Nearly two million patients to receive person-centred support to manage their own care

People with long-term conditions will be supported to better manage their own health and care needs, thanks to the roll-out of an evidence-based tool over the next five years.

NHS England has agreed a deal which will grant nearly two million people access to more person-centred care as part of its developing Self Care programme.

Local NHS organisations and their partners are being invited to apply for free access to patient activation licences, which will help them assess and build their patients’ knowledge, skills and confidence, empowering people to make decisions about their own health and care.

The Patient Activation Measure (PAM) is a validated tool which captures the extent to which people feel engaged and confident in taking care of their health and wellbeing.

By measuring people’s activation levels through PAM, organisations can ‘meet people where they are’ and tailor support and services to the individual’s needs.

Locally, it is expected that measuring and improving patient activation will lead to patients enjoying better experiences of care and outcomes, making more positive choices about their health and wellbeing, and experiencing fewer unplanned hospital admissions.

Building on well-received trials in six areas, NHS England has now agreed a five-year licence to expand the use of the PAM tool with up to 1.8 million people, as a core component of the Self-Care programme.

Dr Alf Collins, NHS England national Clinical Advisor, said:  “Truly empowering patients to keep themselves well, manage their conditions and stay out of hospitals requires health professionals to understand the needs, the skills, and the confidence of the individual patient they are working with.

“The Patient Activation Measure shows real promise as a tool to achieve this, and I look forward to seeing how more local areas can use it in innovative ways to provide care which is more person-centred, delivering better outcomes for patients and better value for taxpayers.”

Measuring Patient Activation forms a core element of the NHS Five Year Forward View’s ambition for the NHS to become better at helping people to manage their own health by ‘staying healthy, making informed choices of treatment, managing conditions and avoiding complications’.

Compelling evidence collated in a report by the King’s Fund in 2014 shows that people who recognise that they have a key role in self-managing their condition, and have the skills, knowledge and confidence to do so, experience better health outcomes. One American study cited in the report found that the risk of highly activated patients being re-admitted to hospital following discharge was almost half that of less activated patients.

However, ability levels vary from person to person, which makes understanding and measuring an individual’s level of activation so important.

NHS England has been testing the use of PAM in 5 CCGs and the UK Renal Registry since 2014.

Dr Ollie Hart, GP and clinical lead for person-centred care at Sheffield CCG, one of the participants, said: “In Sheffield, we have been finding PAM a really useful tool for tailoring our level of support and health coaching to match a person’s needs. By embedding it in our processes for supporting people with diabetes, we have gained a better understanding of patients’ needs and behaviours, allowing us to ensure that resources – particularly staff time – are being used more effectively for their benefit.”

An independent interim evaluation report by the University of Leicester looking at the experience in Sheffield and the other participating areas has also been published today. The qualitative study provides practical lessons and considerations for those who wish to use the PAM in their local areas.

In 2016/17, around 40 clinical commissioning groups (CCGs) and other primary care organisations will be granted access to PAM licences, subject to an application process. They will include those involved in key NHS change programmes like New Care Model Vanguards and Integrated Personal Commissioning demonstrator sites, which are helping to form the blueprint for how NHS services will be delivered in the future, particularly for people with long-term conditions.

The application process for licences is now open – details of how organisations can apply are available on the NHS England website.

The closing date for applications is 12pm on Tuesday 17 May, and it is expected that the successful applicants will be announced in early June.

Should you have any questions, please email:

Evidence for the effectiveness of patient activation was the subject of a report from The King’s Fund in 2014: Supporting People to Manage their Health: An introduction to Patient Activation.


  1. Valerie bradley says:

    I have bipolar l am in palliative care for heart failure,and other servere comorbidities, my three types of arthritis, and my servere mental health conditions,prevent me selfcaring,and the loss of my fulltime CARER my late husband who died 3 years ago has devastated me,l have a PA/carer for 29 hours a week,but still need more care outside this time,an ongoing CHC healthcare IRP panel next month has brought my mental health down further,l feel the NHS think people who are ill can miraculously suddenly take care of their own health they cannot,this is all a money saving exorcise, let’s just say my death would seem like a good idea right now!.
    Regards Valerie bradley

  2. Christine Nash says:

    I hope this includes sensory impairment as well as just physical imapairments. I this going to be available in Braille and BSL?

    • NHS England says:

      Dear Christine,
      Through the PAM tool, NHS England is looking to address the needs of individuals by measuring their levels of knowledge, skills and confidence. It encourages all sites using the PAM to make the necessary arrangements in their local settings to accommodate for individuals’ needs, as part of our ethos of person-centred care.
      Kind regards,
      NHS England

  3. Anonymous says:

    This method would appear to be aimed at and benefit articulate and literate patients. How would vulnerable people such as those with literacy or learning disabilities or emotiomal distress, be assisted to navigate their way through such a system or involve their carers? What advocacy,complaints or interpretation or translation would be a available?

    • NHS England says:

      The purpose of measuring a person’s levels of skills, knowledge and confidence is to help health care professionals to assess each individual patient, and then tailor the services to their particular needs. This will enable to ‘meet people where they are’ to support them in ways appropriate to these individuals. Nobody who needs a high level of support will find it taken away from them if their local NHS uses this tool. The Parent/Carer version of the PAM tool is available, and it is also available in different languages (see PAM Frequently asked questions<>)
      Kind regards,
      NHS England

  4. Chris Reid says:

    why not just sack all the medical staff and have a tick box website. Imagine how much that will save. Just think you wont have to actually deal with real people. I like the use of selective American studies to help justify the cuts you are enforcing on the people of this country. I am afraid NHS England is the destroyer of the NHS as we know it.

  5. Pearl Baker says:

    As a Carer and escort for a relative it has been a ‘Marathon, trying to get my Travel cost refunded. I keep my fingers crossed, as two months ‘out of date’.

    ‘Patient Centre’ in control of their own ‘Health and Social’ Wellbeing is already with us in NAME, however the funding of ‘Personal Budgets’ lags behind the ‘rhetoric’.

    Where are the Independent Advocates? where are the AHPs in Mental Health ‘Sorry’ ‘not in Mental Health’.

    Why have BUS PASSES been withdrawn for the Mentally Ill? No Physical and Mental ‘equality’ here.

    Nobody has informed the Mentally Ill they are still entitled to a BUS PASS if they are unable to hold a ‘driving licence’?

    This is a constant ‘Merry go round’ and nobody can get off, because the rules are always changing.

    I have no objection to my ‘Personal story’ being told, but sometimes the Kings Fund have other ideas!