37 areas to lead rollout of tool to deliver person-centred care

People with long-term conditions in 37 areas across England are next in line to receive person-centred support to manage their own care, thanks to the roll-out of an evidence-based tool over the next five years.

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, helping professionals tailor support to better meet their needs.

NHS England agreed a deal to grant 1.8 million people access to the tool as part of its developing Self Care Support programme, and invited local NHS organisations and their partners to apply to use them in their areas.

37 bids – including a number of new care model vanguards and sites working as part of the Integrated Personal Commissioning (IPC) Programme – have now been confirmed, which will see use of the tool spread across England and applied to help improve care and outcomes for a variety of different patient groups.

For example:

  • Tower Hamlets CCG will use PAM to tailor the information and support individuals need to take an active role in the person centred care planning process. It will use PAM to understand “where the individual is at” to help inform the conversation and support them to develop their goals and outcomes.
  • In Blackpool, PAM will be used in the Extensive Care Service of the Fylde coast new models of care to support frail elderly patients with multiple long-term conditions and at high-risk of an emergency admission. Knowing their level of activation will help the service to adapt their interventions so they are appropriate to the patient’s current level of confidence, knowledge and skills.
  • In Southwark, besides using PAM to tailor support to individuals, staff will be supported to value and interpret patient activation, with tools and self-management support to mobilise collaborative, and less medical model, attitudes and ways of working.

Anu Singh, Director for Patient and Public Participation and Insight at NHS England, said: “We know that many patients want to be equal partners in their own care – supported to manage their conditions and keep themselves well, and empowered to make decisions about the services they do need. The Patient Activation Measure helps to break down the traditional divide between patient and professional which has prevented this in the past, while ensuring that those who need the most support receive it.

“I’m delighted we have been able to deliver this important tool to so many different areas, and I look forward to seeing the results of the many different plans they have to deliver more person-centred care and better outcomes for patients as a result.”

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 – by using the PAM, organisations can ‘meet people where they are’ and tailor support and services to the individual’s needs.

The list of organisations successful in securing free access to PAM licences is given below. All of these sites, in partnership with other organisations, will use the PAM tool to measure levels of patient activation in their local areas, tailor interventions and support people to manage their own health. Further details of how these organisations will use the PAM licences is available here.

  • Blackpool Teaching Hospitals Foundation Trust (part of the Fylde Coast Vanguard)
  • Brent CCG
  • Bristol CCG
  • Central London CCG
  • Chiltern CCG
  • Dorset County Hospital NHS Foundation Trust (part of the ‘Developing One NHS in Dorset’ Vanguard)
  • Ealing CCG
  • Gloucestershire CCG (part of the Integrated Personal Commissioning Programme and the test bed site)
  • Fylde & Wyre CCG (part of the Fylde Coast Vanguard and the Lancashire & Cumbria Innovation Alliance test bed site)
  • Kernow CCG (part of the Integrated Personal Commissioning Programme)
  • H4All CIC Ltd – Hillingdon CCG
  • Hammersmith and Fulham CCG
  • Harrow CCG
  • Hartlepool and Stockton-on-Tees CCG (part of the Integrated Personal Commissioning Programme)
  • Horsham and Mid Sussex CCG
  • Hounslow CCG
  • Lancashire Care NHS Foundation Trust (part of the ‘Better Care Together’ (Morecambe Bay Health Community) Vanguard and Lancashire & Cumbria Innovation Alliance test bed host)
  • Leeds Community Healthcare Trust
  • Luton CCG (part of the Integrated Personal Commissioning Programme)
  • Newham CCG
  • North Hampshire & West Hampshire CCGs (closely affiliated to the Better Local Care (Southern Hampshire) Vanguard and part of the Integrated Personal Commissioning Programme)
  • North Somerset CCG
  • Pennine Acute Hospital Trust
  • Pennine Care NHS Foundation Trust (part of the ‘Stockport Together’ Vanguard)
  • Sheffield CCG (closely affiliated to the ‘Working Together Partnership’ Vanguard)
  • Solihull CCG (part of the ‘Solihull Together for Better Lives’ Vanguard)
  • Somerset CCG (part of the South Somerset Symphony Programme Vanguard and the Integrated Personal Commissioning Programme)
  • South Eastern Hampshire CCG (closely affiliated to the ‘Better Local Care’ (Southern Hampshire) Vanguard and part of the Integrated Personal Commissioning Programme)
  • South Gloucestershire CCG
  • South Tyneside CCG
  • Southern Health Foundation Trust  (part of the Better Local Care (Southern Hampshire), and North East Hampshire and Farnham Vanguards)
  • Southwark CCG (sharing licences with the Foundation Healthcare Group Vanguard)
  • Tameside Hospital NHS Foundation Trust
  • Tower Hamlets CCG (part of the Tower Hamlets Integrated Provider Partnership Vanguard and the Integrated Personal Commissioning Programme)
  • West London CCG
  • Wirral CCG (part of the ‘Wirral Partners’ Vanguard and the ‘Cheshire and Merseyside Women’s and Children’s Services’ Vanguard)
  • Worcestershire Health and Care NHS Trust

NHS England will also work with some other sites to further develop their patient activation proposals.

Sites that are part of the Integrated Personal Commissioning Programme:

  • Barnsley CCG
  • Cheshire West and Chester Council
  • Hampshire County Council
  • North, East and West Devon CCG
  • Portsmouth City Council
  • South West Lincolnshire CCG

New Care Models Vanguard sites:

  • Derbyshire Healthcare NHS Foundation Trust (part of the Wellbeing Erewash Vanguard)
  • Northamptonshire Healthcare NHS Foundation Trust (closely affiliated to Lakeside Healthcare Vanguard)
  • West Cheshire CCG (part of the West Cheshire Way Vanguard)

Test bed site:

  • Heywood, Middleton and Rochdale CCG



  1. Ken Muir says:

    We are interested in using the measure as part of a risk based cancer prevention program across Greater Manchester.
    Could you tell me if this would be possible and if so how we could pursue this.
    Many thanks.

  2. Clive Bowman says:

    It is disappointing that the PAM tool has not been tested against shorter more agile instruments

  3. Adrienne Bean says:

    I am currently working on stratification within Cancer. I can only see snap shots of the questions asked. Can I ask whether the tool is suitable for use with “routine” cancer patients?
    and whether there are any of the sites listed who have included cancer as a Long Term Condition.

    • NHS England says:

      Dear Adrienne,
      As outlined in the King’s Funds paper, ‘Supporting People to Manage their own Health’ (May 2014), patient activation has been linked with health outcomes among healthy patients, as well as outcomes among patients who have many different types of physical health conditions, including cancer. Our current sites are using PAM across multiple long-term conditions, but none are working with specific cohorts of people living with cancer.
      Kind regards,
      NHS England

  4. Pearl Baker says:

    What is the difference between a PAMs licence? and others outside that System being able access their own funds from Health and Social Services to organise their own health and social care? under the heading ‘Patient centred choice’? It is already stated in the MCA2005 code of Practice that those subject to a ‘Property and Finance’ Order are entitled to a Personal Budget, helped by an Independent Advocate or family member.

    Section 117 of the 1983 MHA are usually those suffering from a LTC this ‘Group’ are already disadvantaged by the inequality of ‘The Better Care Fund’ distribution.

    I refer to the current ‘needs assessment’ that should include vocational activities. There is no ‘Monitoring’ that any of the above is taking place. I have collected much ‘data’ on this that concludes many LTC Patients have no idea of their right to anything. If your LA is ‘broke’ no chance.

    • Stella I.Tsartsara says:

      Pearl, sensible comment
      Specially as LTC are the patients per excellence why patient centered integrated care is needed.
      What is LA?

    • NHS England says:

      Dear Pearl,
      The Patient Activation Measure (PAM) is a tool which captures the extent to which people feel engaged and confident in taking care of their health and wellbeing, and is intended to help organisations better tailor support and services to individual needs. This is a different concept to a Personal Health Budget. Please see our Frequently Asked Questions<> for more information about how measuring patient activation can help people with long-term conditions better manage their own health and care needs.
      Kind regards,
      NHS England.