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.

Patient activation and supported self-management are part of the NHS Long-Term Plan commitment to make personalised care business as usual. Personalised Care means people have choice and control over the way their care is planned and delivered, based on ‘what matters’ to them and their individual strengths and needs.

Universal Personalised Care sets out how a comprehensive model of personalised care will be put into practice. Supported self-management and patient activation is one of six key components of the model.

NHS England is working with partners to understand how patient activation can lead to more personalised care. As part of this, we purchased 1.8m licenses for the PAM tool in 2016, which are now being utilised across over 90 sites. Currently sites are using PAM to understand the activation level of their local population and tailor their services according to individuals’ needs, which  can help 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.

Research published by the Health Foundation shows that supporting patients to manage their health conditions can reduce avoidable use of health services. An analysis of PAM responses collected from over 9,000 patients in Islington CCG found that, compared to those who felt least able (PAM level 1), those who felt most confident and able to manage their health condition (PAM level 4) had:

  • 38% fewer emergency admissions;
  • 32% fewer A&E attendances;
  • 18% fewer general practice appointments;
  • and were 32% less likely to attend A&E with a minor condition that could be better treated elsewhere.

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 contact the Patient activation team.

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