In this paper, I use a social practices view of literacy to challenge dominant conceptions of health literacy. Health literacy is frequently defined as an abstract skill that can be measured through individual performance tests. The concept of health literacy as a skill neglects the contextual nature of reading and writing in health care settings. It risks ignoring the many ways in which patients access and comprehend health information, make sense of their experience and the resources they draw on. The paper presents findings from a study of forty five literacy and ESOL (English for Speakers of Other Languages) students’ health-related reading and writing practices in the north-west of England. I suggest that health literacy needs to be understood as a situated social practice and that it is a shared resource frequently achieved collectively by groups of people, for example families. I conclude with some reflections on the implications of my research for adult education practice.