Listening to the BBC's popular 'Medical Matters' podcast recently, I was impressed by the effectiveness of three simple steps the NHS trialled in Bedfordshire to reduce the numbers of people who don't turn up on time for an appointment at their GP. 6 million missed appointments cost the health service millions of pounds a year, adding up to days of lost GP time, all because of 'do not attends' (DNAs). Traditional approaches to the problem have included sending out reminder letters and putting up posters in the waiting room telling patients how many people miss their appointment or how many GP days are lost.
The first and second steps are that when somebody is making an appointment, the patient is asked to write it down on a small card, rather than the receptionist doing it, and repeat back out loud the time and date (easier if people are on the phone). The third step is that posters were put up in the surgery focussing on the positive, saying that 95% of patients do turn up to their appointments on time.
The numbers of no-shows have fallen dramatically in the areas where this approach has been trialled, and the staff at GPs have been amazed at how successful these inexpensive and simple steps are. 'Do not attends' were reduced in total by nearly 32%! The most influencial single action was asking people themselves to write down the details of their appointment, which reduced no-shows by 18%. With the posters, the traditional message enabled people to think it's normal to not attend on time, and the people who didn't turn up don't see the posters anyway!
The principles at work here come, unsurprisingly, from social psychology. Professor Cialdini, who was behind the trial, explains that we all prefer to follow through on commitments we have made (especially if they are made publically), and that we like to follow the lead of people similar to us. So, writing down and repeating back the appointment time is making an active commitment, and seeing the poster saying what a large number of people do turn up on time makes us think that 'I want to be part of that 95%'!
So, how can we apply these principles to walking more often, or walking further? Take a challenge on the Walk4Life website, but then tell people about the challenge you have chosen! Tell your friends and family (they might join you in the challenge, you never know!), tell them in person or on facebook or twitter! We all know that we are more likely to remember things if we write them down. Look for a walking group to join near you, and write down the walks you want to join them on! Start to feel like you are the sort of person who walks regulary - walks to the bus stop instead of jumping into a car, walks to the shops or school, walks to take the recycling. And, if you are a parent with the opportunity for your child to join a walking bus, try the techniques with other parents, "will you drop your child off at the start point?", or "will you help escort the children tomorrow?" - "yes, I will"!