Health literacy and patient information

Library and Knowledge Service: Health Literacy Team

Contact name: Lorna Dawson

Contact email: [email protected]

Date completed: January 2023

Short summary of the initiative/project

South Tyneside and Sunderland is one of the most deprived areas in the country. People living in deprived areas are likely to have lower health literacy and reading levels. It is estimated that the local reading age is around 9 to 11 years old.

South Tyneside and Sunderland NHS Foundation Trust has over 900 patient information leaflets. These are given to patients but many are written at a higher reading age than 9 to 11 years old. This means it is hard for local people to understand and be involved in their health.

This project aims to improve the reading age of the leaflets given to patients.

This project aims to:

check the reading age of the leaflets

change the reading age of the leaflets

make sure new leaflets are written at a reading age of 9-11

How did you get started?  Any tips to share?

Before I started, the Consultant in Public Health spent 2 years advocating for health literacy work in the Trust. This involved explaining to senior leadership what health literacy is, why it is important, and how it underpins work around health inequalities that the Trust is already doing.

With senior leadership backing, the Consultant in Public Health and Project Management Lead secured funding for a small health literacy team to do a project around changing the reading age of patient information in the Trust.

The Trust produces a lot of different patient information and the funding was time limited. It was important to choose what information to focus on. Staff were least resistant to the idea of changing patient leaflets so these were chosen as the focus of the health literacy intervention.

Tips

It really helps to have senior leadership in board. This can take time. Explaining how it underpins health inequalities is helpful as this is a priority for a lot of Trusts.

What really clicked with senior leadership was the idea of reading age. The national reading age is 9 to 11. The Trust was sending information that was clearly not written at that level. This was a lot of money in terms of paper. It was also something the Trust could do something about.

Health literacy can cover so many different things – signage, upskilling patients, changing letters, changing leaflets. It’s easy to get spread too thin trying to do too much. Choose a focussed project which can show a clear ‘before and after’. Be clear and firm around the scope and limits of your project because people will ask you to go beyond them.

Who did you work with?

Consultant in Public Health

Project Management Office

Senior Leadership

Clinical Governance

Library Services

Communications and Engagement Team

Equality and Diversity Team

What happened? 

To change the patient information leaflets, the first step was to get health literacy staff in place. Then we needed to take a baseline measure of the leaflets. This meant we could have before and after measures to show the difference the project had made. We had to decide what the before and after measures would be. We chose numerical data such as reading grade and number of pages. This is because senior leadership understood the concept of reading grades. Number of pages could be used for a cost analysis. We took the baseline measure of all the leaflets. This is where we are at at the moment.

At the same time, we have been spreading the message of health literacy in the Trust. The Consultant in Public Health and Project Management Lead have continued to reinforce the importance of health literacy. The health literacy team ‘launched’ in October. There is an intranet page with tips and links. This has created a real interest in health literacy across the Trust. This means that, when the team start making changes, they are more likely to be accepted.

What next?

We’ll be sharing the results of the audit with the Trust. This will warm people up for the next stage of the project which is making changes to the leaflets.

We’ll be changing the reading grade of the leaflets that need it. This is a really big task. It not only involves changing the leaflets, but weaving it into the current leaflet process, and recommending changes sensitively but firmly. This will take a significant amount of time but will be a real achievement when it is done. It will also mean we will have delivered a coherent health literacy intervention with demonstrable results.

Alongside this, we’ll be developing support guides, pages and training. We want to embed health literacy into the everyday running of the Trust. We want everyone to be able to write for a reading age of 9 to 11, not just a specific team. Developing support will hopefully help us achieve this. It will also mean that there is support for new leaflets to be written at a reading age of 9 to 11 going forward.

Although the project is fixed term, we’d like the health literacy team to be part of the Trust for longer. There is scope for us to have input on lots of different types of information. So we’re also looking at changing other types of information as examples of what we could move onto after leaflets.