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Spreading change

This guide is part of the NHS England-funded Realising the Value programme led by Nesta and the Health Foundation, which seeks to develop person- and community-centred approaches for health and wellbeing. This guide offers two things: a framework for understanding and changing behaviour, and real-world examples of how these changes happen in practice.



The evidence for the benefits of promoting a person- and community-centred approach in health and wellbeing settings is strengthening. Yet spreading improvement and change within health and social care organisations is notoriously challenging. Behavioural science offers some reasons for why this is the case:

  • People tend to be confronted with much more information than they are willing or able to process.
  • People seek to minimise effort and are disproportionately affected by small barriers to change.
  • People typically stick with the way things are – the status quo.
  • People tend to interpret facts using mental ‘shortcuts’ (rules of thumb or assumptions) that confirm our existing views.

This guide is for people who champion these approaches in health and social care, in other statutory bodies and in community-based organisations. Change is more likely to spread when both statutory organisations and community-based organisations align approaches. For this reason, we feature case studies from both parts of the system.


Date Published

September 7, 2016