The Health Literacy Demonstrator: What we learned: Overview of the programme Dr Phyllis Easton Health Intelligence Manager NHS Tayside Lead, Health Literacy Demonstrator Programme

I’ve just had keyhole surgery and I didn’t realise there would be more than one keyhole My 18 year old son had a clinic appointment this week and he went to the wrong place because that was the address on the letter When my wife broke her collarbone, I had to explain everything she had been told by the doctor we saw My dad got new tablets and I was helping him make sure he knew how to take them but it was so complex I was struggling

I was guilty of giving patients a pile of leaflets and thinking that I had given them everything they needed I was working with a young woman who seemed to be engaged and willing to work with me but then I would send her an appointment and she wouldn’t turn up You just assume you will know if someone is struggling with the information you are giving them but I realise now that is not the case

Who might experience low health literacy? People with learning disabilities People with cognitive or sensory impairment People with low functional literacy People whose first language is not English (language vs. literacy – some may have low functional literacy in their own language) People who are worried People who are distressed People who are unwell People who attend services that are not health literate

(Scottish Government 2014) Health Literacy “People having enough knowledge, understanding, skills and confidence to use health information, to be active partners in their care, and to navigate health and social care systems” (Scottish Government 2014) Ask participants to define Health literacy Most people will struggle with health literacy New surroundings, new people, unfamiliar settings New language, use of technical terms and jargon – vulnerable sometimes dependant, frightened people – HC environment -alien context for most people Health Literacy – not about people’s literacy skills – but people with low or poor literacy skills will struggle even more Compare this term to computer literacy – we all appreciate that often, regardless of how literate someone is, it’s not a given that they will be computer literate – different skill Health literacy is the skill of understanding and navigating health care contexts 5

Health literacy is .. “a patient’s ability to obtain, understand and act on health information AND the capacity of health care providers and health care systems to communicate clearly, educate about health and empower patients” Source: Minnesota Health Literacy Partnership

Q. How do you improve people's computer literacy?

www.healthliteracyplace.org.uk

Demonstration Programme objectives To improve people’s confidence, knowledge, understanding and skills to access support, collaborate with their professionals and self manage at home after leaving hospital To improve people’s confidence, knowledge understanding and skills in accessing their out patient appointments, collaborating and sharing decisions with their healthcare professionals and safeguarding their safety and ability to self manage

The Programme Health literacy walk through an outpatient department from appointment letter to self management Meaningful communication before and after medical interventions Improving self management with high risk medication Understanding a complex condition Using Teach-Back at transitions of care Health literacy education for current and future healthcare professionals

Health Literacy Walkthrough: Paediatric Neurology

Meaningful communication before ....

....Meaningful communication after Medication reviews with respiratory patients at discharge from hospital

Managing anticoagulant therapy Review of Warfarin Yellow Book Review of anticoagulation information Exploring information media

Using Teach-Back to understand and manage complex conditions Supporting patients to understand and manage heart failure Embedding Teach-Back in practice with respiratory patients

Training for healthcare staff Training for healthcare staff teams in demonstrator programme clinical areas Working with University of Dundee School of Nursing and Health Sciences to include health literacy on the curriculum

Today is for sharing the learning Issues are not unique to NHS Tayside or to the clinical areas involved The Demonstrator has provided countless opportunities and has had a good deal of success ..... but It has also thrown us some challenges and limitations We have some solutions Health literacy work is still evolving Today is for sharing and learning