Demarketing dysfunctional demand in the UK National Health Service.

This article considers demarketing as a strategy to manage dysfunctional demand in the UK NHS. Demarketing seeks to persuade customers not to use a service which is provided. It appears in all four modes in the NHS as general, selective, ostensible and unintentional demarketing with an emphasis on supply-side applications. It is proposed that, as a demand-side strategy, it would allow purchasers of health care on behalf of communities, to discern values, attitudes and beliefs which predicate current behaviour through the use of the Theory of Planned Behaviour; and, subsequently, to develop appropriate demarketing alternatives to change these behaviours where they are dysfunctional for both consumer and provider. This approach is proposed for the significant behavioural changes required to manage the increases in the use of emergency services: in particular, general practitioner night calls, which are already developing evidence-based demand management strategies. Such alternative strategies need to demonstrate their acceptability to consumers rather than just the professionals. Such demand management strategies would be made more acceptable as they are drawn from both consumer and normative attitudes, values and beliefs. In this way demarketing could demonstrably provide a framework for intervention, collaboration, decentralization, explicitness and an ethical foundation to the key problem of demand management in health care.