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Altering Demands for Services Fringe thursday Kilsyth

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					Altering demand for services
The use of social marketing

What we want to cover • • • •
The challenges of changing demand What is social marketing One embarrassing family tale Two case studies

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Attendances at accident and emergency departments, England, 1987-88 to 2006-07
Number of attendances (millions) 20 18 16 14 12 10 8 6 4 2 0 1987-88 1988-89 1989-90 1990-91 1991-92 1992-93 1993-94 1994-95 1995-96 1996-97 1997-98 1998-99 1999-00 2000-01 2001-02 2002-03 2003-04 2004-05 2005-06 2006-07

From 2003/04 attendances at Walk in Centres w ere i l d d

New attendances

Follow-up attendances

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Age-standardised incidence of and mortality from female breast cancer, England, 19712003 (ONS)

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Screening attendance - 4 PCTS

PCT

Attendees

Attendees as % of invited

Non attendees

Non-attendees as % of invited

Grand Total

City and Hackney Newham Tower Hamlets Waltham Forest

7,422 9,726 6,197

54 52 45

6,432 8,997 7,659

46 48 55

13,854 18,723 13,856

7,193

66

3,714

34

10,907

(1 April 2003 – 31 March 2006)

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What does great social marketing look like?

Our approach to any commission • Targeted approach is more likely to succeed • An insight-driven approach will be more effective • Objective setting is vital to success • Engaging and involving the local community ensures buy-in to decision-making and ownership of outputs • Modern communications establish relationships and dialogue • Evaluating interventions proves they work • It is possible to measure your return on investment (ROI)

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Reducing A&E attendances in Tower Hamlets
Understanding A&E usage and designing a marketing and communications campaign

The issue (Situation)

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Escalating attendance at hospital A&E departments for minor complaints A&E is an inefficient and inappropriate option:

•

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The process (action)

• • • • • •
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Data analysis Insight generation Creative brief Creative development Implementation Evaluation

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Data analysis – the findings
Repeat users by ethnicity
10000 8000 6000 4000 2000 0
4 4 4 4 4 4 4 4 4 4 0-2 -5 -6 -7 -1 -4 -3 -8 -9 50 40 70 20 30 10 60 80 90 010 4

Bangladesh White British Other

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Insight generation: the health professionals
Key insight: • Hard-pressed A&E staff view asking for help as “not taking responsibility”

“Most inappropriate use is for tummy pains and gastric illness. Most of these people are Bengali and they have not done anything already! This is a major problem.”

“Young men use A&E inappropriately, for example, upset stomach, headache. They would be better going to a GP, ringing NHS Direct or treating themselves. They need to change their attitude to their health and take more responsibility for helping themselves.”

“Bengalis have a different notion of health and sickness. When we provide health advice all they want is a cure.”

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Insight generation – the patients
Key Insight: • People from Bangladesh believe all the good doctors work in the hospital

“When you go to your GP, he may ask you a few questions and say ‘oh, you are alright.’ But how would he know if he hasn’t checked you? He hasn’t even put on his stethoscope, so how can he know?”

“You might wait for a long time but at A&E you are sure to be seen by a doctor and to be properly tested”

“Most of the time, the GP just asks a few questions. They don’t do nothing. They just say it’s a headache or stomach ache”

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Creative development - the campaign

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Outcome
Independent evaluation found • 6.4% reduction in A&E attendances year on year (September-January period), even though attendances at nearby Homerton and Newham hospitals increased by 3.6% and 2.6% over the same period. • In the same period, attendances fell at the Royal London Hospital, particularly among women aged 20-29 (-11.1%). • For young men aged 20-29, appointments at the two key GP practices went up 9% and 16% respectively, a significant increase on previous years in the target area. • The evidence suggests that local initiatives including ‘Local Heroes’ have had a positive effect in reducing inappropriate use of A&E at the Royal London Hospital.

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COPD Campaign
Cheshire & Merseyside

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Lifestyle Type

Case Management + patient pathway

I48, I50 and J51

Diagnostic Testing + Lifestyle Management Lifestyle Management

G43

F39

Undiagnosed / lower risk

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Target
F39 (Settled older couples and pensioners with low income renting small flats and maisonettes)

G43 (Settled but poor older people in low-rise social housing, often found in declining industrial areas)

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The challenge, to get people to

Quit smoking Wrap up warm Recognise symptoms That will:

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Improve quality of life Lengthen life expectancy Reduce emergency admissions

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Three phase campaign
Phase 1 Warm up – local poster and leaflet

campaign to raise awareness of the campaign

Phase 2

Telephone health champions – scripted telephone

campaign offering

• • •

Written information Referral to smoking cessation Offer of a follow up call

Phase 3 positive calls
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Follow up – providing requested information to all

Campaign Facts

Calls completed

Duplicates or unavailable or unsanswered

Info Packs requests

Call back request

Smokers transferred

4,292

490

2,645

1,183

249

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Thank you
Martin Machray
Client Director – Marketing Services martin.machray@drfoster.co.uk 0787 949 2974

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