About Patient Activation in NHS England’s Self-care programme
- How is Patient Activation being used within the Supported Self Care programme?
- How many PAM licences are needed to assess the activation of the same person over several years?
- Are there other derivatives of the PAM available for people with different needs?
- Is there any learning available about clinician support for patient activation?
- Are there any cohorts for whom PAM is not suitable to use?
- Do we need to complete an Equality Impact Assessment (EIA) for using the PAM?
- Will there be further opportunities to apply for licences from NHS England?
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: ‘staying healthy, making informed choices of treatment, managing conditions and avoiding complications’. To meet this commitment, NHS England set up the ‘Supported Self Care’ programme to scale-up support for people living with long-term conditions (LTCs) to manage their own health and wellbeing, empower them to make decisions about their health and care whilst delivering financial benefit to the wider healthcare system.
Patient activation is a measure of people’s knowledge, skills and confidence to manage their own health and is a core enabler for the Supported Self Care programme. Health and care systems that know the activation level of their population can begin to tailor their services in order to support people on a ‘journey of activation’, thus helping them lead better lives at a lower cost to the system.
In 2016, NHS England agreed a licence to use the Patient Activation Measure (PAM) tool with up to 1.8 million people through key NHS change programmes, including the new care model vanguards and integrated personal commissioning demonstrator sites. Learning from the PAM learning set sites is being gathered together to support organisations who have taken up the PAM licences in 2016-17. A web-based platform, the PAM Knowledge, Skills and Confidence network has been set up for the sites to share learning with each other, join in discussions and have access to training materials and other useful resources.
One licence per person is needed. It can be used any number of times with the same person up to the end of the licence agreement. For licences already secured from NHS England, these are valid up to March 2021.
Yes, PAM tools available to use as part of the NHS England licence agreement include the Parent/Carer PAM and validated language translations of PAM derivatives (as required). Use of the PAM tool with a patient and their carer(s)/parents only counts as one licence.
In 2014, NHS England surveyed over 1750 clinicians, including doctors, nurses and allied health professionals, to explore their attitudes and beliefs, their self-reported behaviours and practices to support people in taking a more active role in managing their health and care. This used a modified version of a tool called Clinician Support for Patient Activation (CSPAM). The findings from the survey are available on our website and it also provides an insight into clinicians’ perceived barriers and their support needs.
The CSPAM tool is available from Insignia Health if you wish to use it as a reflective tool with your clinicians.
Our experience from the Learning Set indicates that PAM may not be suitable for people with conditions such as severe learning disability, severe mental health problems or severe dementia.
The reading age for PAM is 11-12 years. For people with a lower reading age, the Carer and Parent version of PAM is available to use.
Equality Impact Assessments (EIAs) are no longer a statutory requirement in England. However, they continue to be used by public sector organisations as a way of demonstrating compliance with public service equality duty.
It is the decision and individual responsibility of each organisation using the PAM to undertake an EIA in line with their local patient activation plans and broader context of how they will use PAM, which will be unique for each locality.
All of the 1.8m PAM licences secured by NHS England in 2016 have now been allocated. We are currently developing our strategy on further use of patient activation licences and how it can demonstrate and support sustainable change in the NHS. We expect more information to be available in 2017 and will communicate via our webpages as this develops. In the meantime, you may want to connect with colleagues in your region who have been allocated PAM licences. It may be that these sites can grant you a portion of their licences – you can view a list of our sites here.
Alternatively, PAM licences are commercially available from Insignia Health (email: firstname.lastname@example.org). They will be able to advise you about licensing costs and different language versions that are available.