The World Health Organisation (WHO) defines health literacy as:
“….the personal characteristics and social resources needed for individuals and communities to access, understand, appraise and use information and services to make decisions about health”.
In 2015 Public Health England and the Institute of Health Equity published a report entitled “Improving health literacy to reduce health inequalities”. This showed that up to 61 per cent of the working age population in England finds it difficult to understand health and wellbeing information. Low levels of health literacy impact significantly upon a person’s ability to:
- manage long term conditions;
- engage with preventative programmes and make informed healthy lifestyle choices; and
- keep to medication regimes.
This leads to worse health outcomes across a range of indicators, increased health inequalities for affected individuals, and increased preventable mortality.
“the strongest correlation to ill health – stronger than education level, deprivation, age or ethnicity – is health literacy”.
In order to tackle this NHS England has set up a national collaborative to take a whole system approach to addressing health literacy. Three partners on the Collaborative (Health Education England, NHS England and Public Health England) jointly supported a demonstration health literacy site in the East Midlands. Among the site activities was the delivery of Skilled for Health, which is the national, evidence based health literacy resource. This focused on people with diabetes and lower levels of health literacy living in deprived communities in Leicester and Leicestershire. They were also identified as struggling to manage their condition and the intervention was designed to test if improving their health literacy had an impact on this. Health Literacy Awareness Training was also delivered to 186 health practitioners from many organisations, the main ones being NHS (GPs and hospital staff), Public Health, voluntary sector, the fire service, social services and commissioning.
A health literacy ‘how to’ guide based on that work has now been published.
Additional demonstration activity in the West Midlands also involved the delivery of Skilled for Health to people with a variety of long term conditions living in deprived communities in Coventry to again test if improving their health literacy had an impact on how they self-managed their condition. The findings mirrored those of the national demonstration site, showing a positive effect.
The next phase in the Collaborative’s work will be to build on the demonstration activity:
- to test some of the techniques contained in the ‘how to’ guide as part of NHS England’s Shared Decision Making activity within the Greater Nottinghamshire Sustainability and Transformation Programme (STP)
- to develop a health literate decision support framework which will also be tested within the Greater Nottinghamshire STP; and
- to undertake a review and update of Skilled for Health.
To view the Skilled for Health Resources.
For other health literacy resources please go to the health literacy resource library.
Improving the quality and accessibility of health information
The Information Standard is an accreditation scheme for organisations that produce health and care information for patients and the public. It was set up to help drive up the quality of consumer health and care information. Information Standard membership enables organisations that produce information to use the easily recognisable kite mark. This ensures that patients and equally, health professionals and others that signpost to health and care information can be assured they are accessing good quality information where they see the logo (kite mark).
The Accessible Information Standard tells organisations how they should ensure that disabled people receive information in formats that they can understand and they receive appropriate communications support to help them. Since August 2016 all publicly funded health and adult social care services, including hospitals and GP practices, have been required to meet the Accessible Information Standard.
More information and resources are available here on our website.
Shared Decision Making (SDM) and patient decision aids (PDAs)
NHS England is committed to supporting Shared Decision Making. This involves letting patients review all the treatment options available to them so they can work with their healthcare professional to make the decisions that work best for them.
Shared Decision Making can bring patients and healthcare professionals together, on an equal footing, to make decisions focused on the needs of each individual. More work is needed to change systems and processes within the NHS that support Shared Decision Making. We are working with partners, including NICE, to look at what changes are needed to support Shared Decision Making across the NHS.