Chief Allied Health Professions Officer’s Conference 2016 Workshop 4: Supporting self-care and behaviour change – Chair Linda Hindle Health Coaching. Trudi Dunn and Nina Finlay, Health Coaching Trainers/ Clinical Specialist Physiotherapists, West Suffolk NHS Foundation Trust

1. Health Coaching for
patient centred care and
behaviour change
Trudi Dunn & Nina Finlay
Health Coaching Trainers
Clinical Specialist Physiotherapists
West Suffolk NHS Foundation Trust

2. www.hee.nhs.ukwww.eoeleadership.nhs.uk/healthcoaching
What we’re going to cover
1. Why health coaching?
2. What is health coaching?
3. The EoE project
4. The West Suffolk Hospital Experience
5. Top tips
2

3. www.hee.nhs.ukwww.eoeleadership.nhs.uk/healthcoaching
NHS aspiration includes helping
patients take responsibility
• NHS Constitution
• Renewable Energy –
sustainability
• Cost savings

4. www.hee.nhs.ukwww.eoeleadership.nhs.uk/healthcoaching
This is becoming more urgent
- our growing long term condition challenge
• Lifestyle causation
• Multiple comorbidity
• Age and poverty related
• Unaffordable

5. www.hee.nhs.ukwww.eoeleadership.nhs.uk/healthcoaching
The impact is overwhelming

6. www.hee.nhs.ukwww.eoeleadership.nhs.uk/healthcoaching
Our current approach isn’t
working
• Clinicians are not trained in the science of
behaviour change
• Low levels of patient understanding,
compliance and behaviour change
• Alignment between what patients want and
what is provided is poor - goals, treatment
choices, shared decision making
• Poor communication e.g. introductions,
interruptions and complaints
• Paternalism breeds dependency… and
increasingly affects patient satisfaction
• Bennett H, Coleman E, Parry C, Bodenheimer, 2010
• GMC Annual report 2013,
• Rhoades DR, Fam Med 2001.
• Wolever R, 2013
• Coulter A, 2011
• KPMG Creating value with patients, carers and
communities 2014

7. www.hee.nhs.ukwww.eoeleadership.nhs.uk/healthcoaching
Health Coaching – What is it?
Health Coaching is talking to people with LTCs in a way that
supports & empowers them to
 better manage their own care
 fulfil their self-identified health goals
 improve their quality of life
 move away from a dependent model of care

8. www.hee.nhs.ukwww.eoeleadership.nhs.uk/healthcoaching
Health Coaching - East of England
• HEEoE
• Dr Penny Newman
− Medical Director NCH&C
− Clinical lead for HC HEEoE
• Dr Andrew McDowell
− Psychologist
− The Performance Coach
• 800 clinicians
• 20 accredited trainers in EoE
• 1of 6 centres nationally
NHS Innovation Accelerator
Fellowship - 2015

9. www.hee.nhs.ukwww.eoeleadership.nhs.uk/healthcoaching
Reported benefits Patients
• ↑ motivation to change
• ↑ satisfaction
• Improved health/outcome
Clinicians
• ↑ effective consultations
• ↑ resilience & job satisfaction
• Use with colleagues and others
Organisation
• ↑ quality of care
• ↓ complaints
• Meet strategic priorities
• Improve multidisciplinary working
• Impact on utilisation, costs and outcomes

10. www.hee.nhs.ukwww.eoeleadership.nhs.uk/healthcoaching
West Suffolk Hospital Health
Coaching Programme
Business case to trust board
Formal sign off
Extensive marketing
Administration
Organise CPD
Evaluation
Report on outcomes

11. www.hee.nhs.ukwww.eoeleadership.nhs.uk/healthcoaching
Requires clinicians to be open
to change
• Recognise the need for change
• Learned behaviour hard to change
• Requires complex interpersonal skills
• Time pressures
• Using a coaching approach when colleagues are not
• Contra cultural – very different from biomedical model

12. www.hee.nhs.ukwww.eoeleadership.nhs.uk/healthcoaching
Clinician feedback post training
• 94% strong or very strong
Mind set shift amongst those
trained
• 97% likely or extremely likely
Likely to recommend training
to others
• 100% agree or strongly agree
Coaching helpful for working
with patients with LTCs
• 100% agree or strongly agree
Health Coaching encourages
greater responsibility & self-
management
• 100% agree or strongly agree
HCPs would benefit from learning
something about using coaching
with patients

13. www.hee.nhs.ukwww.eoeleadership.nhs.uk/healthcoaching
Clinician reported benefits post
clinical application of HC
Clinician
feedback
6 weeks
post
training
↑
Empowerment
Improved
listening skills
↑ patient
involvement
Improved
communication
skills
↑ adherence
to treatmentPromotes
self
management
↑
Motivation
Improved
patient
experience
Facilitating not
telling
↑ confidence
on discharge
Shared decision
making

14. www.hee.nhs.ukwww.eoeleadership.nhs.uk/healthcoaching
Clinical
Application
of HC at
WSH
Women's
health Discharge
planning
CHD & Cardiac
rehab
Foot
ulcers
Relaxation
Voice
therapy
Persistent
pain
Obesity
Amputee
rehab
COPD,
asthma
Diabetes
↑Activity
Complex
social
readmission
Stress
Paediatrics

15. www.hee.nhs.ukwww.eoeleadership.nhs.uk/healthcoaching
Top tips
Top
down
support
Align with
local
strategy
Engage
local CCG
Utilise
local
training
team
Admin
support
Protected
time
Work in
pairs
Be
audacious
Business
case up
front