Reducing non-urgent attendance at A&E

Department of Health


We helped the Department of Health identify a range of cost-effective opportunities for reducing so-called ‘inappropriate’ attendance at A&E – using the principles of behavioural science to promote subtle shifts in how service users perceive different elements of the health landscape.


Winner: MRS Best Healthcare Research Award 2016

Nominee: MRS Awards 2016: Grand Prix Award for Greatest Impact


With A&E departments widely reported as being over-stretched, the Department of Health and NHS England identified the problem of ‘inappropriate attendance’ as a priority action area.

With several high-profile comms campaigns having proved ineffectual, the DH’s Behavioural Insights team commissioned us to understand what was really shaping parents’ decision to attend A&E to address non-urgent health concerns.

Our research revealed how the seemingly ‘irrational’ decision often felt rational to parents.

In part, this was the result of social and technological shifts, combined with personal worry and the vagaries of local service provision.

Above all, however, it reflected how parents were being drawn in by the strength and stability specialism of the A&E ‘brand’ – particularly in comparison with other health services. Certain ‘cues’, it transpired, were reinforcing their perception of Emergency Departments as safe, specialist places (e.g. the wearing of scrubs / medical uniforms, and the visibility of ‘technical’ equipment).

In revealing the profound impact of these signifiers, we outlined a range of opportunities for shifting parents’ relative perceptions of different services – while also highlighting the need to upskill parents to have more confidence in their own health diagnoses.