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Turning a challenge into an opportunity: Health literacy training for NHS knowledge and library service staff - Sue Robertson & Joanne Naughton

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Sue Robertson
Knowledge and Library
Services Development Lead
Health Education England
Email:
sue.robertson@hee.nhs.uk
Twi...

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www.hee.nhs.uk We work with partners to plan, recruit, educate and train the health
workforce.
Turning a challenge into an...

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www.hee.nhs.uk We work with partners to plan, recruit, educate and train the health workforce
Strategic Ambition
“NHS bodi...

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Turning a challenge into an opportunity: Health literacy training for NHS knowledge and library service staff - Sue Robertson & Joanne Naughton

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Presented at LILAC 2022

Presented at LILAC 2022

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Turning a challenge into an opportunity: Health literacy training for NHS knowledge and library service staff - Sue Robertson & Joanne Naughton

  1. 1. Sue Robertson Knowledge and Library Services Development Lead Health Education England Email: sue.robertson@hee.nhs.uk Twitter: @SueK4H Joanne Naughton Knowledge and Library Development Manager Health Education England Email: joanne.naughton@hee.nhs.uk Twitter: @JoanneStemp
  2. 2. www.hee.nhs.uk We work with partners to plan, recruit, educate and train the health workforce. Turning a challenge into an opportunity: Health literacy training for NHS knowledge and library service staff LILAC Conference April 11th 2022
  3. 3. www.hee.nhs.uk We work with partners to plan, recruit, educate and train the health workforce Strategic Ambition “NHS bodies, their staff, learners, patients, and the public use the right knowledge and evidence, at the right time, in the right place, enabling high quality decision-making, learning, research and innovation to achieve excellent healthcare and health improvement.” 3
  4. 4. www.hee.nhs.uk We work with partners to plan, recruit, educate and train the health workforce Equipping Knowledge and Library Specialists Skills: Health Education England has produced a suite of training resources to increase the awareness and skills of all. Most are delivered through NHS knowledge and library services staff. Resources: We have compiled data and developed resources for strategic targeting of health literacy interventions. Impact: Shared decision making (in line with NICE guidance) Skills for digital engagement with the public Tools for tackling inequalities 4 Libraries Connected and public libraries are excited about the potential of working with librarians and knowledge specialists in the NHS and other sectors to build on information literacy and improve health literacy in the general population.” Sue Ball MBE Staffordshire Libraries and Health Offer Lead, Libraries Connected
  5. 5. www.hee.nhs.uk We work with partners to plan, recruit, educate and train the health workforce 5 The expertise of knowledge and library staff supports the development of health literacy for patients, ensuring medical information is both understandable and patient- centred, allowing patients to make informed decisions about their care and thereby ensuring equality of access to healthcare.” Professor Liz Hughes MBE Deputy Medical Director, Health Education England “ Health information for NHS staff and patients NATIONAL RESOURCES AND TOOLS CASCADED TRAINING TRAINING LOCAL WORKFORCE
  6. 6. @NHS_HealthEdEng About the Programme
  7. 7. @NHS_HealthEdEng All change!
  8. 8. @NHS_HealthEdEng The Ups!
  9. 9. @NHS_HealthEdEng The Ups! Learning together and experimenting A wealth of free tools Wider access to training Accessible training Playing to our strengths Adaptable set of training resources
  10. 10. @NHS_HealthEdEng Learning Opportunities
  11. 11. @NHS_HealthEdEng Our Learning Technology issues Human issues: building empathy, distractions How people value virtual training Maintaining quality of virtual training
  12. 12. @NHS_HealthEdEng Moving Forward…
  13. 13. @NHS_HealthEdEng Health literacy: get to know the data in your area 13 Variation across England (% struggling words and numbers): Across Cheshire and Merseyside: Cheshire East: 54.36% Manchester: 72.76% Borough-level geodata commissioned by HEE from University of Southampton: http://healthliteracy.geodata.uk/
  14. 14. @NHS_HealthEdEng More information E-Learning for Healthcare https://www.e-lfh.org.uk/programmes/healthliteracy/ Health and Digital Literacy Partnership https://library.hee.nhs.uk/patient-information
  15. 15. www.hee.nhs.uk We work with partners to plan, recruit, educate and train the health workforce. Thank you for listening
  16. 16. Sue Robertson Knowledge and Library Services Development Lead Health Education England Email: sue.robertson@hee.nhs.uk Twitter: @SueK4H Joanne Naughton Knowledge and Library Development Manager Health Education England Email: joanne.naughton@hee.nhs.uk Twitter: @JoanneStemp

Editor's Notes

  • Sue

    Welcome.

    My name is Sue Robertson and with my colleague Joanne Naughton, we're going to talk about the training we deliver to improve health literacy.

    We work as part of the national Health Education England Knowledge and Library Team providing  strategic leadership for NHS knowledge and library services in England. We are also part of the Health Literacy and Patient Information workstream.

    Catherine McLaren can't be with us today. Catherine has worked with us to develop and deliver this training programme and we'd just like to acknowledge her contribution

    Turning a challenge into an opportunity is always, well, a significant challenge!!
    To make it happen, you need to be embedded in a clear, focused and flexible strategy.
    HEE expresses its strategic ambition through a framework called KfH like this:……..
  • Sue

    Read out the slide.

    To achieve that ambition, improving health literacy is obviously key: the more we all understand health, the more accurate and efficient our health systems will be to the benefit of everyone. We believe that one of the key drivers to effect that change is for Knowledge and Library specialists to champion health literacy, the skills it involves and the digital literacy skills which underpin it. Of course, for Knowledge and Library staff to do that, they first need the skills themselves and the confidence and passion to use them. So the health literacy programme we are describing today is specifically intended as an intervention to enhance the confidence and skills of Knowledge and Library staff in health literacy and patient information.
    In putting significant energy here, we are not alone. Indeed, we are surfing a wave of interest: There is a real buzz about health and digital literacy at the moment and that goes right across the health and care system.

    That is driven by a strong focus on the need to address health inequalities, which is of major national and global interest currently. Key to addressing inequality is ensuring that everyone has proper access to high quality health information.
    The whole issue has been magnified significantly by the pandemic which has also thrown up the importance of combatting misinformation; again providing quality information is key.
    The NHS Knowledge and Library Services have always engaged with this patient information agenda, but that has been given a serious boost by our strategic framework and its high-level ambition, first published in 2014 and reviewed in 2021.  



  • Sue

    The training included Awareness training and train the trainer programme, covering the impact of low health literacy both for the individual and the healthcare system. There is a strong emphasis on practical tools and techniques to improve everyone's health literacy

    HEE began rolling out this training  across England during 2019 in face-to-face and has continued to develop the programme after the closure of CHLF in 2020.

    Take up was strong and feedback was very positive.  There was a real sense of engagement among knowledge specialists because of the power of the practical tools to improve health literacy and ultimately help people to have control over their own health and well-being.

    Since that time, 264 knowledge and library specialists from across the NHS, Higher Education and Public libraries have attended health literacy training and we have 61 active trained trainers cascading this programme in the NHS.  We know that this training has now been cascaded to 300 NHS staff.

    You can see the kind of impacts that we are seeing from the slide but to do this well we need to work in partnership with others. We cannot do this alone whether it is 

    Shared decision making (in line with NICE guidance)
    Skills for digital engagement with the public
    Tools for tackling inequalities

  • Sue
    Key to this partnership working is the training that we offer across the wider NHS system


  • Joanne

    Let me give you a little more detail.
    We deliver 2 x 3 hour training sessions: one on health literacy awareness and one on Train the Trainer.
    Health Literacy Awareness:  
    In this session we cover:
    The impact of low health literacy: We explore the effect on the individual through sharing stories and examples of the impact of low health literacy affects treatment and lives. We explore examples of the healthcare system: both in terms of cost and the impact on the morale of staff and their time.
    We explore what health literacy is and how it fluctuates for all of us over our lifetimes depending on circumstances, our health and wellbeing and so on.  
    We also adapted the training to cover misinformation in relation to the pandemic. 
    We then move on to cover some tools which can be used by healthcare professionals to help people to improve their communication and health literacy e.g. teach back and chunk and check.  Throughout the session, we use a range of tools e.g. SLIDO, Ideaboardz and even role play in break out rooms to maintain interaction and participation.
    Train the Trainer: Focuses on delivery of the Royal Society for Public Health accredited training with some extra tools and techniques if trainers have more time.  This session views the materials from the point of view of the trainer so it involves thinking through how you would use an exercise or tool with a particular focus on virtual delivery and the type of tools that can be used.  Participants also have the chance to deliver a short health literacy training session and gain feedback from peers.
  • Joanne
    Prior to 2020, our health literacy training had all been in person and was a full day.
    In early 2020, the HEE Team were preparing a national health literacy event, to launch a new suite of health literacy training resources ranging from a 15 minute induction through to e-learning, to a one hour session accredited by the Royal Society for Public Health, alongside the 3 hour awareness and train the trainer sessions developed specifically for NHS KLS. In order to be inclusive, we had planned this event to be delivered virtually which was just as well as things turned out!
    We had over 100 people sign up to the conference and we learned some valuable, early lessons about virtual delivery.
    We did not realise at the time that virtual delivery would be our standard mode of delivery from that time onwards.

  • Joanne

    We started delivery at a time when virtual delivery was new to everyone, so it felt very much like learning together…

  • Joanne
    Attendance rocketed and was much more inclusive (a broader range of staff attending). Staff were dispersed – some working from home, some redeployed.
    An opportunity to experiment and our participants were interested in trying new tools e.g. SLIDO, Ideaboardz, padlet.
    We learned about how to exploit delivery tools to make training materials accessible
    Our skills were complementary: technical skills and knowledge of the content and delivery. Initially, we played to our strengths and then we took the opportunities to learn from each other.
    We have been able to cater for different learning styles and for accessibility requirements by providing slide set in advance so people have time to review. We also ask questions just before breaks to give reflection time.
    Once the materials were ready, we could adapt them and use them with new partners e.g. training for prison librarians, public librarians and other partners.
    Some tips on accessibility:
    Asking on the booking form if people have any specific requirements.
    Using Teams functionality to full effect: transcription; live captions.
    Ensuring that we send materials in advance so people have time to read and digest.
    Using accessibility functionality in powerpoint – including Alt Text to describe images.
    Being flexible about how we share materials e.g. Padlet or email.
    Reducing distractions e.g. blurring backgrounds, switching headphones but no one size fits all!



    Transcription: once enabled by the organiser, any participant should be able to view the transcription which is in near live time. A copy of the transcription is automatically generated for the organiser so need to let participants know if you are using it.
    Live captions: once enabled, any participant can switch on and the rest of the group won’t see the captions. Very useful as a back up during the meeting.


  • Joanne

    There were some challenges too. We wouldn’t describe the challenges as downs. We adapted and learned as did our participants. Our learning opportunities were their learning opportunities.
  • Joanne

    Technology barriers: some people couldn’t access Teams, some people were joining on phones, some people couldn’t access the resources we shared via Padlet so this was time consuming for our administrator and for us…
    Technical hitches – problems with break out rooms distracted from the content.
    Distractions and not being fully present: from home deliveries to people working on a desk with interruptions.
    Some of the relationship building, empathy was lost. Our original sessions were 1 day, we covered more exercises e.g. reviewing patient information and people built trust over the day – story telling session more effective face to face.
    Keeping pace with demand while maintaining the quality of delivery.
    Some people cancelled last minute: is it harder for people in the work environment to attend training? When you are away for the day, people manage without you and there are fewer distractions.
    How have we dealt with these issues:
    Technical issues have lessened over time as people and organisations come to grips with Teams. We initially delivered via Webex. We liked the interface as it was designed as a training interface but Teams became the standard interface in the NHS and the decision was taken to move to Teams for delivery which has worked well.
    Teams changes constantly so we always practice before every session. We do our best to minimise learning during a session, although this still does happen!
    Building empathy:
    For the awareness session, the groups are quite large so it is difficult to get to know each other. We have short icebreakers and we leave it up to participants to decide whether they want cameras on or off. We have experimented with having people introduce themselves in person and in the chat.
    We ask people to share stories and to role play during the training and we realise that these can be challenging so we put ourselves on the spot too. We always share stories before we ask others to and we also role play when we have the time.
    We have ground rules around respect and confidentiality to help people to feel more comfortable to share.
    We try to stay open minded and ready to adapt as we go.
  • Sue

    Exciting time to be involved in health literacy work.

    We have recently signed a national Health and Digital Literacy Partnership – working with CILIP, Libraries Connected and Arts Council England

    As part of this partnership we have 8 pilot projects, small-scale local projects where knowledge and library services are working together from different sectors to upskill local populations to improve their health and digital literacy.

    Digital literacy skills are key and underpin health literacy skills. We plan to have a stronger focus on digital literacy in our training programme going forward.

    In several of these projects  training is being cascaded widely to partners within and outside the NHS

    Expanding capacity to meet demand: planning to work with our trained trainers to meet the demand within NHS KLS and beyond.

    Training delivery for HEE is likely to remain virtual: the benefits in terms of access to training outweigh the negatives.

    We have delivered HLA training to  264 knowledge specialists and we now have 61 active trained trainers in the NHS.

    There is a strong demand for this training from the healthcare system (already mor than 300 trained) so we need to be responsive.  This year we have increased delivery to one session per month.
    We sense an opportunity.

    There is a thriving health literacy community of practice where resources and expertise are generously shared. The Community of Practice has a jiscmail discussion list which is very active and meets several times a year.

    As we said earlier, we aim to stay open minded and adaptable as the environment and training needs change.
  • Sue

    We would like to highlight a tool that you might find helpful when looking at local health and digital literacy in your area.  We know that health literacy levels are low in England from a research study led by Gill Rowlands which showed that  43% adults not understanding health information with words only and 61% where there are words and numbers.

    There are significant variations across the country as you can see from the slide.

    You can find out information for your local borough on healthliteracy.geodata.uk by either entering the name of your borough or looking at a map 

    Access to this data can help to provide a focus for local action planning on tackling health and digital literacy.
  • Sue

    If you want to learn more about health literacy then do try our E-Learning or if you want to find out more about our partnership and join us to ensure that everyone has the skills to have good healthcare conversations then let us know.


  • Sue

    Thank you for listening

    Please do ask any questions

    A new book on health librarianship is due to be published in 2023 by Faber. The book will cover a range of aspects of our work and roles. There will be a chapter on health literacy which will cover in more detail the impact of low health literacy and some key techniques to improve health literacy.

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