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NICE Citizens Council: Should incentives be used to encourage healthy behaviour?

The thorny question of whether incentives are an acceptable way of encouraging and promoting healthy behaviours will be the focus of the next Citizens Council meeting.

The Citizens Council of the National Institute for Health and Care Excellence (NICE), which provides public input into the Institute's work, holds its next meeting in London on 20 and 21 May 2010. At this meeting the Citizens Council will be asked to consider whether incentives - which could be financial - have a real role to play in encouraging people to live healthier lives. Scenarios where incentives might be considered include losing weight, adhering to medication or staying free from illicit drugs. Whilst this approach isn't commonly used in the UK, some health services are trialling it and there is evidence for incentives being effective in some situations. The Citizens Council will hear evidence from speakers covering all aspects of this topic, before taking part in thorough discussions to examine the issues in detail.

The Citizens Council consists of a diverse group of 30 individuals, reflecting the age, gender, socioeconomic status and ethnicity of the people of England and Wales. The council meets twice a year to hear expert information on challenging topics and thoroughly discuss the issues raised. It is a formal committee of the Institute, helping to identify broad social values and how NICE might apply them in preparing its guidance.

Sir Michael Rawlins, Chair of NICE, said: “The contentious matter of whether incentives have a place in encouraging people to adopt healthy behaviour is exactly the sort of issue about which NICE wants the public's viewpoint. The Citizens Council makes an important contribution to the work of NICE by providing a snapshot of what the general public thinks about controversial healthcare issues. NICE can then take this opinion into account when developing its guidance processes.

“This time, the Citizens Council is asked to consider incentives in the context of healthcare and public health. This is a pertinent topic for NICE: previous clinical guidelines on psychosocial interventions for drug misuse have included recommendations on this approach, and it will be explored within various public health guidance topics such as smoking in pregnancy.

“Incentives can take a range of forms; some may be cash, vouchers for food or other items, or even donations to charity. They might also include giving individuals access to services that otherwise may not have been available to them.

“Using incentives may be seen as divisive in some fields. There is a question of whether this concept could be seen as simply rewarding people for doing what some may argue they should aim for anyway - such as losing weight, or stopping smoking. Others may believe that incentives are unfair to people who already make an effort to live healthily at their own expense. Another view could be that anything which helps break the cycle of ‘bad habits' and replaces it with ‘good habits' is important and should be tried. Or do incentives just encourage some people to ‘play the system' and gain the benefit whilst not really improving their health behaviour?

“We are keen to hear from the Citizens Council on precisely this kind of difficult social values issue, as it will help provide guidance to our independent advisory committees when they are required to make recommendations involving this approach.”

A report on the Council's views will be available on the NICE website for public comment, before the Council submits a report to the Board of NICE setting out its findings.

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This page was last updated: 19 May 2010

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Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.