Why is the Patient Activation Measure so useful?

A Blog by Matt Evans, MSK Personalisation Project Manager for the It's All About People Personalisation Programme team

The Patient Activation Measure (PAM) is a way of understanding where a person is on their own health journey, so that health and care support can be tailored exactly to their needs. 

In Lincolnshire, we are using the Flourish system to implement patient activation assessments. Flourish consists of a set of 13 questions that, when answered, provide a score from 0 to 100.  

This indicates to health and care professionals how ready a person is to manage their own health and/or conditions based on their level of knowledge, competence and confidence. The score a person achieves determines which of four activation levels they are placed in (see diagram below). 

That’s not to say that everyone fits into one of four pigeonholes.

Instead, it is a way of thinking about people in four groups rather than just the one 'patient' label.

I think of it more like going shopping for new clothes. The same outcome (e.g. new jeans) are available in many sizes but I only want to spend my money on the ones that fit me and I draw upon my confidence and knowledge to select the most suitable style. It is a tailored approach.

Ideally, we'll support people to move up, within and through the PAM levels because the evidence shows that higher levels of activation results in improved health and lower healthcare costs.

Once we know what level a person is at, we start to think about what support they need to 'move up' to the next level. For example, it would be wasteful to overload a Level 1 person with fliers, intense time, and information. They are typically overwhelmed and not ready to engage in that level of complexity. Health Coaching might help them to better understand what changes they can make and therefore begin to change some behaviours.

Similarly, a Level 4 person doesn’t want to waste any time waiting. They are highly motivated so are likely to get on with administering their medication or taking part in specific exercises that have been set for them. They will not need a lot of intervention.

We often hear health and care colleagues say "We already work in a personalised way." But do they really understand how far personalisation can go?

We are keen to explore this and work out what resources are appropriate for the different levels of activation.

If you would like to get involved in this work, or want to find out more, don't hesitate to get in touch - email me at matthew.evans34@nhs.net. We'd love you to come on board!