From 17-19 July 2026, UCL’s 10th International Behaviour Change Conference took place in Lisbon, Portugal. A highlight of the behavioural science calendar, the event brought together more than 300 delegates from 44 countries to showcase work translating behavioural science (BeSci) into solutions for some of today’s greatest societal, environmental and technological challenges. This year was no exception. Perhaps one of the most compelling and relevant talks was that of Prof. Marijn de Bruin (Radboud University Medical Centre), one of the conference’s opening keynote speakers. He raised a deceptively simple point of reflection… Behavioural Science Has Matured… But Have The Systems Around It? The systems that are necessary for BeSci to function as intended, that facilitate or hinder its ability to address the challenges it’s intended to remedy. As virtually any behavioural scientist will tell you, context is King. Behaviour doesn’t happen in a vacuum, interventions which may work exceedingly effectively in one place/at one time, may fall completely flat in another because behaviour is more than the sum of its parts. To understand, to predict, to influence effectively we need to understand the big picture, not simply the individual points of specific interest. This really resonated because, as anyone working in healthcare, pharma can attest, healthcare has never had more evidence or more data. We understand more about behaviour than ever before. We know the importance of medication adherence, shared decision-making, prevention, health literacy, clinician communication and patient engagement. Yet translating that knowledge into routine practice often remains frustratingly difficult. The problem, Marijn argued, is increasingly not a lack of evidence. It’s the systems we expect to deliver it. Behaviour Change isn’t The Bottleneck Anymore… BeSci has traditionally focused on helping individuals make healthier choices – taking medication consistently, quitting smoking, being more physically active, and many other things besides. These interventions of course remain hugely important and of great value – Marijn’s own work around HIV treatment adherence demonstrated firsthand how BeSci insights and recommendations can lead to cost-effective interventions that improve adherence. The challenge now isn’t whether these achievements are possible in their own right, but rather that implementation of these types of interventions can be slowed or even halted by reimbursement processes, realities of workforce pressures and/or organisational priorities. This led to the intriguing yet simultaneously intuitive reflection… Perhaps we need to think about changing the systems that shape behaviour, not just the behaviour itself. Healthcare is full of examples where individuals are asked to overcome structural barriers through motivation alone. We’re encouraged to eat healthily, while our environments surround us with unhealthy food that is quicker, easier, requires less effort and is often tastier than the ‘better for us’ alternative. Patients have to navigate multiple long-term conditions, while services to help them do so are increasingly fragmented and much less frequently holistic. Sometimes a single condition can require the input of specialists from different disciplines of medicine, yet these branches often don’t communicate directly or effectively with one another. A patient with Parkinson’s disease may, for example, be under the general care of a neurologist, but may also need the support and insight of a geriatrician, physiotherapist and urologist. Given their different areas of focus and priorities, patients can find themselves having to reconcile recommendations from multiple specialists. Advice or treatment proposed by one clinician may inadvertently create challenges in another area, yet those specialists rarely meet together to agree a coordinated plan. The neurologist may prescribe medication to improve mobility and reduce tremor for example, but those same medications can worsen dizziness or increase the risk of falls, creating or exacerbating concerns for the geriatrician. At a time when so many health-related challenges exist, rising obesity and ageing populations to name just two complex multidimensional ones, pressures on healthcare systems are increasing. Given the strain these services are often already under, prevention becomes increasingly important and distinctly less ‘optional’. Yet despite this, prevention struggles for funding, political urgency, and often organisational attention relative to treatment. Marijn argues, compellingly, that BeSci is well placed to make an obvious contribution here, not just with helping individuals change behaviour, but by helping healthcare organisations design services that make healthy choices easier, more accessible and more sustainable. It Is No Longer Innovation Which Presents a Key Challenge, but Implementation… Healthcare rarely lacks ideas, we regularly generate valuable and robust insights into patient needs, clinician decision making and barriers to service delivery, we recognise unmet needs, design interventions and demonstrate effectiveness. The challenge Marijn argues, is that we often lack the mechanisms for reliably scaling and sustaining those good ideas. Implementation stalls because the organisations in which they must exist are not necessarily designed to absorb change. As some of today’s biggest health challenges are influenced by complex dynamics upstream to the patient themselves, including broader policy decisions, commercial environments and digital ecosystems, improving population health needs more than simply encouraging individuals to make better decisions and choices. It also means influencing the environments in which those choices are made, which would represent an important evolution in behavioural science, shifting from focusing on changing individual behaviour towards including consideration of, and changing, the systems that shape the behaviour itself. It was a pointed reminder that if we want evidence to improve patient outcomes, we need to think beyond producing better interventions. We need to work towards building and reshaping healthcare systems, so they are capable of recognising, adopting and sustaining them. The ultimate takeaway was that our greatest opportunity may no longer lie in generating more evidence alone, but in influencing and improving the systems that determine whether that evidence translates into better care. Behavioural science has become increasingly adept at understanding and changing behaviour. The next challenge may be understanding and changing the systems within which that behaviour occurs. The question isn’t always whether an intervention works. It’s whether the system is ready to support it. If your organisation is grappling with implementation, adoption or behaviour change challenges, our team can help uncover the behavioural and systemic factors shaping outcomes. We’d be delighted to discuss your goals and priorities and create tailored strategies to achieve your objectives. If you’d like to hear from us, fill in the Contact form below. Apply Now!