The financial case and enhancing productivity

Low health literacy rates are associated with higher financial costs to trusts. It is estimated to account for 5% of national health spending, owing to the interrelation between health literacy and unhealthy lifestyles, low uptake of preventative initiatives (vaccinations and screening), incorrect or inappropriate use of medications, increased hospital use, and reduced life expectancy (NHSE, 2022a). Low levels of health literacy are linked to poorer self-management of health and conditions, which is in turn related to higher overall healthcare costs (Public Health England, 2015). Health literacy is related to patient education and understanding of when and how to appropriately use healthcare services. Research into whether health literacy interventions impact on the use of primary care and emergency services has been mixed, but shows an overall potential to reduce use of services (O’Cathain et al, 2022). Research from Healthwatch (2018) has found that costly emergency readmissions to hospital could be avoided if patients were provided with better communication and support at the point of discharge.

Tackling health literacy can therefore lead to productivity and efficiency benefits for trusts, as it has an indirect impact on improving patient flow and reducing overall pressure on healthcare services (NHSE and Health Literacy Matters, 2024). There is also emerging evidence that health literacy interventions contribute to reducing waiting lists and Did Not Attend (DNA) rates by providing accessible information to enable patients to attend appointments, alongside improving medical compliance (NHSE and Health Literacy Matters, 2024) – although further work is required at the trust level to better link the outcome data.

Reducing waiting times is a key operational priority for trusts, with a target of 65% of patients to be waiting less than 18 weeks over 2025/26 (NHSE, 2025b). Alongside this, there are expectations for trusts and systems to reduce health inequalities as part of their broader elective care reform (NHSE, 2025c). We know that many trusts are actively implementing inclusive approaches to backlog recovery and supporting patients, alongside partners in primary care, while they are waiting for care. Efforts to improve health literacy could be more embedded within these approaches, to increase the chances of patients managing their own care, ‘waiting well’ and reducing unnecessary appointments – unlocking another potential saving.

There are also predictions that reducing the size and complexity of written resources could potentially save organisations financial costs related to printing or other communications related costs.

Trusts could play an important role in enhancing the evidence base on the impact of health literacy interventions on boosting productivity, by ensuring that any evaluation of interventions considers the impact on wider operational priorities such as healthcare use, reducing waiting lists and DNA rates and any other associated financial savings.