Case study: Blackpool Teaching Hospitals NHS Foundation Trust
Blackpool Teaching Hospitals NHS Foundation Trust (BTH) provides acute and community care to a population of approximately 330,000 people across Blackpool, Fylde, and Wyre. The trust employs around 4,500 staff and delivers services primarily through Blackpool Victoria Hospital.
Blackpool is one of the most deprived areas in England, leading to significant health inequalities. The town has the lowest male life expectancy in the UK, at just over 73 years – around six years below the national average (Blackpool Council, 2025). High levels of unemployment, poor housing conditions, and prevalence of smoking, alcohol consumption, and obesity contribute to these health disparities. These inequalities result in a higher prevalence of long-term health conditions, such as cardiovascular disease, respiratory illnesses, and mental health disorders, placing increased demand on healthcare services (Blackpool Council, 2024).
Health literacy plays a crucial role in shaping health outcomes, particularly in areas of deprivation such as Blackpool. The literacy age in this area is lower than the national average, with only 53% of children achieving the expected standard in reading, writing, and maths, compared to the national average of 61% (Blackpool Council, 2025).
Initiative
BTH has developed its health literacy programme to address the challenges many patients face in understanding and engaging with healthcare. Recognising that low health literacy contributes to poorer health outcomes and wider health inequalities, the trust has made it a priority to integrate clear and effective communication. Embedding in the trust’s wider health inequalities work, the programme is overseen by the trust’s executive lead for health inequalities, executive medical director, Chris Barben.
Initially, the programme was shaped by a series of staff workshops held in November 2024, which identified key barriers and opportunities in improving patient communication. These discussions emphasised that enhancing health literacy is not only about simplifying information but requires a cultural shift in how staff communicate, support patients, and
embed health literacy into daily clinical practice.
As a result, the trust developed its ‘Five Towers of Health Literacy’, which outline its key commitments including:
- embedding health literacy in leadership and governance
- integrating it into patient safety and quality improvement
- ensuring staff are trained in effective communication techniques
- making written health information clearer and more accessible, and
- improving verbal communication through active listening and techniques such as ‘teach back’ to confirm patient understanding.
To ensure real and measurable change, the BTH established Specific, Measurable, Achievable, Relevant, and Time-Bound (SMART) objectives under each of these commitments and have compiled these in an organisational action plan, which aims to improve health literacy at every level of the organisation.
Training and workforce development are a core focus, with staff receiving training in patient-centred communication techniques such as active listening and plain language. A health literacy champions network is being established to embed best practice and ensure staff feel confident in supporting patients with low literacy levels.
Alongside workforce training, the trust is also working to improve written communication by reviewing patient correspondence, including appointment letters and discharge summaries, to make them clearer and more accessible. Readability tools, including AI-based support, are being used to ensure materials are written at an appropriate reading level.
Similarly, verbal communication is being enhanced through efforts to reduce the use of medical jargon, with staff encouraged to check patient understanding at regular intervals. Training in ‘teach back’, which has previously been taught mainly to junior doctors, is being expanded across all departments to become a standard approach in clinical interactions.
Recognising that physical and digital navigation can also be barriers to healthcare access, BTH is reviewing its hospital signage and wayfinding systems to make navigation easier for patients. Efforts are being made to rename departments using patient-friendly language and to simplify on-site maps and signposting. In addition to these practical changes, BTH is also addressing systemic challenges by streamlining internal processes, reducing bureaucratic barriers to change, and prioritising patient feedback in designing and refining its health literacy initiatives.
Evaluation and impact
The trust is actively evaluating the success of its health literacy work to ensure it is meeting its objectives and making a measurable impact on both staff and patients.
The programme’s progress is being assessed through patient feedback, staff engagement, and key performance indicators. One of the primary methods of evaluation is the collection of patient-reported understanding of healthcare information. Patient surveys and structured feedback mechanisms are being used to measure whether individuals feel more confident in managing their health, attending appointments, and adhering to medical advice. Additionally, BTH is tracking hospital readmission rates as an indicator of whether improved communication is reducing misunderstandings that lead to unnecessary repeat visits.
From an operational standpoint, staff engagement and training uptake are key indicators of success. Early feedback from staff indicates that those who have received training feel more confident in explaining health information and checking patient understanding.
Initial findings from case studies within the trust are already demonstrating positive outcomes. In the nutrition and dietetics department, simplified dietary advice and clearer patient resources for lowered reading ages have led to improved adherence to nutritional guidelines. In bereavement services, a focus on compassionate and jargon-free communication has helped families better navigate the end-of-life process. The trust is currently producing videos for bereavement advice, to complement written communications. Further evaluation is ongoing in areas such as the ophthalmic surgery unit, where efforts are being made to improve patient preparedness for surgery through clearer written and verbal communication.
Efforts to rename departments in more patient-friendly terms, improve map clarity, and simplify appointment letters have been well received, with ongoing data collection assessing the extent to which these changes are reducing patient confusion.
While the initiative’s progress has demonstrated early results, BTH acknowledges the programme is in its early stages and challenges remain, particularly in embedding health literacy principles into long-term operational structures. Barriers such as workforce pressures, staff time constraints, and historical reliance on complex medical terminology continue to be addressed through ongoing training, process streamlining, and cultural change initiatives. To ensure continued success, the trust is prioritising leadership accountability, staff motivation, and patient co-production, ensuring that future interventions are guided by the experiences of patients.