A strategic approach to health literacy

improvement

Julia Taylor, Director of Liverpool Healthy Cities

Emma Page, Senior Social Marketing Executive, Liverpool PCT

Scale of the inequalitychallenge in North WestHighest rate for:Deaths from heart disease and strokeDeath rate from suicide and injuries of undetermined intent in malesAlcohol related admissionsHospital admissions for depression, anxiety disorders and for schizophreniaSelf-reported violenceSecond highest rate for:Deaths from cancer and smoking related illnessLevel of binge drinkers Claiming incapacity benefits for mental and behavioural disordersReported level of feeling in poor health by the populationNine per cent (400,000 people) of the working-age population are on incapacity benefit, largely for preventable or manageable conditions

Building blocks to tackle health inequalitiesHealth and health equity in all local policy

• Political commitment, Leadership & Governance• Health and Equity Impact Assessment• Data, Social gradient (Asset Mapping)• Health Inequalities Strategy & Neighbourhood

Action Plans• City Wide Health Literacy programme• Resilience and Mental Wellbeing

 Health literacy at the heart of Healthy Cities Phase V development

Healthy urban environment and designHealthy urban planning.Housing and regeneration.Healthy transport.Climate change and public health emergencies.

Healthy living.Preventing non communicable diseasesLocal Health SystemsTobacco-free citiesAlcohol and drugsActive LivingHealthy food and dietViolence and injuriesHealthy settingsWellbeing & happiness

Caring and Supportive EnvironmentsBetter outcomes for all children.Age-friendly cities.Migrants and social inclusion.Active citizenship.Health and social servicesHealth Literacy

Health Literacy Domains 

Health systems Educational systems Media Marketplaces,Home & Community Workplace settings Policy making arenas  

 

HealthLiteracy

Where we need to act

Across the Life Course• Health Systems• Home Community (Pre natal, early years)• Education & lifelong learning• Workplace• Information Marketplaces (media)• Political- citizenship• Academic support –evidence ‘what works’

& ‘how to measure’

Where we are taking action• WHO Global Guide 1 & 2• Presented at UN High Level social committee• Leading WHO Healthy Cities sub- network on Health Literacy• Political Commitment• Health Inequalities Strategy –cross cutting theme• Neighbourhood integrated approach• Pre-natal and Early Years –needs further development• Reader Organisation Uni. of Liverpool & Libraries• Schools and adult learning• Health @ Work• Pharmacists• Primary Care Trust

118 LiverpoolYour Guide to being healthy, living well and finding help in LiverpoolGuide to everyday lifeLiving a healthy lifestyleStaying well

Do we need a strategy?

• Learning from scoping exercise published by the Health Improvement Strategy Division of Scottish Government…

– No clear or shared view of the meaning of health literacy

– Ideas underpinning health literacy are complex

– No appetite or requirement for health literacy strategy - pursuing separate strategy counterproductive

– Focus should be on integrating health literacy into existing areas of work

– Large and daunting agenda - important to focus on a limited set of priorities to begin with

Marketing(customer orientation)

SkillsStaff

Health literacy

improvement

Improving navigationof core health services

Core health services

999 / ambulance

A&E

GP

Pharmacies

Walk in centres

GP-led walk-inservice

GP out of hours(OOH)

NHS Direct

TRADITIONAL MODERN

Our aim

• Maximise number of instances when patients receive right care, in the right place and at the right time

• Focus on designing a simple system that guides patients to where they need to go

Research findings

• Almost 3 in 5 people say they know there are services other than their GP and A&E available, but not exactly what they offer

• Most patients who attend A&E ‘inappropriately’ do so because they don’t know about / understand / trust alternative services

Comprehensive service users

Modern service users

Uninformed traditionalists

Loyal traditionalists

Discontented unawares

25%

26%

16%

13%

20%

Research findings

• No central coordination of marketing - rely on service providers to promote services which has led to unclear and confusing messages

• Patients don’t drive communications: one-size-fits-all approach rather than needs and benefits driven targeted approach

• Compounded further by lack of staff knowledge and training to ensure consistent signposting

Our strategy

• Establish a protocol to coordinate and manage the marketing of core health services to ensure consistency and a long-term vision

• Develop a long-term marketing plan that is targeted and benefits-driven

• Train all NHS staff to act as service navigators and ambassadors for core health services

THANK YOUany questions?

julia.taylor@liverpoolpct.nhs.ukemma.page@liverpoolpct.nhs.uk