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Patient Activation Measures (PAM) 

The Patient Activation Measure (PAM) is a patient-reported measure that describes the knowledge, skills and confidence a person has in managing their own health care.

Through our PAM pilot, we are looking to establish how the process supports those working with patients/ residents.

The Five Year Forward View sets out the challenges and need to drive the necessary scale of transformation required to fund the needs of future patients in a sustainable way.

Through PAM we aim to support and close one of the three main gaps identified - health and wellbeing.

The challenge is to ensure organisations play their part in getting serious about prevention, reducing health inequalities and improving life expectancy across the local system.

We know that 60-70% of premature deaths are caused by behaviors that can be changed. When people start to feel in control they do many things differently.

Patient Activation as a concept can support those that have the knowledge, skills and confidence to manage their own health and health care.

People have varying degrees of levels of activation and in particular the 25-40% of the population with the lowest level of activation, are found to be the least likely to adopt healthy behaviors and access healthcare. Evidentially these patients with lower PAM scores have 8% higher cost than those more activated (Kings Fund 2014).

Patient Activation Measure

The Patient Activation Measure (PAM) is a measurement that assesses the knowledge, skills and confidence integral to managing one`s own health and healthcare.

The key to supporting `Patient Activation` is in determining where along the continuum the person is in levels of activation. Determining this at an early stage can ensure adequate support is put in place to optimise the active role they can play in staying healthy.

The way to determine levels of activation is through The Patient Activation Measure (PAM), a patient-reported measure that has been validated in the United Kingdom and is in use within Mid Sussex CCG.

Health professionals also need a paradigm shift from paternalistic care to “What’s important to me” and from provider as the expert to the patient as the expert in the room.

When activation changes, multiple behaviors change e.g. reduced smoking, weight loss, increased medication compliance, increased screening attendance, reduced A&E attendance, reduced hospital admissions. When people experience success their motivation improves.

Project Overall aim

The intention is to test PAM training on two differing groups of staff that could influence change through the use of PAM:

The first project will look at the use of PAM within a Housing Association (HA) environment looking to assess if the use of PAM would be effective within this setting and then to look at the practical use of PAM in a HA evaluating  the effect of training on its staff –

The second project will evaluate with the use of CS-PAM on a group of CCG clinicians following a series of training events.

Both projects are expected to be completed by March 2018

Project Objectives

• Support staff in Housing to encourage people in sheltered housing to be supported to maintain independent living and reduce the costs of visits to the GP or ED and reduce transfers to more expensive dependent living.
• Enhance the culture and behaviours of CCG Clinicians to use PAM in a way that ensures a positive shift in how patients are motivated to reduce further risk of falls.

Evaluating the project

Using the NHS Leadership Development Evaluation Framework (2016) an evaluation will determine if the use of PAM is appropriate within the Housing Association and, if so which staff cohort would be most beneficial to the organisation to train.
Within Crawley, Horsham & East Sussex CCG, the use of CS-PAM, which is the tool that helps demonstrate to what extent clinicians are supporting the principles of PAM and self-management, will evidence the impact that this has in their understanding, behaviours and approach.

For more information, or to find out how you can get involved or implement this in your area, please contact Ursula Clarke, Senior Programme Manager