, which now has a fellowship of around 1,100 eminent academics and practitioners across universities, business, government and civil society. 42 learned societies are also members, representing over 90,000 social scientists in all walks of life.
In 2015, ahead of the last general election, we published The Business of People, to highlight the contributions of the social sciences to the myriad economic, social and environmental challenges which confront the UK and the wider world.
This successor report – The Health of People – represents a timely intervention in policy and public debates about the health and wellbeing of our society. From transforming health services to influencing health-related behaviours, the report makes clear that too much of the potential of social science still lies untapped. And it makes a set of clear recommendations to improve the provision, transmission and uptake of research evidence in ways that can make tangible improvements to population health.
I would like to extend my warmest thanks to those who have devoted time to the project over the past year, especially to Professor Susan Michie FAcSS, who expended considerable time and energy in expertly steering the report through to completion, and the members of her Working Group, as well as to our Review Group, whose experience and insights provided a valuable reality check on our conclusions. Let me also thank Sharon Witherspoon MBE FAcSS and Daniela Puska of the Campaign team, and Professor Jon Glasby FAcSS, a member of our Board, all of whom made important contributions to the drafting of the report and management of the project.
Finally, we are grateful to Ziyad Marar and colleagues at SAGE Publishing for their ongoing partnership and for publishing the report; and to the Association of the British Pharmaceutical Industry (ABPI), British Psychological Society, Cancer Research UK, Nesta, Society for the Study of Addiction, and Wellcome Trust for their generous support.
We are in a period of transition, both within the NHS and wider health system, and across UK universities and research. Reports like this, and the wider efforts of the Campaign to demonstrate how social science can help to meet our shared priorities, have never been more urgently email@example.com
Acknowledgements[Page ix]Working Group
Susan Michie FAcSS (Chair), Professor of Health Psychology and Director of the Centre for Behaviour Change, University College London; Gwyn Bevan, Professor of Policy Analysis and Director of the MSc in Public Management and Governance, London School of Economics and Political Science; Rona Campbell FAcSS, Professor of Public Health Research, University of Bristol; Joanna Coast, Professor in the Economics of Health & Care, University of Bristol; Simon Christmas, Visiting Senior Research Fellow, King’s College London; Robbie Foy, Professor of Primary Care, Leeds Institute of Health Sciences, and a General Practitioner; Jon Glasby FAcSS, Head of the School of Social Policy, University of Birmingham; Ann Hoskins, Independent Public Health Consultant; Marie Johnston FAcSS, Professor of Health Psychology, University of Aberdeen; Mike Kelly, Professor and Senior Visiting Fellow in the Department of Public Health and Primary Care, University of Cambridge; Lawrence King, Professor of Political Economy and Sociology, University of Cambridge; Theresa Marteau FAcSS, Professor and Director of the Behaviour and Health Research Unit, University of Cambridge; Matt Sutton, Professor of Health Economics, University of Manchester; Robert West, Professor of Health Psychology and Director of Tobacco Studies, University College London; Tim Whitaker FAcSS, Director of Communications, Hanover Housing Association; Sally Wyke, Deputy Director and Interdisciplinary Research Professor at the Institute of Health and Wellbeing, University of Glasgow; Dagmar Zeuner, Director of Public Health, London Borough of Merton.Review Panel
Ian Dodge, National Director for Commissioning Strategy, NHS England; Carol Tannahill FAcSS, Director, Glasgow Centre for Population Health and Chief Social Policy Adviser; Sir John Tooke, Executive Chairman and Founder, Academic Health Solutions.[Page x]With Thanks To
Particular thanks to Sharon Witherspoon MBE FAcSS, and also to Stephen Anderson, Daniela Puska, Alessandro Lanuto, Helen Spriggs and Sam Martin at the Campaign for Social Science, David Walker FAcSS and Roses Leech-Wilkinson, as well as Nicola Gale, Russell Mannion, Rachel Posaner, Christian Bohm and David Evans for comments and support with an early draft of this report.
The many people who contributed to the report through roundtable discussions and the Call for Evidence are acknowledged at the back of the report.
The report is kindly supported by the British Psychological Society, Cancer Research UK, Nesta, SAGE Publishing, Society for the Study of Addiction, The Association of the British Pharmaceutical Industry, and the Wellcome Trust.
Scope of this Report[Page xi]
This report is concerned with how the social sciences can help improve population health. While biomedical sciences are primary drivers of health treatments and healthcare, the social sciences have an important role in informing and helping change the environments, policies, practices and behaviours that influence the health of people.
We use the term ‘health’ to cover wellbeing and mental health, as well as physical health. We also acknowledge that health and social care are interdependent: the one needs to be considered in the light of the other. We use the term ‘social sciences’ to cover a wide range of academic disciplines, including psychology, anthropology, political science, sociology, economics and geography. We sometimes talk about the ‘social sciences’ and sometimes ‘the social and behavioural sciences’. When we use the longer phrase, it is to remind readers that social sciences include distinctive approaches to human behaviour, emphasising that if we are to improve population health, we need a comprehensive approach to behaviour change, drawing on the full gamut of theories, evidence and methodologies from the social and behavioural sciences.
‘The term ‘behavioral’ refers to overt actions; to underlying psychological processes such as cognition, emotion, temperament, and motivation; and to bio-behavioral interactions. The term ‘social’ encompasses sociocultural, socioeconomic, and socio-demographic status; to biosocial interactions; and to the various levels of social context from small groups to complex cultural systems and societal influences. The core areas of behavioral and social sciences research are those that have a major and explicit focus on the understanding of behavioral or social processes, or on the use of these processes to predict or influence health outcomes or health risk factors.1’
This report has as one of its major themes the importance of the social sciences in achieving behaviour change; it also acknowledges the importance of social sciences in improving health in other ways: by describing the social and economic determinants of health inequalities, helping understand economic factors in health and healthcare, and so on. But this is not an attempt at an exhaustive account of how [Page xii]the social sciences have contributed to improvements in health. Instead it is a short report on how the current relationship between the social sciences, health policies and interventions and health could be improved for the health of people.
This report is timely in that it is published soon after a report from the Academy of Medical Sciences, Improving the Health of the Public by 2040. Our recommendations complement theirs and, together, the recommendations form a solid basis for action that could transform the health of people in the UK.2
Executive Summary[Page xiii]
This report examines the current and potential role of social and behavioural sciences in improving population health, with health considered in its broadest sense to include wellbeing and mental health. It argues that while the social sciences are already making a contribution, this needs to go further if we are to tackle the challenges of improving population health. This use should include population-level changes in policy and practice to improve health, by environmental changes as well as promoting health-related behaviours, such as self-management of long-term conditions, and the practices of health providers and planners. Effective interventions are those that recognise the systems within which health and ill-health occur and those that need to change to achieve improvements. Change is needed at many levels: for example, in the behaviours of health service planners and those delivering services. We present case studies to show what has been achieved but also point to how much more could be done if social sciences were more systematically involved in health policy and practice.
Attempts to change behaviour are often based upon ‘common sense,’ flawed assumptions about how people behave and unrealistically optimistic interpretations of limited evidence. For example, strategies relying on provision of information or guidelines alone seldom result in significant change but are often used despite repeated failures of this approach.
This report argues that the social sciences provide models and methods for a more comprehensive and coherent approach to behaviour and behaviour change that takes account of the physical and social context, physical and psychological capability, and people’s ‘reflective’ and ‘automatic’ motivational processes. Long-term maintenance of change is key to improving health and the factors that influence this often differ from those that trigger short-term change. The social sciences provide a wide range of methods for developing and evaluating interventions and frameworks that can be tailored to health needs and practical circumstances. The report makes the case that the development of a national strategy for accelerating advances in the social and behavioural sciences, and for embedding the translation of these advances into policy and practice, would be a sound investment in the health of people.[Page xiv]
Recommendations[Page xv]1. Recommendations for coordinating and funding research and implementation
2. Recommendations for capacity building
- 1.1 We call for a UK strategic coordinating body for research into population health. It should bring together major research funders (such as National Institute for Health Research (NIHR), Medical Research Council (MRC), the Economic and Social Research Council (ESRC), Wellcome Trust, Cancer Research UK, and British Heart Foundation), public health bodies (such as Public Health England, Health Protection Scotland, Public Health Wales, Public Health Agency for Northern Ireland, NHS England, Scotland, Wales and Northern Ireland), and relevant learned societies (such as the Academy of Social Sciences and Academy of Medical Sciences).3
- 1.2 This coordinating body should take as its remit a wide view of population health and approaches to improving it, recognising (i) the role of behaviour in improving health and the environmental and social systems within which behaviour occurs and changes, and (ii) the diversity of change agents at population, community and individual level influencing health indirectly as well as directly. Its aim should be to support high-quality, multi-disciplinary research on these issues and on how best to translate research evidence into policy and practice.
- 1.3 One of the new body’s first tasks should be to commission a review of the existing infrastructure for health research, including social and behavioural research and its implementation in healthcare and public health, [Page xvi]involving stakeholders, funders, and major research centres. This review should examine research funding, funding agencies, funding mechanisms, and infrastructure for implementation at national, regional and local level, including resources and roles dedicated to this.
- 1.4 The review should make recommendations regarding the building of an integrated system for multi-disciplinary research and implementation. This would include reviewing existing centres and networks, addressing the weaknesses in the current approaches while building on their strengths, to ensure critical mass and stability.
- 1.5 The review should consider establishing a number of ‘implementation laboratories’. These would focus on the development and evaluation of implementation strategies for the health service, local government and other parts of society relevant to health.
3. Recommendations for data provision and access
- 2.1 The UK strategic coordinating body should review the existing skills and expertise available for research into behavioural and social sciences in relation to health. This review should assess how the necessary skills and expertise can be developed, including the need for more diverse and appropriate training pathways, and include training in how to engage effectively with potential users of research, as well as how medical researchers and practitioners (including Directors of Public Health, service commissioners, and managers) could engage more strategically with social science expertise.
- 2.2 The UK strategic coordinating body should consider how best to encourage and incentivise those involved in promoting health and commissioning and delivering healthcare services to make appropriate use of research findings and expertise, including social science evidence. In doing so, it should make use of behavioural and social science research about incentivisation and research translation.
- 2.3 We recommend that the strategy for capacity building should include developing greater numbers of people who can ally high-level data and informatics skills with substantive knowledge of health research.4 This will require a strategic priority among research funders and a focus on training pathways to provide new capacity, [Page xvii]and include consideration of how to draw mathematics, physics and data analytic specialists into social and behavioural health and health delivery research.
- 2.4 We recommend that all research funders consider a new interdisciplinary research agenda on the importance of macro- and micro-environments and of social relationships (including the roles of changing social norms and social support) in bringing about behaviour change.
- 3.1 We support the calls of the Wachter review5 for the development of efficient and effective systems for collecting data relevant to behaviour change in healthcare and public health. The use of such data (usually in the form of de-personalised data sets, where individuals are not identifiable) is essential for public-benefit research to improve the health of the nation.
- 3.2 The UK strategic coordinating body should play an active role in unlocking the current difficulties in accessing health data and linking them to social data to provide research access that is both necessary to improve population health and consistent with public acceptance of public-benefit research carried out with appropriate safeguards.
- 3.3 We also call for a greater urgency in the deliberations of NHS Digital and the Department of Health over health data linkage and for the ‘social consent’ model we propose in this report to form an important foundation for these policy discussions.
- 3.4 We recommend that parliamentarians, policy-makers, health organisations and the broader public should be engaged in an urgent debate about the benefits of opening up access to link ‘de-personalised’ health data with broader social data to improve health policy, practice and behaviour. Social scientists should be active participants in these discussions about data linkage, as they have useful research and evidence about public views on these matters.[Page xviii]
Job titles and affiliations are those at the time of engagement with the project.Participants at roundtable discussionsHealth service delivery
Stephen Anderson, Executive Director, Campaign for Social Science; Eric Barratt, NHS Healthy Workforce Programme Manager, NHS England; Anda Bayliss, Research and Innovation Manager – Evidence, Royal College of Nursing; Siôn Charles, Deputy Director, Bevan Commission; Ed Day, Senior Clinical Lecturer in Addiction Psychiatry, National Addiction Centre, Institute of Psychiatry, and Consultant at Birmingham & Solihull Mental Health NHS Foundation Trust; Erik Ducker, Portfolio Developer – Communities and Knowledge, Wellcome Trust; Posy Goraya, Senior Manager, NHS RightCare, NHS England; Sir Malcolm Grant CBE FAcSS, Chair, NHS England; Laura Harper, Research Manager, Health Foundation; Paula Lorgelly, Deputy Director, Office of Health Economics; Christine McGuire, Science Research and Evidence Directorate, Department of Health; Amie McWilliam-Reynolds, Head of Research, Healthwatch; Susan Michie FAcSS, Director, Centre for Behaviour Change, University College London, and Chair of The Health of People project; Al Mulley, Managing Director, The Dartmouth Center for Health Care Delivery; Carol Propper CBE, Associate Dean of Faculty and Research and Chair in Economics, Imperial College Business School; João Rangel de Almeida, Portfolio Development Manager, Wellcome Trust; Chris Walters, Chief Economist, NHS Improvement; Tim Whitaker FAcSS, Director of Communications, Hanover Housing, and member of The Health of People Working Group; Sharon Witherspoon MBE FAcSS, Head of Policy, Campaign for Social Science.[Page 62]Prevention
Louise Ansari, Director of Communications, Centre for Ageing Better; Mark Baker, Director of the Centre for Guidelines, NICE; Amanda Bunten, Behavioural Insights Team, Public Health England; Tim Chadborn, Behavioural Insights Lead Researcher, Public Health England; Ed Day, Senior Clinical Lecturer in Addiction Psychiatry, King’s College London, and Consultant at Birmingham & Solihull Mental Health NHS Foundation Trust; Erik Ducker, Portfolio Developer – Communities and Knowledge, Wellcome Trust; Kevin Fenton, Director of Health and Wellbeing, Public Health England; Paul Lincoln, Chief Executive, UK Health Forum; Christine McGuire, Science Research and Evidence Directorate, Department of Health; Wendy Meredith, Director of Population Health Transformation, Greater Manchester; Susan Michie FAcSS, Director of the Centre for Behaviour Change, University College London, and Chair of The Health of People project; Laurence Moore FAcSS, Director of the MRC/CSO Social & Public Health Sciences Unit, University of Glasgow; João Rangel de Almeida, Portfolio Development Manager, Wellcome Trust; Helen Walters, Public Health Consultant Advisor, NIHR – NETSCC; Robert West, Director of Tobacco Studies, the Cancer Research UK Health Behaviour Research Centre, UCL, and member of The Health of People Working Group; Sharon Witherspoon MBE FAcSS, Head of Policy, Campaign for Social Science; Dagmar Zeuner, Director of Public Health, London Borough of Merton, and member of The Health of People Working Group.Use of health data
Jo Churchill, Member of Parliament for Bury St Edmunds; Tommy Denning, Information Governance Policy Manager, Department of Health; Erik Ducker, Portfolio Developer – Communities and Knowledge, Wellcome Trust; Katie Farrington, Director of Digital and Data Policy, Department of Health; Harry Hemingway, Director of the Farr Institute of Health Informatics, UCL; Susan Michie FAcSS, Director, Centre for Behaviour Change, University College London, and Chair of The Health of People project; Ronan Lyons, Professor of Public Health, Swansea University and Director, CIPHER, and Co-Director of the SAIL Databank; Freda Mold, Lecturer in Integrated Care, University of Surrey; Louise Park, Associate Director (Health), Ipsos MORI; Nicola Perrin, Head of Policy, Wellcome Trust; Andrew Roddam, Vice President & Global Head Epidemiology, GSK; Shobna Vasishta, Programme Manager, SHARE; Robert West, Director of Tobacco Studies, Cancer Research UK Health Behaviour Research Centre, UCL, and member of The Health of People Working Group; Sharon Witherspoon MBE FAcSS, Head of Policy, Campaign for Social Science.[Page 63]Respondents to Call for Evidence
Carol Atkinson, Associate Dean: Research, Manchester Metropolitan University Business School; Clare Bambra FAcSS, Professor of Public Health Geography, Durham University; Julie Barnett, Professor of Health Psychology, University of Bath; Bernadette Bartlam, Lecturer in Health Services Research, Keele University; Yehuda Baruch FAcSS, Professor of Management, Director of Research, Southampton Business School, University of Southampton; Nicola Bolton, Principal Lecturer, Cardiff School of Sport, Cardiff Metropolitan University; Mark Brosnan, Reader in Psychology and the Director of Research for Psychology, University of Bath; Daniela Carl Deputy Chief Executive, Regional Studies Association; Ruby C M Chau, Visiting Scholar,The University of Sheffield; Sarah Chaytor, Head of Public Policy, Office of the Vice-Provost, UCL; Linda Clare FAcSS, Professor of Clinical Psychology of Ageing and Dementia, University of Exeter; Jessie Cooper, Lecturer in the Sociology of Public Health, Institute of Psychology, Health and Society, The University of Liverpool; Rob Davies, Public Affairs Manager, CLOSER UCL Institute of Education; Zowie Davy, Senior Lecturer, School of Health and Social Care, University of Lincoln; Claire Donovan, Reader, Institute of Environment, Health and Societies, Brunel University; Danny Dorling FAcSS, Halford Mackinder Professor of Geography of the School of Geography and the Environment, University of Oxford; Simon Dyson, Professor of Applied Sociology, De Montfort University; Chris Eccleston, Professor, Department for Health University of Bath; the Economic and Social Research Council; Natalie Forster, PhD Candidate in Sociology, University of Edinburgh; Stewart Fotheringham FAcSS, Professor of Computational Spatial Science in the School of Geographical Sciences and Urban Planning, Arizona State University; Simone Fullagar, Professor of Sport and Physical Cultural Studies, University of Bath; Sarah Galvani, Professor of Adult Social Care, Manchester Metropolitan University; Kenneth Gilhooly FAcSS, Research Professor in Quantitative Gerontology, Brunel University; Anna Gilmore, Professor, Department for Health, University of Bath; Trisha Greenhalgh, Professor of Primary Care Health Sciences, University of Oxford; Lea Hagoel, Department of Community Medicine and Epidemiology, Technion; Catherine Hamilton-Giachritsis, Senior Lecturer in Forensic Psychology, University of Birmingham; Linda Hantrais FAcSS, Emeritus Professor of European Social Policy, Loughborough University; Steve Hanney, Emeritus Professor, Brunel University; Alex Haslam FAcSS, The University of Queensland; Jenny Hatchard, Research Fellow, Department for Health, University of Bath; Jonathan Hill, Senior Lecturer in Physiotherapy, Keele University; Clare Jinks, Reader in Applied Health Research, Keele University; Sarah Macdonald, [Page 64]Research Fellow, Nottingham University; Linda Machin, Honorary Research Fellow, Keele University; Daryl Martin, Lecturer in Sociology, University of York; Tony McEnery FAcSS, Director of the ESRC Centre for Corpus Approaches to Social Science and Distinguished Professor of English Language and Linguistics, Lancaster University; Jane Meyrick, Senior Lecturer, Department of Psychology, University of the West of England; Jennifer Newton, Head of School of Social Sciences, Faculty of Social Sciences and Humanities, London Metropolitan University; Josephine Ocloo, Research Fellow (Improvement Science), London Imperial College; Rachel O’Hara, Senior Lecturer in Public Health, University of Bath; Lois Orton, Senior Research Fellow, University of Liverpool; Eugenia I Pearson; Cassandra Phoenix, Reader, Department for Health, University of Bath; Victoria Pinoncely Research Officer, Royal Town Planning Institute; Subhash Pokhrel, Senior Lecturer, Brunel University; Shirin M Rai FAcSS, Professor, Department of Politics and International Studies, University of Warwick; Emma Rich, Senior Lecturer, Department for Health, University of Bath; Carol Rivas, Senior Research Fellow, University of Southampton; Peter Rouse, Medlock Research Associate, University of Bath; Paul Salkovskis, Professor of Clinical Psychology & Applied Science, University of Bath; Ted Schrecker, Professor of Global Health Policy, School of Medicine, Pharmacy and Health, Durham University; Rebecca Shortt, Senior Policy Manager, The Brain Tumour Charity; Martyn Standage, Professor, Department for Health, University of Bath; Afroditi Stathi, Senior Lecturer, Department for Health, University of Bath; Bas Verplanken, Head of Department of Psychology, University of Bath; Justin Waring FAcSS, Associate Dean (Engagement), Director of Centre for Health Innovation, Nottingham University Business School; Kelly J Watson, PhD and Research Associate, School of Environment, Education & Development, University of Manchester; Vishanth Weerakkody, Professor of Digital Governance, Director of Business Life, Brunel University; Judith Wester, Director, CEDAR Education CIC; Andrew Weyman, Senior Lecturer, Department of Psychology, University of Bath; Wendy Wills, Professor of Food and Public Health and Director of the Centre for Research in Primary and Community Care, University of Hertfordshire; Kerry Woolfall, Research Fellow Institute of Psychology, Health and Society, University of Liverpool; Penny Wright, Associate Professor in Psychosocial Cancer Care, University of Bath; Jennifer Yiallouros, Senior Health Evaluation and Research Analyst, Cancer Research UK; Keming Yu, Research Director (Impact) Reader in Statistics, Brunel University; and Sam W K Yu, Associate Professor, Department of Social Work, Hong Kong Baptist University.
1 National Institutes of Health: Office of Behavioral and Social Science Research, ‘BSSR definition’, https://obssr.od.nih.gov/about-us/bssr-definition/
2 Academy of Medical Sciences, Improving the Health of the Public by 2040, 2016, https://acmedsci.ac.uk/file-download/41399-5807581429f81.pdf
3 See recommendations in Academy of Medical Sciences, Improving the Health of the Public by 2040, 2016.
5 Wachter, Robert, Making IT Work: Harnessing the power of health information technology to improve care in England, 2016,www.gov.uk/government/uploads/system/uploads/attachment_data/file/550866/Wachter_Review_Accessible.pdf
6 Macintyre, Sally, ‘Keeping social sciences in the MRC family’, 2013, www.insight.mrc.ac.uk/2013/09/24/keeping-social-sciences-in-the-mrc-family/
7 HM Government, A Smokefree Future: A comprehensive tobacco control strategy for England, 2010, http://webarchive.nationalarchives.gov.uk/20100509080731/www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_111789.pdf
8 Davies, Karen, et al., Mirror, Mirror on the Wall: How the performance of the U.S. healthcare system compares internationally, The Commonwealth Fund, 2014, www.commonwealthfund.org/~/media/files/publications/fund-report/2014/jun/1755_davis_mirror_mirror_2014.pdf
9 See Office for National Statistics, ‘Expenditure on healthcare in the UK: 2013 – Total healthcare expenditure per person’, 2015, www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthcaresystem/articles/expenditureonhealthcareintheuk/201 5-03-26#total-healthcare-expenditure-per-person. Also see three articles by the King’s Fund: ‘NHS spending: squeezed as never before’, 2015, www.kingsfund.org.uk/blog/2015/10/nhs-spending-squeezed-never; ‘How does this year’s NHS budget compare historically?’, 2016, www.kingsfund.org.uk/blog/2016/05/how-does-this-years-nhs-budget-compare-historically; ‘UK spending on healthcare and social care’, 2016, www.kingsfund.org.uk/blog/2016/06/uk-spending-health-care-and-social-care; and an analytical paper by the Office for Budget Responsibility, ‘Fiscal sustainability and public spending on health’, 2016, http://budgetresponsibility.org.uk/docs/dlm_uploads/Health-FSAP.pdf[Page 66]
10 Pickett, Kate, and Wilkinson, Richard, The Spirit Level: Why equality is better for everyone, Allen Lane, 2009; Kelly, Michael P., et al., The Social Determinants of Health: Developing an evidence base for political action, final report to the World Health Organization Commission on the Social Determinants of Health, Measurement and Evidence Knowledge Network, 2007, www.who.int/social_determinants/resources/mekn_report_10oct07.pdf
11 Marmot, Michael, Fair Society, Healthy Lives (The Marmot Review), 2010, www.instituteofhealthequity.org/projects/fair-society-healthy-lives-the-marmot-review
12 NICE, ‘Health inequalities and population health’, Local government briefing [LGB4], 2012, www.nice.org.uk/advice/lgb4/chapter/introduction; Doohan, Morgan A., and Kelly, Michael P., ‘The social determinants of health’, in Merson, Michael H., Black, Robert E., and Mills, Anne J. (eds), Global Health: Diseases, programs, systems and policies, 3rd edition, Jones & Bartlett, 2012, pp. 75–113.
13 Office for National Statistics, ‘Estimates of the very old (including centenarians), UK: 2002 to 2015’, 2016, www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/ageing/bulletins/estimatesoftheveryoldincludingcentenarians/2002to2015#statisticians-quote
14 Public Health England, ‘UK and Ireland prevalence and trends’, 2016, www.noo.org.uk/NOO_about_obesity/adult_obesity/UK_prevalence_and_trends
15 Department of Health, Long Term Conditions Compendium of Information: Third edition, 2012, www.gov.uk/government/uploads/system/uploads/attachment_data/file/216528/dh_134486.pdf
16 NHS England, Five Year Forward View, 2014, p. 3, www.england.nhs.uk/wp-content/uploads/2014/10/5yfv-web.pdf
17 Alwan, Ali, Global Status Report on Noncommunicable Diseases 2010, World Health Organization, 2011; Parkin, D.M., et al., ‘The fraction of cancer attributable to lifestyle and environmental factors in the UK in 2010’, British Journal of Cancer, 2011, 105: Si–S81; Cancer Research UK, ‘Cigarettes, diet, alcohol and obesity behind more than 100,000 cancers’, 2011, www.cancerresearchuk.org/about-us/cancer-news/press-release/2011-12-07-cigarettes-diet-alcohol-and-obesity-behind-more-than-100000-cancers?rss=true; Lim, S.S., et al., ‘A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: A systematic analysis for the Global Burden of Disease Study 2010’, The Lancet, 2012, 380: 2224–2260.
18 Office for Budget Responsibility, ‘Fiscal sustainability and public spending on health’, 2016, http://budgetresponsibility.org.uk/docs/dlm_uploads/Health-FSAP.pdf
19 Kelly, Michael P., and Barker, Mary, ‘Why is changing health related behaviour so difficult?’, Public Health, 2016, 136: 109–116, www.sciencedirect.com/science/article/pii/S0033350616300178[Page 67]
20 Academy of Medical Sciences, Health of the Public in 2040, 2016, www.acmedsci.ac.uk/policy/policy-projects/health-of-the-public-in-2040/; All Party Parliamentary Group on Primary Care and Public Health, Inquiry Report into NHS England’s ‘Five Year Forward View’: Behaviour change, information and signposting, 2016, www.pagb.co.uk/content/uploads/2016/06/5YFV_Behaviour_Change_Info_Signposting_15March16.pdf; NHS England, Five Year Forward View, 2014, p. 3, www.england.nhs.uk/wp-content/uploads/2014/10/5yfv-web.pdf; National Institute for Health and Clinical Excellence, ‘Behaviour change’, Local government briefing, 2013, www.nice.org.uk/advice/lgb7/chapter/Introduction; Public Health England, ‘Our support for population behaviour change’, 2016, https://publichealthmatters.blog.gov.uk/2016/09/02/our-support-for-population-behaviour-change/; National Institute for Health and Clinical Excellence, ‘Behaviour change at population, community and individual levels’, 2007, www.ncsct.co.uk/usr/pub/guidance-on-behaviour-change-at-population.pdf
21 Fenton, Kevin, ‘Our support for population behaviour change’, Public Health England, 2016, https://publichealthmatters.blog.gov.uk/2016/09/02/our-support-for-population-behaviour-change/
22 Nesta, Introducing…Health Lab, 2016, www.nesta.org.uk/sites/default/files/introducing_health_lab_v3.pdf
23 Hallsworth, Michael, et al., Applying Behavioral Insights: Simple ways to improve health outcomes, World Innovation Summit for Health, 2016, www.behaviouralinsights.co.uk/publications/applying-behavioural-insights-simple-ways-to-improve-health-outcomes/
24 The Academy of Medical Sciences, Improving the Health of the Public by 2040, 2016, https://acmedsci.ac.uk/file-download/41399-5807581429f81.pdf
25 International Collaboration for Participatory Health Research (ICPHR), Position Paper 1: What is participatory health research? Version: May 2013, International Collaboration for Participatory Health Research.
26 NHS England, Five Year Forward View, 2014, p. 3, www.england.nhs.uk/wp-content/uploads/2014/10/5yfv-web.pdf
27 NHS England, ‘Simon Stevens call for bold action to make NHS fit for the future’, 2015, www.england.nhs.uk/2015/05/fit-for-future/
28 Cabinet Office, Government Response to the Science and Technology Select Committee Report on Behaviour Change, 2011, www.gov.uk/government/uploads/system/uploads/attachment_data/file/60538/Government-Response-House-of-Lords-Inquiry-Behaviour-Change.pdf
29 Academy of Medical Sciences, Health of the Public in 2040, 2016, pp. 17–18, www.acmedsci.ac.uk/policy/policy-projects/health-of-the-public-in-2040/
30 National Institutes of Health, ‘Estimates of funding for various research, condition, and disease categories (RCDC)’, 2016, https://report.nih.gov/categorical_spending.aspx
31 Hine, Deidre, The 2009 Influenza Pandemic: An independent review of the UK response to the 2009 influenza pandemic, 2010, www.gov.uk/government/publications/independent-review-into-the-response-to-the-2009-swine-flu-pandemic
32 National Institute for Health and Clinical Excellence, Behaviour Change at Population, Community and Individual Levels, 2007, www.ncsct.co.uk/usr/pub/guidance-on-behaviour-change-at-population.pdf[Page 68]
33 Aveyard, Paul, et al., ‘Screening and brief intervention for obesity in primary care: A parallel, two-arm, randomised trial’, The Lancet, 2016, Nov 19, 388(10059): 2492–2500, www.thelancet.com/journals/lancet/article/PIIS0140–6736(16)31893–1/fulltext; Jolly, Kate, et al., ‘A randomised controlled trial to compare a range of commercial or primary care led weight reduction programmes with a minimal intervention control for weight loss in obesity: The Lighten Up trial’, BMC Public Health, 2010, July 27, 10: 439; Jebb, Susan A., ‘Primary care referral to a commercial provider for weight loss treatment versus standard care: A randomised controlled trial’, The Lancet, 2011, Oct 22, 378(9801): 1485–1492, www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)61344-5/abstract
34 Teenage Pregnancy Independent Advisory Group, Final Report: Teenage Pregnancy: Past successes – future challenges, 2010, www.gov.uk/government/uploads/system/uploads/attachment_data/file/181078/TPIAG-FINAL-REPORT.pdf
35 Wellings, K., et al., ‘Changes in conceptions in women younger than 18 years and the circumstances of young mothers in England in 2000–12: An observational study’, The Lancet, 2016, 388(10044): 586–595; Social Exclusion Unit, ‘Teenage pregnancy’, 1999, http://dera.ioe.ac.uk/15086/; http://dx.doi.org/10.1016/S0140-6736(16)30449-4
36 Skinner, Rachel, et al., ‘England’s teenage pregnancy strategy: A hard-won success’, The Lancet, 2016, 388(10044): 538–540, http://dx.doi.org/10.1016/S0140-6736(16)30589-X
37 UCL News, ‘Teenage pregnancies hit record low, reflecting efforts of England’s strategy to reduce under-18 conceptions’, 2016, www.ucl.ac.uk/news/news-articles/0516/230515_teenage_pregnancies
38 UNICEF, ‘Child well-being in rich countries: A comparative overview’, Innocenti Report Card, 11, 2013, www.unicef-irc.org/publications/pdf/rc11_eng.pdf
39 Public Health England, NHS Health Checks: Applying all our health (guidance), 2015, www.gov.uk/government/publications/nhs-health-checks-applying-all-our-health/nhs-health-checks-applying-all-our-health
40 Baker, Colin, et al., ‘A process evaluation of the NHS Health Check care pathway in a primary care setting’, Journal of Public Health, 2015, 37(2): 202–209, https://academic.oup.com/jpubhealth/article-lookup/doi/10.1093/pubmed/fdv053; Kypridemos, Chris, ‘Cardiovascular screening to reduce the burden from cardiovascular disease: Microsimulation study to quantify policy options’, BMJ, 2016, 353, www.bmj.com/content/353/bmj.i2793
41 Thaler, Richard, et al., Nudge: Improving decisions about health, wealth and happiness, Yale University Press, 2008; Kahneman, Daniel, Thinking, Fast and Slow, Farrar, Straus and Giroux, 2011.
42 Nuffield Council of Bioethics, Public Health: Ethical issues, 2007, http://nuffieldbioethics.org/wp-content/uploads/2014/07/Public-health-ethical-issues.pdf
43 Ibid., p. 42.[Page 69]
44 McGill, Rory, et al., ‘Are interventions to promote healthy eating equally effective for all? Systematic review of socioeconomic inequalities in impact’, BMC Public Health, 2015, 15: 457, http://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-015-1781-7; Olstad, Dana L., et al., ‘Can policy ameliorate socioeconomic inequities in obesity and obesity-related behaviours? A systematic review of the impact of universal policies on adults and children, Obesity Reviews, 2016, 17(12), http://onlinelibrary.wiley.com/doi/10.1111/obr.12457/full#references; Adams, Jean, et al., ‘Why are some population interventions for diet and obesity more equitable and effective than others? The role of individual agency’, PLoS One, 2016, http://dx.doi.org/10.1371/journal.pmed.1001990; Marteau, Theresa M., Hollands, Gareth J., and Fletcher, Paul C., ‘Changing human behavior to prevent disease: The importance of targeting automatic processes’, Science, 2012, Sept 21, 337(6101): 1492–1495, http://science.sciencemag.org/content/337/6101/1492.full
45 House of Lords Science and Technology Committee, Behaviour Change, Second Report of Session 2010–12, www.publications.parliament.uk/pa/ld201012/ldselect/ldsctech/179/179.pdf
46 Institute for Fiscal Studies, Tax and Benefit Policy: Insights from behavioural economics, 2012, www.ifs.org.uk/comms/comm125.pdf
47 House of Lords Science and Technology Committee, Behaviour Change, Second Report of Session 2010–12, www.publications.parliament.uk/pa/ld201012/ldselect/ldsctech/179/179.pdf
48 Public Health England, The Public Health Burden of Alcohol and the Effectiveness and Cost-Effectiveness of Alcohol Control Policies: An evidence review, 2016, www.gov.uk/government/uploads/system/uploads/attachment_data/file/574427/Alcohol_public_health_burden_evidence_review.pdf
50 Bader, Pearl, Boisclair, David, and Ferrence, Roberta, ‘Effects of tobacco taxation and pricing on smoking behavior in high risk populations: A knowledge synthesis’, International Journal of Environmental Research and Public Health, 2011, Nov, 8(11): 4118–4139, www.ncbi.nlm.nih.gov/pmc/articles/PMC3228562/; Goodchild, Mark, Perucica, Anne-Marie, and Nargisb, Nigar, ‘Modelling the impact of raising tobacco taxes on public health and finance’, Bulletin of the World Health Organization, 2016, 94: 250–257.
51 Action on Smoking and Health, Smoking Still Kills: Protecting children, reducing inequalities, 2015, http://ash.org.uk/information-and-resources/reports-submissions/reports/smoking-still-kills/
52 Kate Frazer, et al., ‘Legislative smoking bans for reducing harms from secondhand smoke exposure, smoking prevalence and tobacco consumption’, The Cochrane Library, 2016, 4 February, 2:CD005992, http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005992.pub3/abstract
53 Kotz, Daniel, et al., ‘How cost-effective is ‘No Smoking Day’?’ Tobacco Control, 2011, 20: 302–304, http://tobaccocontrol.bmj.com/content/20/4/302; Brown, Jamie, et al., ‘How effective and cost-effective was the national mass media smoking cessation campaign ‘Stoptober’?’, Drug and Alcohol Dependence, 2014, 135: 52–58, www.drugandalcoholdependence.com/article/S0376-8716(13)00470-5/fulltext[Page 70]
54 West, Robert, ‘Performance of English stop smoking services in first 10 years: Analysis of service monitoring data’, BMJ, 2013, Aug 19, 347: f4921, www.bmj.com/content/347/bmj.f4921
55 Stead, Lindsay F., et al., ‘Physician advice for smoking cessation’, The Cochrane Database of Systematic Reviews, 2013, http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000165.pub4/abstract
56 NICE, ‘Smoking: Brief interventions and referrals’, Public Health Guideline [PH1], 2006, www.nice.org.uk/guidance/ph1
58 Aveyard, Paul, et al., ‘Brief opportunistic smoking cessation interventions: A systematic review and meta-analysis to compare advice to quit and offer of assistance’, Addiction, 2012, June, 107(6): 1066–1073.
59 Brown, Jamie, ‘Comparison of brief interventions in primary care on smoking and excessive alcohol consumption: A population survey in England’, British Journal of General Practice, 2016, 66(642): e1–e9, http://bjgp.org/content/66/642/e1
60 Coleman, Tim, et al., ‘Impact of contractual financial incentives on the ascertainment and management of smoking in primary care’, Addiction, 2007, 102(5): 803–808, http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2007.01766.x/abstract
61 Kelly, Mike P., et al., ‘A conceptual framework for public health: NICE’s emerging approach’, Public Health, 2009, 123: e14–e20, www.publichealthjrnl.com/article/S0033-3506(08)00279-5/abstract; Baxter, Susan, et al., ‘Synthesizing diverse evidence: The use of primary qualitative data analysis methods and logic models in public health reviews’, Public Health, 2010, 124(2): 99–106, www.publichealthjrnl.com/article/S0033-3506(10)00004-1/fulltext
62 Medical Research Council, Developing and Evaluating Complex Interventions: New guidance, 2006, www.mrc.ac.uk/documents/pdf/complex-interventions-guidance/. See also the Cochrane Effective Practice and Organisation of Care reviews: http://epoc.cochrane.org/our-reviews
63 Nilson, Per, ‘Making sense of implementation: Theories, models and frameworks’, Implementation Science, 2015, 10(53), https://implementationscience.biomedcentral.com/articles/10.1186/s13012-015-0242-0; Michie, Susan, et al., ‘The behaviour change wheel: A new method for characterising and designing behaviour change interventions’, Implementation Science, 2011, 6(42), https://implementationscience.biomedcentral.com/articles/10.1186/1748-5908-6-42
64 Michie, Susan, et al., ‘The behaviour change wheel: A new method for characterising and designing behaviour change interventions’, Implementation Science, 2011, 6(42), https://implementationscience.biomedcentral.com/articles/10.1186/1748-5908-6-42
65 Ibid.; Michie, Susan, The Behaviour Change Wheel: A guide to designing interventions, Silverback Publishing, 2014, www.behaviourchangewheel.com[Page 71]
66 Hallsworth, Michael, et al., Applying Behavioral Insights: Simple ways to improve health outcomes, World Innovation Summit for Health, 2016, www.behaviouralinsights.co.uk/publications/applying-behavioural-insights-simple-ways-to-improve-health-outcomes; Burd, Hannah, and Hallsworth, Michael, Supporting Self-management: A guide to enabling behaviour change for health and wellbeing using person- and community-centred approaches, Realising the Value, Nesta, 2016, www.nesta.org.uk/sites/default/files/rtv-supporting-self-management.pdf
67 International Collaboration for Participatory Health Research (ICPHR), Position Paper 1: What is participatory health research? Version: May 2013. Berlin: International Collaboration for Participatory Health Research, www.icphr.org/uploads/2/0/3/9/20399575/ichpr_position_paper_1_definition_-_version_may_2013.pdf
69 Government Office for Science, Tackling Obesities: Future choices – project report, 2nd edition, 2007, www.gov.uk/government/publications/reducing-obesity-future-choices
70 Falbe, Jennifer, et al., ‘Impact of the Berkeley Excise Tax on sugar-sweetened beverage consumption’, American Journal of Public Health, 2016, 106(10), https://nature.berkeley.edu/garbelottoat/wp-content/uploads/falbe-etal-2016.pdf; Colchero, Arantxa, et al., ‘Beverage purchases from stores in Mexico under the excise tax on sugar sweetened beverages: Observational study’, BMJ, 2016, 352, www.bmj.com/content/352/bmj.h6704
71 See, for example, the Cancer Research UK campaign, Be Clear on Cancer, www.cancerresearchuk.org/health-professional/early-diagnosis-activities/be-clear-on-cancer; and the NHS campaigns Stoptober, www.nhs.uk/oneyou/stoptober/home#fgEyILmUfD2tpTef.97; and Stay Well This Winter, www.nhs.uk/staywell/#jGdjHmhgEpbeZreO.97
72 Examples include the National Institute for Health Research, ‘A systematic review, evidence synthesis and meta-analysis of quantitative and qualitative studies evaluating the clinical effectiveness, the cost effectiveness, safety and acceptability of interventions to prevent postnatal depression’, Health Technology Assessment, 2016, 20(37), www.journalslibrary.nihr.ac.uk/hta/volume-20/issue-37; and O’Mara-Eves, Alison, et al., ‘The effectiveness of community engagement in public health interventions for disadvantaged groups: A meta-analysis’, BMC Public Health, 2015, 15(129), http://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-015-1352-y
73 Jakicic, John, et al., ‘Effect of wearable technology combined with a lifestyle intervention on long-term weight loss: The IDEA randomized clinical trial’, JAMA, 2016, 316(11): 1161–1171, http://jamanetwork.com/journals/jama/article-abstract/2553448
74 Tremblay, Mark S., et al., ‘Global Matrix 2.0: Report card grades on the physical activity of children and youth comparing 38 countries’, Journal of Physical Activity and Health, 2016, 13(Suppl 2): S343–S366, http://ki.se/sites/default/files/b_global_matrix_article.pdf
75 House of Commons Health Committee, Managing the Care of People with Long-term Conditions: Second report of session 2014–2015, p. 3, www.parliament.uk/business/committees/committees-a-z/commons-select/health-committee/inquiries/parliament-2010/long-term-conditions/[Page 72]
76 O’Carroll, R.E., et al., ‘Improving medication adherence in stroke survivors: Mediators and moderators of treatment effects’, Health Psychology, 2014, 33: 1241–1250.
78 Johnston, Marie, et al., ‘Impact on patients and partners of inpatient and extended cardiac counselling and rehabilitation: A controlled trial’, Psychosomatic Medicine, 1999, 61(2): 225–233.
80 Simmons, David, et al., ‘Impact of community based peer support in Type 2 diabetes: A cluster randomised controlled trial of individual and/or group approaches’, PLoS One, 2015, http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0120277
82 Peers for Progress, Global Evidence for Peer Support: Humanizing healthcare, www.ipfcc.org/bestpractices/global-evidence-for-peer-support.pdf
84 Yardley, Lucy, et al., ‘Current issues and future directions for digital intervention research’, American Journal of Preventive Medicine, 2016, Nov, 51(5): 814–815.
85 Kippax, Susan, ‘Effective HIV prevention: The indispensable role of social science’, Journal of the International AIDS Society, 2012, 15(2): e17357, www.ncbi.nlm.nih.gov/pmc/articles/PMC3499803/; Fan, Liu, et al., ‘Interactivity, engagement, and technology dependence: Understanding users’ technology utilisation behaviour’, Behaviour & Information Technology, 2016, www.tandfonline.com/doi/full/10.1080/0144929X.2016.1199051
86 Yardley, Lucy, et al., ‘Understanding and promoting engagement with digital behavior change interventions’, American Journal of Preventive Medicine, 2016, Nov, 51(5): 833–842; Perksi, Olga, et al., ‘Conceptualising engagement with digital behaviour change interventions: A systematic review using principles from critical interpretive synthesis’, Translational Behavioral Medicine, 2016, http://link.springer.com/article/10.1007/s13142-016-0453-1
87 For instance, Appleby, John, ‘How does NHS spending compare with health spending internationally?’, The King’s Fund, 2016, www.kingsfund.org.uk/blog/2016/01/how-does-nhs-spending-compare-health-spending-internationally; OECD, ‘Hospital beds (indicator)’, 2016, https://data.oecd.org/healtheqt/hospital-beds.htm; Kelly, Elaine, and French, Eric, ‘The distribution of healthcare spending: an international comparison’, IFS, 2016, www.ifs.org.uk/publications/8737
88 See, for instance, The UK Medical Careers Research Group (UKMCRG), University of Oxford, www.uhce.ox.ac.uk/ukmcrg/
89 Gawande, Awul, The Checklist Manifesto: How to get things right, Metropolitan Books, 2009.
90 Ibid.; ‘The Checklist: If something so simple can transform intensive care, what else can it do?’, The New Yorker, 2007, www.newyorker.com/magazine/2007/12/10/the-checklist
91 Dixon-Woods, Mary, et al., ‘Explaining Michigan: Developing an ex post theory of a quality improvement program’, Millbank Q, 2011, 89(2), www.ncbi.nlm.nih.gov/pubmed/21676020; National Academy of Sciences, ‘The Hospital Checklist: How social science insights improve healthcare outcomes’, 2016, www.nap.edu/read/23510/#slide1[Page 73]
92 Anthes, Emily, ‘Hospital checklists are meant to save lives – so why do they often fail?’, Nature, 2015, 523(7562), www.nature.com/news/hospital-checklists-are-meant-to-save-lives-so-why-do-they-often-fail-1.18057; Fixsen, Dean, et al., Implementation Research: A synthesis of the literature, 2005, http://nirn.fpg.unc.edu/sites/nirn.fpg.unc.edu/files/resources/NIRN-MonographFull-01-2005.pdf; Ghate, Deborah, ‘From programs to systems: Deploying implementation science and practice for sustained real world effectiveness in services for children and families’, Journal of Clinical Child & Adolescent Psychology, 2015: 1537–4424, www.tandfonline.com/doi/pdf/10.1080/15374416.2015.1077449
93 Nilson, Per, ‘Making sense of implementation: Theories, models and frameworks’, Implementation Science, 2015, 10(53), https://implementationscience.biomedcentral.com/articles/10.1186/s13012-015-0242-0
94 Stone, Sheldon, et al., ‘Evaluation of the national Cleanyourhands Campaign to reduce Staphylococcus Aureus Bacteraemia and Clostridium Difficile infection in hospitals in England & Wales through improved hand hygiene: A four year prospective ecological interrupted time-series study’, BMJ, 2012, 344: e3005, www.bmj.com/content/344/bmj.e3005
95 Fuller, Christopher, et al., ‘The Feedback Intervention Trial (FIT) – Improving hand-hygiene compliance in UK healthcare workers: A stepped wedge cluster randomized controlled trial’, PLoS One, 2012, 7(10): e41617, http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0041617
97 Davenport, Francesca, ‘New tool to improve antibiotic prescribing in doctor surgeries’, Imperial College London, 2016, www3.imperial.ac.uk/newsandeventspggrp/imperialcollege/newssummary/news_22-11-2016-12-16-56
98 Hallsworth, Michael, et al., ‘Provision of social norm feedback to high prescribers of antibiotics in general practice: A pragmatic national randomised controlled trial’, The Lancet, 2016, 387: 1743–1752, www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(16)00215-4.pdf
99 Dreischulte, Tobias, et al., ‘Safer prescribing – A trial of education, informatics, and financial incentives’, The New England Journal of Medicine, 2016, 374: 1053–1064, www.nejm.org/doi/full/10.1056/NEJMsa1508955?af=R&rss=currentIssue&#t=article
100 Clarkson, Jan E., et al., ‘Changing clinicians’ behavior: A randomized controlled trial of fees and education’, Journal of Dental Research, 2008, 87(7): 640–644.
101 Pittet, Didier, ‘Improving adherence to hand hygiene practice: A multidisciplinary approach’, Emerging Infectious Diseases, 2001, 7(2), www.nc.cdc.gov/eid/article/7/2/70-0234_article; Sproat, Lisa, et al., ‘A multicentre survey of hand hygiene practice in intensive care units’, Journal of Hospital Infection, 1994, 26(2): 137–148, www.sciencedirect.com/science/article/pii/0195670194900574[Page 74]
102 Michie, Susan, ‘Improving health by changing behaviour: Health professionals, the public and patients’, 2013, https://medicine.dundee.ac.uk/sites/medicine.dundee.ac.uk/files/Professor%20Susan%20Michie.pdf
103 Stone, Sheldon, et al., ‘Evaluation of the national Cleanyourhands Campaign to reduce Staphylococcus Aureus bacteraemia and Clostridium Difficile infection in hospitals in England and Wales by improved hand hygiene: A four year, prospective, ecological, interrupted time series study’, BMJ, 2012, 344: e3005, www.bmj.com/content/344/bmj.e3005
104 Fuller, Christopher, et al., ‘The Feedback Intervention Trial (FIT) – Improving hand hygeine compliance in UK healthcare workers: A stepped wedge cluster randomised controlled trial’, PLoS One, 2012, 7(10): e41617, http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0041617
105 Health Foundation, ‘Environmental engineering to increase hand hygiene compliance’, 2016, www.health.org.uk/programmes/behavioural-insights-research-programme/projects/environmental-engineering-increase-hand
106 Morris, Stephen, ‘Impact of centralising acute stroke services in English metropolitan areas on mortality and length of hospital stay: Difference-in-differences analysis’, BMJ, 2014, 349: g4757
107 Eurostat, ‘Practising physicians, 2008 and 2013 (per 100,000 inhabitants)’, 2015, http://ec.europa.eu/eurostat/statistics-explained/index.php/File:Practising_physicians,_2008_and_2013_(%C2%B9)_(per_100_000_inhabitants)_Health2015B.png
108 Imison, Candace, et al., ‘Reshaping the workforce to deliver the care patients need’, Nuffield Trust, 2016, www.nuffieldtrust.org.uk/publications/reshaping-the-workforce
109 Royal College of General Practitioners, ‘The 2022 GP: A vision for General Practice in the future NHS’, 2013, www.rcgp.org.uk/policy/rcgp-policy-areas/general-practice-2022.aspx
110 NHS England, ‘General Practice forward view: Workforce plans’, 2016, www.england.nhs.uk/commissioning/primary-care-comm/gp-action-plan/
111 National Audit Office, The Management of Adult Diabetes Services in the NHS: Progress review, 2015, www.nao.org.uk/wp-content/uploads/2015/10/The-management-of-adult-diabetes-services-in-the-NHS-progress-review.pdf
113 Morris, Stephen, ‘Impact of centralising acute stroke services in English metropolitan areas on mortality and length of hospital stay: Difference-in-differences analysis’, BMJ, 2014, 349: g4757, www.bmj.com/content/349/bmj.g4757
115 Academy of Medical Sciences, Health of the Public in 2040, 2016, Annex III, pp. 111–112, www.acmedsci.ac.uk/policy/policy-projects/health-of-the-public-in-2040/
117 www.england.nhs.uk/ourwork/innovation/nia/ [Page 75]
118 See, for example, NHS England, ‘Planning, assuring and delivering service change for patients’, 2015, www.england.nhs.uk/wp-content/uploads/2015/10/plan-ass-deliv-serv-chge.pdf
121 Examples include the National Implementation Science Network, in the US, http://implementation.fpg.unc.edu/sites/implementation.fpg.unc.edu/files/NIRN-ImplementationDriversAssessingBestPractices.pdf; and the Global Implementation Initiative, https://globalimplementation.org/resources/
122 NHS England, ‘New care models – vanguard sites’, 2015, www.england.nhs.uk/ourwork/futurenhs/new-care-models/; House of Lords Science and Technology Committee, Behaviour Change: Second report of session 2010–12, www.parliament.uk/business/committees/committees-a-z/lords-select/science-and-technology-committee/inquiries/behaviour/
123 Ivers, Noah M., et al., ‘Audit and feedback: Effects on professional practice and healthcare outcomes’, The Cochrane Database of Systematic Reviews, 2012, 6: Cd000259, http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000259.pub3/abstract
124 Ivers, Noah M., et al., ‘Growing literature, stagnant science? Systematic review, meta-regression and cumulative analysis of audit and feedback interventions in healthcare’, Journal of General Internal Medicine, 2014, 29(11): 1534–1541, www.ncbi.nlm.nih.gov/pmc/articles/PMC4238192/
125 Ivers, Noah M., et al., ‘No more “business as usual” with audit and feedback interventions: Towards an agenda for a reinvigorated intervention’, Implementation Science (IS), 2014, 9: 14, https://implementationscience.biomedcentral.com/articles/10.1186/1748-5908-9-14
126 Ivers, Noah M., and Grimshaw, Jeremy M., ‘Reducing research waste with implementation laboratories’, The Lancet, 2016, 388(10044): 547–548.
127 Ham, Chris, and Aderwick, Hugh, Place-based Systems of Care: A way forward for the NHS in England, The King’s Fund, 2015, www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/Place-based-systems-of-care-Kings-Fund-Nov-2015_0.pdf; Alderwick, Hugh, Ham, Chris, and Buck, David, ‘Population health systems: Going beyond integrated care’, The King’s Fund, 2015, www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/population-health-systems-kingsfund-feb15.pdf
128 NHS Improving Quality, Population Level Commissioning for the Future, 2014, http://webarchive.nationalarchives.gov.uk/20160805125127/www.nhsiq.nhs.uk/media/2514788/population_level_commissioning_for_the_future.pdf; NHS England, ‘How to’ Guide: The BCF technical toolkit, 2014, www.england.nhs.uk/wp-content/uploads/2014/09/1-seg-strat.pdf
129 Health Foundation, ‘Applying hindsight to insight: Learning so far from our research programme on health informatics’, 2016, www.health.org.uk/blog/applying-hindsight-insight-learning-so-far-our-research-programme-health-informatics[Page 76]
130 Academy of Medical Sciences, Health of the Public in 2040, 2016, www.acmedsci.ac.uk/policy/policy-projects/health-of-the-public-in-2040/
131 See http://tdi.dartmouth.edu/
132 Alderwick, Hugh, et al., Better Value in the NHS: The role of changes in clinical practice, The King’s Fund, 2015, p. 9, www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/better-value-nhs-Kings-Fund-July%202015.pdf
133 See the UK Statistics Authority, ‘Health and care statistics in England – The Statistics Authority’s direction of travel’, 2016, www.statisticsauthority.gov.uk/wp-content/uploads/2016/03/Health-statistics-direction-of-travel.pdf
134 Wachter, Robert, Making IT Work: Harnessing the power of health information technology to improve care in England, 2016, www.gov.uk/government/uploads/system/uploads/attachment_data/file/550866/Wachter_Review_Accessible.pdf
135 Ibid., p. 16.
136 French, Eric, and Kelly, Elaine, The Distribution of Healthcare Spending: An international comparison, Institute for Fiscal Studies, 2016, www.ifs.org.uk/publications/8737; French, Eric, and Kelly, Elaine, ‘Medical spending around the developed world’, Fiscal Studies, 2016, 37: 327–344, doi:10.1111/j.1475-5890.2016.12127
137 These are based on the definitions in the Information Commissioner’s Office Anonymisation Code of Practice: https://ico.org.uk/for-organisations/guide-to-data-protection/anonymisation/
138 Caldicott, Fiona, National Data Guardian for Health Care Review of Data Security, Consent and Opt-Outs, 2016, www.gov.uk/government/uploads/system/uploads/attachment_data/file/535024/data-security-review.PDF
139 National Audit Office, Stocktake of Access to General Practice in England, 2015, www.nao.org.uk/wp-content/uploads/2015/11/Stocktake-of-access-to-general-practice-in-England.pdf
140 Productivity Commission, Data Availability and Use, Draft Report, 2016, www.pc.gov.au/inquiries/current/data-access/draft/data-access-draft.pdf; Desai, Tanvi, et al., Five Safes: Designing data access for research, Economics Working Paper Series, University of the West of England, 2016, www1.uwe.ac.uk/bl/research/bristoleconomicanalysis/economicsworkingpapers/economicspapers2016.aspx; and Moody, Victoria, ‘Access to sensitive data for research: “The 5 Safes”’, UK Data Services, 2015, http://blog.ukdataservice.ac.uk/access-to-sensitive-data-for-research-the-5-safes/
141 Ipsos MORI, Dialogue on Data: Exploring the public’s views on using administrative data for research purposes, 2014, www.ipsos-mori.com/Assets/Docs/Publications/sri-dialogue-on-data-2014.pdf;
142 Ipsos MORI, The One-Way Mirror: Public attitudes to commercial access to health data, 2016, www.ipsos-mori.com/Assets/Docs/Publications/sri-wellcome-trust-commercial-access-to-health-data.pdf
143 www.england.nhs.uk/ourwork/tsd/care-data/ [Page 77]
144 Wellcome Trust, ‘Independent patient data taskforce announced’, 2016, https://wellcome.ac.uk/news/independent-patient-data-taskforce-announced%20
151 Department of Health, Innovation, Health and Wealth, 2011, http://webarchive.nationalarchives.gov.uk/20130107105354/http:/www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_134597.pdf
152 See, for example, www.ahsnnetwork.com/new-atlas-solutions-healthcare-aims-help-speed-adoption-innovation/
153 See recommendations in Academy of Medical Sciences, Improving the Health of the Public by 2040, 2016.
154 Norman Freshney Consulting, ‘UK research landscape for population health research and public health practice: Report for the Academy of Medical Sciences’, 2016, www.acmedsci.ac.uk/snip/uploads/57f23c7da653c.pdf
155 Foy, Robbie, Eccles, Martin, and Grimshaw, Jeremy, ‘Why does primary care need more implementation research?’, Family Practice, 2001,18: 353–355, https://fampra.oxfordjournals.org/content/18/4/353.full
156 Prasad, V., and Ioannidis, J.P.A., ‘Evidence-based de-implementation for contradicted, unproven, and aspiring healthcare practices’, Implementation Science, 2014, 9: 1.
157 Ivers, Noah M., et al., ‘Audit and feedback: Effects on professional practice and healthcare outcomes’, The Cochrane Database of Systematic Reviews, 2012, 6: Cd000259, http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000259.pub3/abstract
158 Ivers, Noah M., et al., ‘No more “business as usual” with audit and feedback interventions: Towards an agenda for a reinvigorated intervention’, Implementation Science (IS), 2014, 9: 14, https://implementationscience.biomedcentral.com/articles/10.1186/1748-5908-9-14
160 Health Education England, ‘Making every contact count’, https://hee.nhs.uk/our-work/hospitals-primary-community-care/prevention-public-health-wellbeing/making-every-contact-count; NHS Education for Scotland, ‘What is the Health Promoting Health Service (HPHS?)’, www.knowledge.scot.nhs.uk/home/portals-and-topics/health-improvement/hphs.aspx; Public Health Wales, ‘Making every contact count’, www.knowledge.scot.nhs.uk/home/portals-and-topics/health-improvement/hphs.aspx[Page 78]
161 General Medical Council, Tomorrow’s Doctors: Recommendations on undergraduate medical education, GMC, London, 2003.
162 Peters, Sarah, and Livia, Andrea, ‘Relevant behavioural and social science for medical undergraduates: A comparison of specialist and non-specialist educators’, Medical Education, 2006, 40(10): 1020–1026, http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2929.2006.02562.x/abstract
163 Alder, Beth, et al., Psychology and Sociology Applied to Medicine, Elsevier Health Sciences, 2011; Goodman, Benny, Psychology and Sociology in Nursing, Learning Matters, 2015.
164 Dixon, Diane, and Johnston, Marie, Health Behaviour Change Competency Framework: Competences to deliver interventions to change lifestyle behaviours that affect health, NHS Health Scotland, 2010, www.healthscotland.com/uploads/documents/4877-Health_behaviour_change_competency_framework.pdf
166 Academy of Medical Sciences, ‘Health of the Public in 2040’, 2016, p. 8, www.acmedsci.ac.uk/policy/policy-projects/health-of-the-public-in-2040/
167 House of Commons, Health and Social Care (National Data Guardian) Bill 2016–17, www.publications.parliament.uk/pa/bills/cbill/2016-2017/0084/cbill_2016-20170084_en_2.htm#pb1-l1g; House of Commons, Digital Economy Bill (HC Bill 45), chapter 5, www.publications.parliament.uk/pa/bills/cbill/2016-2017/0045/cbill_2016-20170045_en_1.htm
168 Wellcome Trust, ‘Sharing research data to improve public health: Full joint statement by funders of health research’, https://wellcome.ac.uk/what-we-do/our-work/sharing-research-data-improve-public-health-full-joint-statement-funders-health
169 See recommendation 2: Academy of Medical Sciences, Health of the Public in 2040, 2016, www.acmedsci.ac.uk/policy/policy-projects/health-of-the-public-in-2040/