How has the context changed since Making it Easy?
Health literacy and the World Health Organization ( WHO) sustainable development goals ( SDGs)
- Improving health literacy levels is crucial for attaining the social, economic and environmental ambitions of the 2030 Agenda for Sustainable Development.
- Harnessing health literacy improves health and reduces health inequities.
Promoting health literacy, a key determinant of health
Source: Health literacy: applying current concepts to improve health services and reduce health inequalities ( www.ncbi.nlm.nih.gov/pubmed/26872738) R.W. Batterham, M. Hawkins , P.A. Collins , R. Buchbinder, R.H. Osborne
The World Health Organization ( WHO) set improving health literacy as a global priority for healthcare, disease prevention and health promotion at its 2016 Global Conference on Health Promotion  .
The two most recent annual reports from the Chief Medical Officer for Scotland, Realistic Medicine  and Realising Realistic Medicine  , highlighted improving health literacy as a vital area for progress within health and care.
Realising Realistic Medicine
Realistic Medicine proposes a change in culture and systems to move practitioners towards ‘focusing completely and relentlessly on what matters most to the people who look to them for care, support and treatment’. It marks a move further away from parental approaches, to a rebalanced connection between people and their practitioners with shared decision-making at its heart.
The Scottish Public Services Ombudsman ( SPSO), in a report on consent  , set out the role for health literacy in building a better understanding for both health and care workers and people using services. There is a key link to be made with work to support people at times when they struggle to communicate their views, for whatever reason. The SPSO report described the work to strengthen consent processes and increase people’s involvement in their health decisions. It drew upon real-life experiences to show how they should inform changes to policy and practice. It offered a checklist to help health and care workers evaluate whether a consent process is clear enough.
Following the report’s release, it became clear there is a need to produce equivalent supporting materials to guide patients too, and help them ask the right questions.
These need to be responsive  to people’s health literacy needs. These will be progressed as part of this action plan, drawing upon experiences in preparing people for conversations about their health and what matters to them. We will also consider whether this information should become a core part of appointment letters.
Achieving our ambition
In Scotland the challenge remains for us all to:
- make things easier, by removing barriers where we find them,
- make our services easier to navigate,
- make sure that health literacy needs inform the design of new services, and
- make our information more engaging and responsive to people’s needs, skills and preferred ways of interacting.
To achieve this we need to engage better with people no matter what skills they currently have. For any of us to be a lead partner in our care, we do not want to be held back by systems or words that are confusing or unclear. All health and care workers can help.
Some of the changes needed may be small but make a big impact; others need a longer-term shift in approach and mind-set. This plan will strengthen culture and practice based on a human rights approach founded on:
- equal access,
- shared decision-making, and
- people supported to live and die well on their own terms with the health conditions they have.
Supporting people to be in the driving seat of their health and care is widely known as self-management. A key element of support for self-management is ensuring that people have the skills to access, understand and engage with the systems and sources of support that keep them well. This challenge will be met through three action areas:
- Share the learning from Making it Easy.
- Embed ways to improve health literacy in policy and practice.
- Shift the culture by developing more health literacy responsive organisations and communities.
This will ensure we design supports and services that better meet people’s health literacy levels.