The Health Literacy National Demonstration Site – What did we do The Health Literacy National Demonstration Site – What did we do? 7th February 2018 Mandy Wardle-McLeish CEO, Community Health and Learning Foundation Surfraz Ahmed, Policy Officer, NHS England

What did we do? Health Literacy Awareness Training delivered to 239 staff across multiple key, organisations ,including Public Health, Voluntary Sector, NHS (GPs and hospital staff), Fire Service, Social Care 57 staff trained in improving community health and wellbeing Delivery of the national evidence based health literacy programme to 56 people with low health literacy, living with Type 2 Diabetes and not managing it effectively

Impact of low health literacy More likely to experience poor health outcomes More likely not to turn up for appointments Less able to follow medication instructions Are unable to explain their symptoms in detail Don’t understand how to use services appropriately Have lower response to screening and prevention programmes

Health literacy is a two sided coin Personal Health Literacy is about people having the skills, knowledge and confidence they need to be able to make decisions about their health and wellbeing;People with the lowest levels of language, literacy and numeracy are the people who suffer the poorest health outcomes in society. Societal It is also about how well information is provided to people and how well services are set up to ensure that they can be accessed, understood, appraised and used by everyone who needs them.

To improve Health Literacy we need to… Work with individuals and communities to ensure their skills are as good as they can be to help them manage their health and wellbeing; Ensure the information and services we are offering are designed to be able to be accessed by everyone, including and especially people with low skills.

Participants undertaking HLA training will: have an understanding of health literacy understand what low health literacy looks and feels like Understand the relevance of health literacy to their role be familiar with tools and techniques that they can use in practice

Outcomes for Practitioners A greater understanding of health literacy and the impact of low health literacy on service users Improvement in practitioners knowledge about the services they could refer/signpost service users to Awareness of and greater confidence in using a range of evidence based simplified communication techniques such as Teachback and SMOG and how to use them

What Changed? Practitioners 87% of participants identified potential changes they would make to their practice because of attending the course Particularly incorporating the practical approaches taught as part of the session eg Teachback/Chunk and Check Knowledge of referral/signposting routes

‘I will be able to put the training into practice Practitioners said…. ‘Has given me confidence to actually discuss these issue sensitively, allowing me to support people effectively’. ‘Really made me "experience" how it would feel to have low levels of literacy’. ‘I will be able to put the training into practice. e confidence to actually discuss these issue sensitively, allowing me to support people effectively’ ‘Really made me "experience" how it would feel to have low levels of literacy’ ‘I will be able to put the training into practice

What does low health literacy feel like…. A chance to see it from the other side. A practical experience. What will I do now…l to have low levels of literacy’ ‘I will be able to put the training into practice

Thinking about this how has it impacted on your practice. Think of examples of when you may have encountered or have had to ( should)take into account low health literacy issues within your role.

The Health Literacy National Demonstration Site – What did we do The Health Literacy National Demonstration Site – What did we do? 7th February 2018 Mandy Wardle-McLeish CEO, Community Health and Learning Foundation Jonathan Berry, Health Literacy Policy Lead, NHS England Maxine Dennis, Operations Director CHLF

What did we do? Health Literacy Awareness Training delivered to 239 staff in various organisations : the main ones being Public Health, Voluntary Sector, NHS (GPs and hospital staff), Fire Service, Social Care 57 staff trained in improving community health and wellbeing Delivery of the national evidence based health literacy programme, Skilled for Health to 56 people with low health literacy, living with Type 2 Diabetes and not managing it effectively

Outcomes for People Increased knowledge and confidence in 4 key areas: Leading a healthier lifestyle Ability to self-manage Medication management Accessing the right service

What Changed? People 97% of participants said they had made changes to their lifestyle following the course. The biggest changes in lifestyle behaviour were: Eating a healthier diet (39%) Exercising more (23%) Reducing sugar intake (13%) At the beginning of the course 45% stated that they sometimes forgot to take their medication. This had reduced to 28% at the end of the course

A Case Study-James I took the portion size handout to work and photocopied it for everyone! They couldn’t believe it’

James Newly diagnosed with Type 2 diabetes James is just about to retire from a physical job. He eats large portions of food frequently throughout the day. A little overweight, James was keen to ensure that potential health issues caused by weight and diet didn’t impact on a happy and healthy retirement James was struggling with a number of issues related to his diabetes, including: managing blood sugar levels feeling generally unwell being constantly thirsty suffering frequent headaches. James’ GP referred him to a local Skilled for Health course to help him to self care more effectively without needing to rely on a lot of medication – one of James’ expressed wishes.

What difference did the course make? James loved the course, finding the fun, interactive style and topics very interesting. James said the course had vastly improved his knowledge of portion sizes, hidden sugars, and how to interpret food labels. Using his new knowledge, he has taken steps to control the hidden salt and sugar in his diet; making simple swaps; and regularly batch cooking/freezing. The biggest shock for James was the portion size information. He has shared what he learnt with his co-workers: “I took the portion size handout to work and photocopied it for everyone! They couldn’t believe it!”

Impact on James Significantly reduced his blood sugar levels Lost half a stone He reports generally feeling ‘much better‘ and is determined to continue implementing the healthy changes that he learnt about

What is Skilled for Health National evidence based resources which bring together health; literacy and numeracy. A programme which can be tailored to audiences’ needs and which covers healthy lifestyles, services and self management Empowers individuals and communities to improve and protect their own health and wellbeing Currently being updated by CHLF Opportunity to try Skilled for Health