Patient literacy challenge for doctors


For immediate release: Wednesday, 17 August 2011

Doctors face a growing challenge to ensure proper care is provided to patients with poor literacy skills.

With literacy levels being a significant barrier to achieving and maintaining patients’ good health, the UK-wide medical defence organisation MDDUS is advising members to ensure patients fully understand prescription instructions and advice given.

One in six people in the UK have a literacy level below that expected of an eleven year old. The figures are likely to be even more alarming with regards to health literacy, which is an individual’s ability to read, understand and use healthcare information to make decisions and follow instructions for treatment.

Doctors don’t expect patients to understand medical jargon, but how do they ensure that patients who lack basic reading skills are given proper care?

In some cases, it may seem clear the patient needs extra help, but MDDUS medical adviser Barry Parker acknowledges the signs aren’t always so obvious. He says: “From a health perspective, the first major issue for doctors is detection of literacy difficulties when dealing with a patient.

“Adults who struggle to read are often too embarrassed to disclose this, even in the confidential setting of a doctor’s consulting room. It’s also possible they have developed strategies to compensate for their difficulties, so they may not be immediately apparent.”

MDDUS urges doctors to look out for subtle signs that a patient may have literacy problems. “Doctors can only make allowances for literacy difficulties if they know they exist,” says Parker.

“However, they must remain vigilant to this possibility, particularly if patients appear to have difficulty completing forms in surgery or have unexpected problems explaining their symptoms or following written advice. Patients for whom English isn’t their first language may have similar troubles, but will be easier to identify and extra time can be taken to ensure the doctor is fully understood, with the help of an interpreter if necessary.”

Medical information is now increasingly presented to patients in written form – via leaflets or posters, thus creating further difficulties. “Where leaflets are used, they should be presented in the simplest format possible to assist those with literacy difficulties. It’s important to steer clear of medical jargon, keep key messages simple and avoid information overload,” adds Parker.

“There is a significant safety issue if the patient is asked to rely only on written information they cannot read or interpret. Where possible, instructions on how to take medication and potential side effects should be given verbally and supplemented with written material.”

In Wales, the government has addressed the growing problem of health literacy and how it affects patients’ wellbeing by commissioning a report which Public Health Wales has recently published. It finds that although health bodies are conscious of the need to use basic English in literature, it may not go far enough in reaching those with poorer reading skills. The report plans to save the NHS money while, more importantly, improving health outcomes.

GMC guidance Good Medical Practice states that doctors must “give patients the information they want or need in a way they can understand.”

The guidelines also highlights the need to “share with patients, in a way they can understand, the information they want or need to know about their condition, its likely progression, and the treatment options available to them, including associated risks and uncertainties. You must make sure, wherever practical, that arrangements are made to meet patients’ language and communication needs.”


For further information contact Richard Hendry on 0845 270 2034 or 07976 272266, or email

Note to editors

MDDUS (The Medical and Dental Defence Union of Scotland) is a medical and dental defence organisation providing access to professional indemnity and expert medico- and dento-legal advice for doctors, dentists and other healthcare professionals throughout the UK. For further information on MDDUS go to

This page was correct at the time of publication. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.

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