Lack of information and fear of Covid-19 is preventing some patients from getting the healthcare they need. Applying behavioural insights to information for patients may help reassure people when it is safe to attend. Dan Berry, Behavioural Science Unit, Hill+Knowlton Strategies provides a six-point guide. 

The Covid Choices survey found that lack of trustworthy information is associated with concern about contracting COVID-19. Providing clear and consistent information can help overcome this, harnessing behavioural insights can help address people’s fear.
 

Attitudes: What are the risks and benefits?

•   Patients have a lot of pros and cons to weigh. Some risks are more apparent than others, so patients may give those more attention than to benefits that less readily come to mind. Each clinic should communicate its own specific risks and benefits. The best way to communicate clearly is to use case studies or whole numbers – rather than percentages. For example, ‘last year we detected early stage cancer in 350 patients, who went on to be treated successfully’, so it is easy for the patient to grasp the benefits.

Trust: The experience and values of procedures from a patient’s viewpoint.

•   The perceived source of a message can matter as much as the content of the message itself. If patients attend a clinic frequently and get to know their doctor or nurse, those professionals are trusted and respected messengers. Creating a perception that a request to attend an appointment is from a doctor or nurse rather than an anonymous ‘from the hospital’ message can boost trust.

• Conceding a small problem adds to the authenticity of the overall message. In communications, concede a blemish such as ‘while the waiting room isn’t as comfortable as it was, we’ve done this to keep you safe’.

•   We tend to go with the flow of what most other people do, or what we perceive they do. A problem with COVID-19 is that people may perceive group objections or concerns that are no longer the case – such as people not attending clinics. Communicate a positive social norm, such as ‘our clinics are getting back to normal and patients are coming back in again’ rather than ‘sadly loads of our patients are cancelling’ which is a negative norm.
 

Reduce uncertainty: Demystify the process and give concrete steps

•   Most of us dislike uncertainty. Patients may not know where they can sit to wait for their clinic or how to get through the hospital site. Do all you can to minimise that uncertainty. For example, share photographs of what the waiting room now looks like, or of the route from the entrance to the clinic.

•   Many patients may be initially persuaded to attend appointments, for example when having a phone consultation with a nurse, but then subsequently not do so. One way to narrow this gap between someone’s good intentions and their actions not following through is by asking the patient to make a pledge. There is some evidence that even stating out loud a pledge to attend can be effective.

 

Below are some other behavioural recommendations to help increase patient confidence.
 

Reciprocity:

Most patients care about the NHS and want to do their bit to protect it.

Communicate that, right now; they can do their bit by attending their clinics.

Attention:

We are all bombarded with more information than we can possibly consciously process. 

A typical NHS clinic may be plastered wall-to-wall with signage. While this is well-intentioned it may risk the crucial COVID-19 information not being noticed as much as desired. 

Likewise, outpatient  letters commonly run to multiple pages. Less is more: what can the clinic cut of it’s other messaging – at least temporarily –  so COVID-19 messages are noticed?

Understand ‘the real why’: 

Spend time thinking of some hidden barriers. These are things that matter to real people in the real world, but which may not be said in a survey. 

For example, maybe a patient likes attending their diabetes clinic because they chat with people in the waiting room and swap gossip with the receptionist. 

If that social connection is no longer possible due to social distancing, this might be the reason for nonattendance – even if the patient is unlikely to consciously state this.
 

The Behavioural Science Unit, Hill+Knowlton Strategies, provided pro bono sub analysis to the Covid Choices survey.