How behavioural science can help us spread and scale innovation and improvement

Posted by: Diane Ketley - Posted on:

Why consider behavioural science?

Influencing people to change their behaviour is a crucial part of achieving spread and adoption of innovation and improvement. Understanding how best to enable the required change in behaviour is therefore essential. Dan Berry, head of behavioural science, NHS England, recently gave a short taster presentation on how behavioural science can help us enable such changes to spread and scale innovation and improvement.

What is behavioural science?

Behavioural science is the science of understanding why people make the decisions they do and understanding how to influence those decisions. Some of the factors in decision making are apparent and easily understandable e.g. available skills, time, resources however other factors, often called habit or culture, are harder to define and understand. Behavioural science focuses particularly on the subset of behavioural factors that may appear hard to understand or may even appear irrational (see photo below) such as when we don’t eat as sensibly as we know we should. These behaviours are often not due to lack of knowledge or intention.

Photo: William Brown. Location: San Diego, USA

In this video Dan explains that the many terms used in this field, such as behaviour science, behaviour insights, behaviour economics and nudge, are essentially the same.

Humans make decisions using two systems, the first is a slow, reflective, controlled and rational system (like Sherlock Holmes). The second way of making decisions, contrasts with the first, as it is fast, automatic and unconscious (gut reaction, Homer Simpson).

We often think that people make their everyday decisions using the first way of making decisions but actually many go with the second method, that gut reaction, as their decision making process.

‘We tend to think people are more ‘Sherlock Holmes’ than they are in everyday life’

How can using behavioural science help us spread and scale change?

Applying behavioural science to support scale and spread, Dan offered four practical approaches to take and offered health care examples of each, details in the video:

  • Show the norm

People like to go with the crowd so showing how their behaviour is different is often enough to change their behaviour. Consider sharing comparative data.

  • Change the default

Alter the default setting or ‘do nothing option’ in systems can be very effective. Consider what the ‘do nothing option’ should be.

  • Display familiarity

New innovations and improvements are unfamiliar and most people like what is familiar or the usual thing. Consider how to make the innovation or improvement familiar

  • Frame risks and benefits

The way something is framed or communicated can make a big difference to people’s gut reaction. Consider how to frame the change (the innovation and improvement) for maximum effect.

It is then really useful to learn, as we do in the video, how two of the frameworks, COM-B and EAST, fit in the behaviour change approach used in NHS England (NHSE).

Dan shares the behaviour change process used by the NHSE behaviour change team which has four stages of Define, Understand, Design and Apply. Dan also explains where the two change frameworks, COM-B and EAST fit, in this process (see diagram)

  • COM-B is used to better understand people’s behaviour and lists all the factors influencing behaviour grouped under three headers, C= capacity, O=opportunity, M=motivation.
  • EAST – is used to help in changing people’s behaviour and offers four groups of ways to do this. E=easy, A=attractive, S=social, T= timely

What next?

Although only a taster presentation many valuable insights, approaches and frameworks were covered offering us a practical application to inform our thinking and planning for spread and scale.

For more details on this topic contact or @Dan_Berry79. Look out for details of a masterclass early in 2023.

More information on spread, scale and adoption, including blogs and videos, available on the NHS Horizons website. Details of the Leading the Spread and Adoption of Innovation and Improvement: A Practical Guide in the blog here. If you’re interested to read more there are previous blogs and further blogs to follow. Please follow @DianeKetley @HorizonsNHS#NHSSpread

Sherlock Holmes image