Case study: Steps to Health
Steps to Health is a social enterprise that will set up and run incentive schemes to support and reward people for taking better care of their health.
NEEDEncouraging and helping people to lead healthier lives is one of the most important challenges facing the NHS. The need to take action on public health is urgent. What were once called “diseases of affluence” – heart disease, cancers, stroke – are now ubiquitous; smoking levels remain stubbornly high; and obesity and diabetes are growing even among children. And these conditions increasingly hit the poor hardest, worsening health inequalities. All this gives the NHS a duty to empower people to take better care of themselves, to support them to kick bad habits and stick with healthy ones. SOLUTIONHealthy Incentives offers NHS organisations a promising tool to help them tackle the problem. It is a social enterprise that will set up and runs incentive schemes to support and reward people for taking better care of their health, whether by quitting smoking, exercising, managing chronic illnesses or losing weight. We believe the time is ripe for the NHS to try out such a programme. The evidence from the clinical literature for using incentives to encourage behaviour change is promising. Furthermore, in order to give the venture the greatest chance of success, we have incorporated into our pilot programme both recommendations from the clinical literature on when incentives work best, and input from our target participants group (gleaned from ethnographic research). PROJECTOur aim is to develop the programme into a nationwide venture that is commissioned by PCTs and other NHS organisation to set up and run reward schemes. As well as running the project in Birmingham, we intend to use the pilot period to pursue leads from other NHS commissioners, several of whom have already expressed strong interest in setting up reward schemes. PILOTThe initial pilot of the programme will involve four cohorts of 200 participants each. These cohorts were chosen a) to assess the effectiveness of the rewards programme among different groups and b) to tackle the PCT’s main public health needs. The four groups are: 1. People will long-term medical conditions who have been enrolled in Birmingham Own Health telephone-based disease management programme. They will be on lists of GP practices in Sutton (we have chosen three practices to participate in the programme). This is a relatively affluent area with an older, mainly white population. 2. People who have been identified as at moderate or high risk of cardio-vascular disease through the PCT’s new cardiovascular screening programme. They will be on lists of GP practices in the areas of Bordesley Green, Small Heath and Acocks Green (we have agreed with three specific practices that they participate in the programme). This is a deprived area with a young population with a high percentage of people of Pakistani origin.
3. Women who are pregnant and who are smokers at the time of their first midwife attendance. They will be using midwifery services in Shard End or Erdington (we will aim to recruit 100 from each area). These are low-income areas with a predominantly white population and high levels of smoking in pregnancy.
4. Year 10 (14-year-old) children attending school in Kingstanding and Oscott. We will be working with Cardinal Wiseman School in Oscott and College High in Kingstanding, subject to further discussions with staff. Kingstanding and Oscott are poor areas with a mainly white population. PartnershipsWe are working Birmingham East North Primary Care Trust to deliver this project |
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