Rewarding Behaviour - How To Get What We (all) Want


What is the magic formula for behaviour change? Does it even exist? This blogpost will use our experience in healthcare research to point towards a possible answer..... Within our work at Customer Faithful, we frequently see supply & demand conflict in the UK healthcare system. A case is point is the challenge of trying to get a GP appointment. Back in 2016, we worked on a 2-year project to try and understand why so many missed appointments happened in the UK's National Health Service (NHS). According to NHS own figures, it adds up to 19m hospital and GP appointments each year, costing the NHS around £900m at a time when it is tasked with billions of cost savings to respond to a growing and ageing population.

From our research into why appointments get missed, it's clear that there is no single cause, nor one 'silver bullet' to fix it. But we suspect that any sustainable solution will require tangible benefits not just to patients and the NHS, but to the public-at-large. Even something as simple as a text-message system for appointment reminders requires more than just a technology investment from health providers. It needs sensitive, yet impactful messaging, sent at the right time, in an appropriate language that respects patient privacy but also the scarce appointments resource it is trying to manage. Even then, success requires patients who are socially understanding enough to recognise that not cancelling or attending their appointment deprives someone else of using it too.

Since 2008, the popularity of influencing behaviour through so-called 'nudge theory' (Thaler) has steadily grown. The essence of this is simply offering some optional encouragement to the consumer, such as the often-quoted example of adding the image of a housefly into the men’s room urinals at Amsterdam’s Schiphol Airport, intended to ‘improve the aim’.

However, I'm skeptical of the broad application of this, and find such nudges are the exception rather than the rule. In healthcare for example, few in the Western world can still be unaware of the risks of obesity, given the 'weight' of public health campaigns, encouraging us to make healthier choices. Yet, here in the UK, obesity levels have continued to rise steadily for two decades.

Instead, I believe that only a 3-way contract has a fighting chance of changing behaviour:

  1. Rewards for 'Me' - individuals are inevitably drawn towards products and services that meet the needs of themselves (and sometimes loved ones) first and foremost
  2. Rewards for the Provider - suppliers need to find ways of meeting this consumer need in a sustainable and/or profitable way. Even not-for-profit organisations have to be able to keep their promises to stakeholders
  3. Rewards for the Greater Good - this can be interpreted in many ways. Typically it's seen as helping Society as a whole, such as by widening availability to all, and in more recent decades, benefitting the environment ('saving the planet') fits here too.

The problem is that the rewards need to be perceived as equitable in order to create the 'everybody wins' mindset that's required to enable behaviour change to reach the Holy Grail of a 'no-brainer'. That means not only sharing out the benefits, but communicating them clearly, consistently and persuasively.

Rewarding behaviour is as important to behaviour change as it ever was. But 'softly-softly' approaches to a single benefit group will not achieve scale, speed or sustainability. It's time for a more active, less cautious approach to supply and demand challenges, especially involving public services.

Photo by Bhumi Finding Herself -