The marketing remedy to reduce NHS costs

If government departments understood how advertising could be used to make savings, not just change behaviours, the NHS could save billions, according to Sir Chris Powell.

Credit: Getty Images
Credit: Getty Images

Yet again, the NHS is in the news and a figure of  between £8 billion and £10 billion has to be saved. Huge efficiencies are going to have to be found, so could advertising and marketing help? Perhaps, and there are two possible ways it could make a difference.

It would be economically efficient to market pharmacies as the first port of call for patients. GP’s surgeries are crammed with people who have the sniffles, and a chemist is well able to diagnose minor conditions and offer suitable medicines to sufferers. The system would be more economical, surgeries would be emptier and patients would receive a quicker, no-appointment service.

With incentives, chemists' outlets could be designed to make it clear that they offer this service, and advertising could point out the advantage to patients and build a brand of "first visit". It wouldn’t be easy – it is not a magic solution, and advertising rarely produces dramatic and immediate results. But with consistent effort and spend, we could see a big diversion of patients to the quicker, better service of a chemist for minor complaints. This is already the custom in Europe, so it should not be impossible in the UK.

Another possibility could be using advertising to allay public fears about accident and emergency services. The medical advice is clear: with the proliferation of medical specialities, only the largest hospitals can offer round-the-clock cover for emergency conditions. We have far too many hospitals that are too small. If an ambulance takes you to one of these on a Sunday afternoon, you are more likely to be met by a medical student than an appropriate specialist. But any politician who supports the closure of a hospital does so at their peril, and seats in Parliament have been lost on this issue alone, so it just doesn’t happen. The medics are blocked by the terrified politicians.

A likely root of the problem is the public belief that, in an emergency, proximity to a hospital is all. But it isn’t. The critical factor is how quickly an ambulance can get to you. Once the paramedic has arrived, it is rare that a patient will not survive for at least the next hour, and any large hospital can be reached in an hour. I suspect that most of us still think the ambulance driver is a stretcher-bearer, not someone skilled in stabilising patients until they reach the hospital.

A campaign to demonstrate the skills of paramedics would reassure the public and reduce the pressure for an A&E at the end of every road

Not only is there direct public benefit in lives saved from having appropriately staffed hospitals, but the economic efficiencies of scale produce considerable savings to the system and better value for the taxpayer. I can imagine that a sustained campaign to demonstrate the skills of paramedics would reassure the public and reduce the pressure to have an A&E department at the end of every street.

Maybe these two examples are flawed (there have certainly been previous attempts to divert patients to chemists – but none of any impressive scale or persistence), but the principle of using advertising and marketing as part of the armoury for change in public services – in the same way as they are used in the private sector – should stand.

When the Coalition took office in 2010, one of its first acts was to dramatically cut the state’s use of advertising, clearly signalling its view that such spend was a form of waste. But if this spend is intelligently directed, it can be a source of great efficiency and, in the austerity era, the savings that could flow from good marketing would be a route to reducing cost without cutting (and often improving) public services. Ad campaigns sound expensive, costing millions of pounds, but we are looking for savings in the billions.

There are already examples: Change4Life in health and, perhaps most famously, the drink-driving and seatbelt campaigns in road safety – but these are examples of using advertising to improve longevity, not to make savings. I suspect it never occurs to government departments that marketing could be much of a tool for that purpose.

Rory Sutherland and the "nudgers" have been able to bring some of the skills of our trade – understanding how human beings react – to improve some aspects of public service; a small unit was even based in Downing Street for a while. But advertising and marketing should be represented centrally in government, tasked with spotting opportunities where savings could be made or services improved economically.

Sir Chris Powell is the chair of the Advertising Standards Board of Finance and former chief executive of BMP DDB

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