Nudge or nanny

Nudge, nudge is no longer just a phrase out of Monty Python, it is now an arm of Government policy. In November 2010 the health secretary, Andrew Lansley, told us that they would 'nudge' rather than 'nanny' us to better health. The Government is also trying to 'nudge' businesses to behave differently, through voluntary agreements rather than regulation.

It is a reaction against the 'nanny state' so beloved by the last Government. Unfortunately, as with so much that Andrew Lansley says, it all sounds plausible, but one is left wondering what exactly he means – until recently that is. A few weeks ago NHS Bedfordshire said there could be a saving of £700m if missed GP patient appointments were ended.

In a project carried out in the county, researchers looked at the impact of using behaviour change techniques to reduce the number of 'did-not-attends'. It was all done by nudging rather than nannying. The techniques used in the study were: getting patients to confirm their appointment by verbally repeating the details to the receptionist, getting patients to write the appointment down themselves, and placing positive messages around the GP practices that attending appointments is the 'social norm'. In addition they were rung the day before.