At this stage in the review you are ready to:


  • develop a draft Health Literacy Action Plan
  • consult with stakeholders
  • confirm ownership of the Plan
  • implement and monitor the Plan.


Section 4 of the Guide will take you through these activities.


Developing the plan


A Health Literacy Action Plan describes the service improvements you plan to make in the short, medium and long-term, following a health literacy review.


When you develop the plan, you'll need to work with service delivery teams to figure out how to best approach the changes to be made.


In this video, DHBs and primary care practices share advice about what to put in a Health Literacy Action Plan and how to engage staff in developing the plan.

Video transcript

Christine McKay (Portfolio Manager, Oral Health & Child Health, CMDHB):

I think for any other DHB or any health provider to develop a Health Literacy Action Plan, you really need to understand why you want to do this. And of course you want to do it so that your consumers are actually more engaged in their own health, their decision-making and the way they navigate health services and that’s a prime reason, but part of it is quality of service and being able to enable staff to communicate better. This doesn’t mean about talking more or doing lots more pamphlets. It’s about the quality of the conversation.

Benedict Hefford (Director Primary Health & Community Services, CMDHB):

The key thing about a plan like this is to make it practical. You know, start with the willing and they’re kind of early adopters if you want to use that sort of language. Identify the longer term systemic issues but actually they are going to take a long time to address as well. So where are the quick wins, where’s the short term actions that can be put in place to improve things right now because that gives a bit of momentum.

The other thing is making sure that that plan has got quite tangible timeframes, actions, who’s responsible, who’s going to do it. It’s a bit like any kind of project or service improvement process. If it’s clear what’s going to happen and when and who’s going to do that, then you’re much more likely to get some traction on change on the ground.

Cheryl Goodyer (Manager, Capability, Māori Health Development Group, CCDHB):

Understanding the audience. Having worked in this organisation for a while, I can appreciate how many staff we have and how busy people are. It is always people’s intention to improve what we do for our patients and their whānau, so appreciating that we needed to engage the stakeholders that were involved.

We really needed to have a short, sharp engagement, so putting the findings of the report at the beginning of the action plan meant that we could give them the information upfront and hopefully use it as a time-saver, and then they were able to look further into the report for more information.

Dr Chris Reid (Clinical Leader, GP, Kerikeri Medical Centre):

Think of something fairly simple like you want to improve, get a team approach to it, involve the patients and see where in the chain of care you give in terms of the information where you could perhaps improve.

Margie Apa (Director Strategic Development, CMDHB):

I think the guides that are – and the guidance that’s been developed by the Ministry – are really important and very useful. Very important for people to understand these are tried and true methods and to take those lessons away, so use the information available, but also really critical for people to think about health literacy reviews as not just about improving services or a quality improvement exercise, this is also about actually changing the culture or the way that a team works.

To be truly open to the insights that the review offers and for patients to really benefit from the experiences of the review – actually teams will change and you’ve got to be prepared to change the way you do the way you do things and it is a culture shift.

[Logos: Ministry of Health and Workbase.]

Implementing the plan


In this video, the DHBs, primary health care organisation and services talk about getting buy-in to the Action Plan and what they have learned.

Video transcript

Cheryl Goodyer (Manager, Capability, Māori Health Development Group, CCDHB):

Initially when we set up the project we had quite an active role in doing the review and writing up the findings, organising the meetings and keeping the stakeholders engaged. In moving forward we’re hoping that the individual groups will take a more active role and we will be able to step back and just help keep it moving and provide some additional support.

Melissa Peterson (Prevention Nurse, Ti Hiku Hauora):

So in our practice, as part of the health literacy action plan, my role is going to be the health literacy coach. A lot of our health professionals in our practice already know some health literacy so as part of that action plan we want to increase everyone’s health literacy knowledge so that they can then increase the knowledge of our patients.

So as a health literacy coach what I’ll be doing is observing our health professionals whilst they’re in a consultation with their patients and then giving feedback as to what they did really well and what areas that there could be improvement on.

Dr Chris Reid (Clinical Leader, GP, Kerikeri Medical Centre):

Be flexible, keep talking about it, be prepared to change your ideas, and be prepared to listen to the patients and their suggestions. It can be difficult to change your thought processes if you think you’ve been doing something right, but actually just for a small – sometimes just a small degree of change you can get the patients onboard a lot more.

John Wigglesworth (Chief Executive Officer, Hokianga Health):

I think small steps at a time. It’s a continuous quality improvement journey. There’s not actually an end point. It’s an ongoing process so small steps, education programmes for your clinicians, self-review, encouragement of self-review, encouragement of supervision for clinicians so that they can reflect on their own practice.

There’s a whole range of methods that you can use and processes. But I think a key advice or tip is take it easy, a step at the time. Know where you’re going and just keep focusing on that.

Rose Lightfoot (Chief Executive Officer, Te Tai Tokerau PHO):

The 3 practices involved in the pilot, the health literacy pilot, we were really lucky to have 3 quite different models that were being implemented in those different settings. So the value for the PHO is that we can take the learnings and the insights from each of those 3 different sites because they’ll be applicable to similar practices elsewhere.

Like there’s not 1 model of care, there’s a whole variety of models of care. And the learnings and the skills and the expertise that have come out of this process for those 3 pilot sites will be applicable in some degree, so we can use the learnings in other settings and help people. And I think it would always be there that we can buddy practices as well so that those who have been through the process already can share their experience with similar practices and help them on their way.

[Logos: Ministry of Health and Workbase.]

Examples of Health Literacy Action Plans


The District Health Boards (DHBS, prior to the 2022 health reforms) and primary care practices who trialled the Guide have shared their Health Literacy Action Plans so that you can see what the finished product might look like.


DHB plans



Primary care practice plans