We have a special guest blog today – we’re joined by NHS Librarian colleagues from George Eliot Hospital NHS Trust, Rayanne and Lisa. You may have seen our monthly Twitter #HealthChats – since July last year, we’ve covered topics such as men’s health, children’s health and the importance of finding and using good quality health information.

Today, Rayanne and Lisa are covering the topic of Health Literacy so without further ado, we’ll hand over to them….

Hello it’s Rayanne and Lisa, your local NHS Librarians at George Eliot Hospital NHS Trust. We are really pleased to have been invited again to write about Health Literacy. We’re keen to raise awareness of how this issue affects us all as patients and carers, as well as the impact on our health services.

So…What is Health Literacy?

Health Literacy is about people having the knowledge, skills, understanding and confidence they need to be able to use healthcare information and services, so that they can be actively involved in their healthcare.

Health Literacy levels in England are very low with 43% of 16 to 65-year-olds having problems understanding written health information; and 61% of 16 to 65-year-olds having difficulties with health information that includes both text and numbers (Rowlands et al., 2015).

There’s quite a difference in Health Literacy levels nationally and within our own county of Warwickshire. Click below to see how your area compares.

Credit: University of Southampton and Health Education England (2020) Health Literacy. Available at: http://healthliteracy.geodata.uk/ (Accessed: 03 August 2021).

Why is Health Literacy important?

People with low Health Literacy may be more likely to miss appointments, misunderstand instructions on prescribed medication, miss key information about their healthcare, and make uninformed decisions.

For example, a 2011 survey estimated that 43% of people in England are unable to calculate paracetamol dosage for a child based on age and weight (Mayor, 2012).

Over the past 18 months, the pandemic has highlighted the extent of the health inequalities in our society. People with lower Health Literacy are more likely to have life limiting long term health conditions (HLS-EU Consortium, 2012) and make less healthy lifestyle choices (Buck and Frosini, 2012). There’s also a huge cost to the NHS- the estimate is that low Health Literacy costs 3-5% of the annual NHS budget (approximately £4-7 billion in 2019-2020​).

So better Health Literacy levels can help enhance quality of life, improve health outcomes and reduce costs for the NHS, and improving Health Literacy is something we can all help with.

Who needs to be aware of Health Literacy?

All of us but particularly those who are caring for others. All staff working in health and social care need an awareness of the signs of poor Health Literacy. Using tools that improve and check understanding are key to delivering effective care.

Organisations also have a responsibility to ensure that information is accessible, and that the healthcare environment doesn’t add to Health Literacy issues – for example, ensuring they use clear signage.

Resources to support Health Literacy

Accessible Information Standard – Information on the legal responsibility all NHS organisations have to provide appropriate information to people with disabilities.

Plain English Campaign – Provides advice on writing in an accessible way.

Patient Information Forum – Provides many useful guides, courses and links to reports.

Tools and Techniques to aid communication

Teach Back and Chunk & Check (available at The Heath Literacy Place – see below)

Teach-Back: A technique for clear communication– This YouTube video by North Western Melbourne Primary Health network introduces this technique to ensure that patients have understood what they have been told.

Health Literacy and Digital Literacy

The increasing use of the internet for banking, accessing local council and health services has implications for those who are not equipped to take advantage of technology, or are unwilling to do so. In 2018, 10% adults in the UK had either never used or rarely use the internet. (Office for National Statistics, 2018). It’s going to be important for people to develop their digital skills to enable them to manage their life and make decisions about their health.

Your local Warwickshire library can often help with this. There will be access to PCs (you may need to book in advance) and they may also run Silver Surfer sessions, providing support for people developing their online skills. Adult Community Learning in Warwickshire also run beginner’s digital courses throughout the year. You can find out more here.

Finding trustworthy information online

For those of us already online, there are some easy ways to improve our internet skills.

Ask yourself…Is this a reliable website? Many of us struggle to find health information you can trust when searching the internet. It’s tempting to dive into Google when you’ve received a diagnosis and are under stress.

Thankfully you can look out for two quality marks:

The HON code (Health On the Net Code) and the PIF tick (the Patient Information Forum tick) which covers UK information.

If the online document has either, it is a good indicator of a reliable health information source. Documents don’t get either unless they meet strict quality criteria.

You can also revisit our previous blog from July 2020 which has other advice for seeking out information online (though do bear in mind, it was written over a year ago).

Trusted websites for health information

NHS website

Information on conditions, treatments, local services and a healthy lifestyle.


Up to date health information for patients. This site has links to other approved information sources, support groups and health charities.

Health and Care Videos

Short and simple videos to help you and the people you care for.


Leading mental health charity with information on mental health conditions, drugs and treatments, support and patient stories. You can also find local information from Coventry and Warwickshire Mind.

Further Information about Health Literacy

Health Literacy Toolkit 

A collection of resources aimed at supporting the NHS to prevent ill health and reduce health inequalities through education and training of the health and care workforces.

Health Literacy Place

A website of health information and resources for Scotland.

Or feel free to contact Rayanne or Lisa at library@geh.nhs.uk

See you at the next #HealthChat.