Healthcare delivery
Prevention best way to reduce NHS demand
Growing pressure on NHS services could be eased if the ‘new mindset and new skillset’ of health coaching was more widely adopted across patient care. This was the prevalent point debated by a panel of esteemed healthcare professionals during Connect Health’s latest Change event, ‘Can health coaching reduce primary care pressure and improve patient outcomes?’
At an event, hosted by Connect Health, earlier this year, strategies for reducing demand on the NHS were high on the agenda. The event chair, Richard Pell, Flippin’ Pain campaign director, at Connect Health, introduced the session, outlining data from the British Medical Association showing the current challenges facing primary care, exacerbated by declining GP numbers and recruitment and retention issues. “There is now the equivalent of 2,000+ fewer qualified full-time GPs compared to 2015, despite practices delivering 29.6 million appointments in January alone – with seven in 10 of those being face-to-face,” Richard explained. “It is recognised that health coaching has the potential to reduce demand on primary care; supportive self- management intervention can guide and prompt people to change their thoughts and behaviour, so they can make healthcare choices based on what matters to them. “Health coaches aim to develop people’s
motivation, knowledge, skills and confidence around a variety of issues and conditions, including weight, diet, mood and persistent pain.
They support people to become more active in the management of their own health and care.” Jag Mundra, population health lead, National
Association of Primary Care (NAPC) discussed ‘how health coaching can reduce demand for primary care appointments’, arguing that “prevention is the best way to reduce growing NHS demand.” Describing the top four health needs of the national population – obesity and diabetes or prediabetes; anxiety and greater mental health issues; frailty; respiratory conditions such as asthma, COPD, smoking and air pollution – and the correlation between patients with such needs seeking increased time with GPs, Jag encouraged healthcare professionals to avoid “hurdles” and to “get started” with health coaching. He presented significant results from a
controlled study undertaken by a PCN in South West England. The study revealed just two health coaching sessions resulted in better outcomes for patients, including an average BMI decrease of 0.3, the need for one less GP appointment and more than six fewer primary
care appointments each year. Jag explained: “As activation [of health
coaching] rises, it’s only a matter of time before physical health improves and contacts fall – a one point rise in activation is linked to a reduction of four GP appointments per patient per year, and primary and secondary care demand savings of £173 to £538 per patient per year. “Health coaching works. Done well, with the right model, it may well pay for itself in short- term demand reduction alone, that’s without counting the benefit to other providers and the benefit of better health and wellbeing in patients. “Health coaching is a great example –
probably the best example – of population health improvement in action. The interventions that have the biggest impact on our populations are those that help us move, eat better, sleep and connect with ourselves and others. What we really want to see here is for this to represent a way of working that ultimately the whole health service, and outside of the health service, enter.” Dr. Selena Stellman, GP lead – MSK and
Personalised Care, NHS North West London Personalised Care Team and GP at North End Medical Centre – discussed the findings of a year-long pilot project delivered in her practice, supporting chronic pain patients with a multidisciplinary team (MDT) approach – which included health coaching. “These patients were high-frequency users
of primary and secondary care services…often dissatisfied with the care they were receiving, and lacking both an understanding of their condition, as well as the self-competence and resources to be able to make changes themselves.” The pilot focused on a self-supportive personalised care approach to pain, working in primary care and community settings, with MDT support. Patients had an initial appointment to explore symptoms and discuss the impact of pain on
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