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

2. 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

3. 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

4. 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

5. (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

6. 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

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

10. 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

11. 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

12. Health Literacy Walkthrough: Paediatric Neurology

13. Meaningful communication before ....

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

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

16. 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

17. 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

18. 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