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Long Term Conditions Collaborative: Making the Connections - Food For Thought



1 in 5 people in Scotland experience difficulties with reading, writing and numbers. These difficulties impact on people's health and on their ability to access and act upon health information (New Light on Adult Literacy in Scotland (Scottish Government 2008))

Tips for Practice

Tips for Practice

Good quality information uses:

Poor quality information has:

  • easy to read font and type size
  • simple, non-clinical language
  • appropriate headings and sub-headings to guide readers
  • personal experiences or examples that readers can relate to
  • visual images that reinforce text
  • information on how to get further help
  • dense text
  • no visuals
  • fussy design
  • misleading or unclear headings
  • too much information
  • information not presented in a logical order
  • no explanation of technical terms or uncommon words

Visit Adult Literacies Online to see a guide on how to make your writing easier to read.

Here are some things you can say and do to help

Let me show you

Demonstrate what you want the person to do and get them to demonstrate that back. Use simple diagrams or models that explain conditions or treatments. Talk them through and give them the material to take home.

Tell me what you have been told so far

Ask people to tell you what they understand about their condition or treatment. This helps you to know how much they have been told already, how much they have taken in and how much more you need to explain.

Talk me through what you will do at home

This is the "teach back" method. Let people feel that you are just checking that you have explained things clearly. If there is any confusion or misunderstanding you have the chance to clarify instructions, perhaps rephrase them, offer checklists or diagrams and to reinforce the most important points.

Would you like someone to go over that with you?

Sometimes people need to repeat or practise things before they feel confident. Who else could support them to do this? Health outcomes are more positive if people leave with accurate information, confident that they know what to do and why they are doing it.

Sometimes people will have difficulties understanding information because English is not their first language. In this situation you can ask them if they need the help of an interpreter or if they would like material in translation. Other people may have additional barriers to understanding you or expressing themselves due to a sensory impairment or a disability (including a learning disability or many conditions such as stroke, dementia, dyslexia and so forth). In this situation, you can ask them what additional support would help them communicate more effectively.

Lots of people have similar problems with reading and writing. There are people who can help you

If you think that someone would benefit from adult learning and it would be appropriate to do something about that now, talk about local learning opportunities. Encouragement from someone they trust can be just the motivator people need to get started. Ask if they have seen any of the Big Plus advertisements on television. If they have, you can help them to relate to the people and situations depicted. The Big Plus helpline will put you in touch with your local contact for literacies provision.

There are people who can give you the information and support you need

Signpost people to the relevant voluntary organisations who provide accessible information and can spend time helping people to understand the information so they are supported to manage their condition and make lifestyle and behaviour choices.

Ask me 3?

This approach, adopted by the US National Patient Safety Foundation, encourages patients to ensure that they have the answers to these three questions at the end of every health consultation. It is good health literacy practice to check that people have the answers to the three questions and have understood these.

What's my main problem?

What do I need to do?

Why is it important for me to do this?

Many of our patients face difficulties in communicating with healthcare staff as a consequence of language and other communication barriers. NHS Health Scotland is working with NHS Boards to implement in partnership, a translation, interpreting and communication support ( TICS) strategy. This will improve quality and service delivery for interpreting in community languages including BSL (British Sign Language). This covers face to face, telephone and online (for BSL). Communications work is also underway with many other partners to create an improvement plan for communication to support people with other communication difficulties (which may arise for example from brain injuries or learning disabilities). As service improvements are made, Health Scotland will be working on training and communications to build staff awareness and skills in caring for people with language and communication support needs.

Food For Thought:

  • Do you know your local contact for health literacy, advice and training?
  • Do you signpost people to the relevant voluntary organisations who can provide support in this area?
  • Do you know how to access the TICS resource?