Page last updated at 01:24 GMT, Thursday, 19 March 2009

Call for more NHS reward schemes

Financial incentives could be used to encourage people to stop smoking

More NHS trusts should be offering cash vouchers as incentives to people who adopt healthier lifestyles, a government adviser says.

Professor Julian Le Grand, chairman of Health England, said financial incentives could be key to reducing smoking, alcohol and obesity rates.

He said vouchers could be exchanged for anything from food to gym membership.

Some trusts are running pilot projects, but the government said there was no consensus about their effectiveness.

In Dundee, smokers are being offered 12.50 a week to spend on groceries if they go a week without smoking.

They are not allowed to spend the money on cigarettes or alcohol.

Incentive schemes could be an important part of tackling health inequalities
Norman Lamb, Liberal Democrat MP

In Birmingham health officials have set up a scheme where participants who pursue healthy activities receive points, which they can then redeem for tickets to sporting events and shopping vouchers.

Both schemes are in their early days, but Professor Le Grand, who is chairman of Health England, which advises the government on public health, said he wanted to see other parts of the NHS following suit.

"There is growing evidence that financial incentives work. Smoking is the obvious place to start, but incentives could also be used to tackle obesity and drinking," he said.

"I think it is hard to put the case for offering people cash directly, but vouchers seems a logical way to go.

"These could be used to buy anything from food and gym membership to furniture. Anything that helps an individual's well-being."

The London School of Economics expert pointed out that the use of negative financial incentives, such as increasing the price of alcohol as put forward by England chief medical officer Sir Liam Donaldson earlier this week, was gaining more support.

But he said the NHS could also learn from countries where positive financial incentives were being used.

In Germany, social insurance contributions are reduced if people attend services such as smoking cessation, screening and dieting classes.

He also cited Newcastle University research which showed people were nearly 60% more likely to increase exercise levels when given financial incentives.


His suggestion received the backing of the Liberal Democrats.

Norman Lamb, the party's health spokesman, said with health inequalities widening, the government's target-based approach was not working.

"Incentive schemes could be an important part of tackling health inequalities, provided that they are well thought out and evidence based."

A Department of Health spokeswoman said NHS trusts were free to pursue incentive schemes.

But she warned there was still no consensus about their effectiveness.

"Research is ongoing to establish whether this kind of intervention can enhance success rates."

Professor Chris Drinkwater, the public health lead for the NHS Alliance, which represents primary care trusts in the health service, said: "I think we will see more trusts trying these out.

"But one major problem is that they are often hard to police and without firm evidence they work, it can be hard to justify the spending."

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