Into the looking glass: A collective self-assessment of health literacy (4)

10 April, 2022

In relation to Andrw Pleasant's work on health literacy, there is good evidence, I believe, that activated and health literate patients use services less.

The King’s Fund “Supporting people to manage their health - an introduction to patient activation” Judith Hibbard Helen Gilburt 2004

“Patient activation’ is a widely recognised concept. It describes the knowledge, skills and confidence a person has in managing their own health and health care.Supporting people to manage their health | The King's Fund (

- People who have low levels of activation are less likely to play an active role in staying healthy. They are less good at seeking help when they need it, at following a doctor’s advice and at managing their health when they are no longer being treated. Their lack of confidence and their experience of failing to manage their health often means that they prefer not to think about it.

- The Patient Activation Measure (PAM) is a patient-reported measure that has been validated in the United Kingdom. It is a powerful and reliable measure of patient activation.

- Patient activation scores have been robustly demonstrated to predict a number of health behaviours. They are closely linked to clinical outcomes, the costs of health care and patients’ ratings of their experience. Highly activated patients are more likely to adopt healthy behaviour, to have better clinical outcomes and lower rates of hospitalisation, and to report higher levels of satisfaction with services.

- Patients with low activation levels are more likely to attend accident and emergency departments, to be hospitalised or to be re-admitted to hospital after being discharged. This is likely to lead to higher health care costs.

- The relationship between patient activation and health outcomes has been demonstrated across a range of different populations and health conditions.

- Intervening to increase activation can improve a patient’s engagement and health outcomes and is an important factor in helping patients to manage their health. Improvements in patient activation scores have been seen for up 18 months following intervention.

HIFA profile: Richard Fitton is a retired family doctor - GP. Professional interests: Health literacy, patient partnership of trust and implementation of healthcare with professionals, family and public involvement in the prevention of modern lifestyle diseases, patients using access to professional records to overcome confidentiality barriers to care, patients as part of the policing of the use of their patient data. Email address: richardpeterfitton7 AT