The NHS’s new incentive-led walking initiative marks a notable shift towards prevention-focused healthcare, highlighting the growing role of behavioural change in improving long-term health outcomes. In this opinion piece, Katie Tryon, Deputy CEO of VitalityHealth, argues that personalised incentives and data-driven approaches will be key to ensuring prevention strategies deliver lasting benefits for individuals, employers and the healthcare system.
NHS England recently announced that it will reward people for something remarkably simple but long ignored as a driver of health improvement: walking. Its “marathon a month” challenge asks people to walk for around 30 minutes a day, log their progress, and earn incentives for sticking with it. The ambition is to sign up more than 100,000 people in the first wave.
While it may seem like a small idea on the surface, it is one of the most significant moves the NHS has made in years, putting prevention at the very heart of its campaign. For too long, prevention has been the part of healthcare everyone agrees with in principle but fails to prioritise or fund in practice. Today’s announcement is a signal that this is starting to change, and it deserves to be recognised as such.
We have seen first-hand how prevention changes lives at Vitality, having used rewards to encourage healthy behaviours for nearly 30 years globally, and almost two decades within the UK.
The evidence has been there for years
One of the fundamental challenges for individuals looking to embed a preventative approach to health is bridging the gap between what we know we should do to remain healthy and what we then actually do.
This is where we have shown that incentives and personalised rewards help to gradually build up healthy habits, cement behaviours and making them more likely to stick. Our own data shows how the right rewards and incentives, coupled with a scientific understanding of how to form and sustain habits, help people live longer, healthier lives.
Our research, conducted with The London School of Economics, found that members who sustained a habit of 10,000 steps 3 times a week for 3 years saw a 41% reduction in type 2 diabetes risk, and a 36% reduction in the risk of stage 4 cancer.
Run the same logic across the wider population, and the potential is significant: better health, healthier communities, and meaningfully reduced pressure on the health system. The same research revealed the financial impact for the NHS could be huge, with NHS hospital costs potentially reducing by as much as £15 billion per year if half of the UK’s inactive adult population began consistently walking 5,000 steps once a week, and those who have poor exercise habits began consistently walking 5,000 steps three times per week.
The potential of active lives and a prevention-first approach is not new information for policymakers. What has been missing is the willingness to act on it at a national scale, until today.
The real challenge was never awareness
We all know the importance of living a healthier life – the challenge has always been turning that knowledge into a habit that sticks. Similarly, most people already know that walking is good for them, yet sustained behaviour change is hard, and it is here that most public health interventions quietly fail.
This is not a new theory. At Vitality, we have spent years studying what motivates people to make healthier choices and, crucially, stick with them. Our experience shows that when incentives are paired with achievable goals, people become more active and become more likely to sustain healthy behaviours over time.
Members engaging with the Vitality Programme are shown time and time again to increase their physical activity. One example being the Apple Watch offering, which is available on qualifying VitalityHealth insurance and VitalityLife insurance plans, and means those who get active pay less for an Apple Watch. Those using this incentive were 34% more active, which is the equivalent of an extra 4.8 days’ physical activity per month.
Effective incentives do more than reward a single action; they help turn repetition into routine and routine into habit. The real measure of success is not whether someone exercises once, but whether they are still doing it months and years later.
As such, incentives have a lot of power and influence, but to invoke real, long-lasting change, incentives must be both concrete and compelling enough to act as a springboard. This is where personalisation comes into play.
Why this scheme needs to be personal, not just simple
The NHS scheme is designed to be simple, and that is the right starting point. Yet simplicity and personalisation need not be considered in isolation.
What motivates someone who already walks 10,000 steps a day is very different to what motivates someone just starting out, and the health impact of the same intervention varies enormously between the two. A flat, one-size-fits-all incentive risks rewarding people who were already active, while doing little for the people who reaching could have the biggest impact on.
Our experience shows that an adaptive approach that calibrates the type and intensity of support to the individual is far more likely to produce change that lasts.
This is where AI and personalisation can play an important role, but only if they are used with real precision. The opportunity is not to simply serve up more health information, but to understand the person you are speaking to – which action will make the biggest difference for each person, how likely they are to take it, and what kind of support or incentive will help them sustain it?
We continually see that behaviour change is often highly individual: the same nudge will not work equally well for everyone, and the same action will not deliver the same health benefit for everyone. Getting this right means using data and information to move beyond generic advice, towards personalised recommendations and rewards that are timely, achievable, relevant and meaningful, helping people build habits that improve their health over the long term.
As such, the government’s new campaign is a significant first step – the next move is to make sure it evolves to work for everyone it reaches, not just the people who were already halfway there. Getting that right, through personalisation and the intelligent use of data, is how a good idea becomes a lasting one.
