Patient activation

People’s ability to manage their own health and wellbeing

‘Patient activation’ describes the knowledge, skills and confidence a person has in managing their own health and care. Evidence shows that when people are supported to become more activated, they benefit from better health outcomes, improved experiences of care and fewer unplanned care admissions.

Patient activation is of particular importance to the 15 million people living with long-term conditions (LTCs) who rely, more than most, on NHS services. By understanding people’s activation levels, the NHS can support those people with LTCs in ways appropriate to their individual needs. The Patient Activation Measure (PAM) is a tool that enables healthcare professionals to understand a patient’s activation level, or their level of knowledge, skills and confidence to manage their LTC.

The NHS Five Year Forward View set out a central ambition for the NHS to become better at helping people to manage their own health. To meet this commitment, NHS England is making supported self care a key part of personalising care. This involves scaling up support for people living with LTCs to manage and make decisions about their own health and wellbeing. Patient activation is a core enabler for this programme.

More information about NHS England’s vision can be found in our Patient Activation narrative.

Since 2014, NHS England has been working with partners to understand how patient activation can lead to more person-centred and personalised care. As part of this, we purchased 1.8m licences for the PAM tool in 2016 which were made available to key NHS change programmes including, amongst others, new care model vanguards and integrated personal commissioning demonstrator sites. These sites are using PAM to understand the activation level of their local population and tailor their services according to individuals’ needs, thus helping them lead better lives at a lower cost to the system.

An initial Learning Set of six organisations implemented projects using PAM to find ways to support people to become more involved in their health and care. Its evaluation focuses on practical lessons and points to consider for others interested in using PAM in their local areas. More information, including the evaluation report and case studies can be found on the Learning Set page.

In her blog post, Dr Karen Eastman, a GP and Clinical Commissioner at Horsham & Mid Sussex CCG, explains how their Tailored Health Coaching service is helping them understand people’s skills, knowledge and confidence to deliver more personalised, person-centred care.

Quick guide to implementation of the Patient Activation Measure (PAM)

A quick guide published by NHS England provides practical and operational support to sites considering the use of PAM licences. It focuses on why patient activation is important in managing people’s health and wellbeing, as well as elements to consider before implementing the PAM. NHS England recommend using the PAM in the context of a fully integrated approach to personalised care for people with long term conditions.

The full version of the PAM implementation guide containing various modules for detailed implementation support is available from the Patient Activation: Knowledge, Skills and Confidence collaboration platform. The platform requires a user ID to access it – this can be requested by sites that have access to PAM licences through NHS England from the Patient activation team.

If you are interested in using PAM within your organisation, please watch this space where we will publish details of any future application process.

You can find out more about PAM in our Frequently Asked Questions and in the King’s Fund ‘Supporting People to Manage their Health’ report.

If you have any queries about Patient Activation, please email