Health Confidence (HCS)

Patients who are more confident in their ability to look after their own health tend to cost less and report better outcomes and experience than those who are not. The Health Confidence Score (HCS) monitors peoples’ confidence in their ability to manage their own health and engage with health and care providers.

The HCS is a short generic measure of patient confidence, with four items, rated on a scale from Strongly agree to Disagree:

  1. I know enough about my health (knowledge) covers what you know about your health, conditions, medication, investigations and treatment.
  2. I can look after my health (self-management) covers your perceived ability to manage your treatment, health and lifestyle, This includes perceived self-efficacy, motivation (reflective and automatic) and capabilities.
  3. I can get the right help if I need it (access) includes social proficiency to navigate and access health and care services that are most relevant to your needs.
  4. I am involved in decisions about me (involvement) covers participation in clinical decisions and how well staff understand your wishes, fears and beliefs.

The first two items address personal capability, while the second pair are influenced by provider engagement. All may be directly affected by the actions of health care providers and public health.

Health confidence is closely related to concepts such as empowerment, perceived self-efficacy, activation, engagement and health literacy.  It is influenced by case mix.  People with better health tend to report higher confidence.

The Health Confidence Score can be used both clinically or for evaluation. Clinically it can help tailor interventions to individual patients’ needs.  For evaluation, it is used to track how much a programme helps people to have more control over their own health.



Benson T, Bowman C, Potts HWW Development and validation of the Health Confidence Score. 2016