Patient Activation Measure

(PAM) evaluation

Patient Activation Measure (PAM) evaluationTimescale: November 2014 - February 2017

Funder: The Health Foundation and NHS England


‘Patient activation’ describes the skills, confidence and knowledge a person has in managing her/his own health and healthcare. The Patient Activation Measure (PAM) is a measurement scale of patient activation based on patients’ responses to questions. The resulting score from completion of the questionnaire places a patient at one of four levels of activation, each of which reveals insight into a range of health-related characteristics. Research has started to show how patient activation may be linked to health and health-related outcomes, and the PAM has been used in the USA to support the management of patients with long-term conditions. However, little is known about how this tool could best be implemented and used in the NHS context.

The research study

The PAM evaluation study aims to better understand the feasibility of using the PAM in the NHS by following the progress of a learning set (comprising five Clinical Commissioning Groups and one disease registry) using the PAM across a range of approaches to improving care and supporting self-management. The aims are to understand how the PAM is being used in practice and how its use develops over time, and to explore the impact of using the PAM in participating organisations at a range of organisational and individual levels. This qualitative study uses ethnographic methods including observation, interviews and documentary analysis.

Research team

Natalie ArmstrongDr Graham MartinCarolyn Tarrant - 2014Sarah Chew 2016
Professor Natalie Armstrong Professor Graham Martin Dr Carolyn Tarrant Dr Sarah Chew
Brad Manktelow
Brad Manktelow



Our final report has been completed and is available to download from the Leicester Research Archive. The final independent evaluation report looks at the experience of the six pilot sites and provides practical lessons and considerations for those who wish to use the PAM in their local areas.

More information is available in the SAPPHIRE News section of the website.


Report and other publications

There has been a lot of interest in this work and we have produced several reports and other publications as the project has progressed – these are shown below:

Invited talks and conference presentations

We have also given several invited talks and conference presentations about the project, these include:

  • Armstrong N, Brewster L, Chew S, Manktelow B, Martin G, Tarrant C. ‘Using the Patient Activation Measure in the UK: learning from early adopters’ Health Services Research UK, Nottingham, July 2016
  • Armstrong, N. ‘Using the Patient Activation Measure’ Resilience in Prescribing, Reading, June 2016
  • Armstrong N, Brewster L, Chew S, Manktelow B, Martin G, Tarrant C. ‘Using the Patient Activation Measure in UK primary care: learning from early adopters’ Trent Society for Academic Primary Care, Leicester, March 2016
  • Armstrong, N. ‘Using the Patient Activation Measure to deliver person-centred care: learning from national early adopters’ South West Academic Health Sciences Network, Exeter, January 2016
  • Armstrong, N. and Owen R. ‘Person-centred care and patient activation’ Nuffield Trust Evaluation of Complex Care 2015, London, June 2015

Publicity and blogs

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