• 25Nov

    Patient activation: report finds a lack of clinician support for independent information seeking

    Two reports have been published today by NHS England’s Person-centred Care Team relating to patient activation and the NHS England self-care/self-management programme. They aim to help to take forward the Five Year Forward View commitment to support people to manage their own health and care.

    Patient activation describes a person’s knowledge, skills and confidence to manage their own health and care. Clinicians have a vital role play in supporting patient activation.

    The first report shares the findings of a survey of over 1750 doctors, nurses and allied health professionals to understand their support for patients taking a more active role in their care, their beliefs and attitudes, and identifies their perceived barriers and training needs.

    This survey shows that clinicians vary significantly in their support for patient activation. A wide range of  scores were seen across the sample (36.4 to 100), demonstrating that some clinicians are more supportive of people taking an active role in their health and care, while others are less so.

    Clinician support for patient activation is not significantly affected by age, gender and region. However, clinician role does seem to have an impact, with nurses having the highest average score (75.9) compared to doctors (70.1) and allied health professionals (71.7).

    Clinicians are most likely to support those aspects of self-management that relate to a patient making behaviour and lifestyle changes in accordance with clinical advice.

    They are less likely to support people making independent judgements and taking independent actions when caring for themselves at home, or people functioning as a member of the care team.

    The report found that clinicians are least likely to support people being independent seekers of information.

    The full report can be read here.

    The second report, co-produced with the Health Foundation and Leicester University, provides early findings to support implementation of the Patient Activation Measure (PAM) across the NHS, which has been piloted with 5 CCGs.

    The early findings include:

    • Patient activation as being a positive force to help support changes towards delivering person centred and integrated services, helping to overcome systemic barriers and staff resistance to change.
    • Increased patient activation is seen as something that could have a positive impact on health care service utilisation, patients’ clinical outcomes, patient engagement, and patient experiences of care.
    • The point at which to record patient’s activation score must be carefully considered: for example, whether this is best linked to a particular event (such as an annual review or in relation to a change in treatment or health state) or determined by time since commencement and/or completion of an intervention.
    • How the PAM questionnaire will be delivered also needs to be thought through carefully: for example, whether it will be completed independently by the patient on paper or electronically, with the support of a healthcare professional or patient peer/advocate, over the telephone or in person.
    • Which healthcare professionals or other service providers will be responsible for administering the PAM and processing the data also needs thinking about.
    • How to deal with language issues and literacy was a common concern among the teams. Questions about the suitability of any available versions of the PAM for some community languages were discussed in all sites, with some sites considering how to ensure it could be used with the whole of their patient population

    The early evaluation report can be read here.