Healthcare delivery
daily life. They were signposted to community groups and appropriate resources, including health coaches, and individually referred to relevant services. A follow-up appointment a few months later reviewed their progress, goals and outcomes. Selena explained: “We went into it thinking that patients wanted to talk about their pain or their medications or physio but, actually, the vast majority wanted to discuss social issues and challenges and how they could self-manage their conditions. They wanted to understand what their condition was, and focus on mental health. So, it was very little about the medical, and more about how they could address wider factors in their lives – and how they could do it themselves. “Very few patients were referred to secondary
care, or musculoskeletal services; most were referred to social prescribers and mental health services. Working in this way, using health coaches and other members of the team – we expect this translates into reduced appointments, referrals and costs.” Telling the story of a patient with fibromyalgia and mental health problems, Selena said: “She found walking difficult and took taxis everywhere. Her coaching sessions focused on pacing, with a walking aid, giving her just a four- minute goal to try. “She gradually increased the duration and found her mood improved. A key part of the coaching for her was having a plan when things went wrong. She started to use public transport because she felt more confident, which meant she could go and see friends. This illustrates how just helpful health coaching can be.” Dr. Chloe Stewart, health psychologist, national specialist clinical advisor in personalised care/MSK, NHS England, discussed the drivers for change and why health coaching should be used more. She explained. “There are growing numbers
of people living with long-term conditions [with many] living with multi-morbidities - two or more chronic conditions.” Reinforcing the points that these patients require the largest number of GP appointments
have a huge part to play in supporting people to develop their own agency, to build their knowledge, skills and confidence in managing long-term conditions. “Consistently since 2010, only approximately
50% of people feel as involved as they want to be in decisions about their care and treatment. This includes responses from 73,000 people annually. We know that in the 2022 primary care survey, 31% of people asked, didn’t have an agreed plan with a healthcare professional from their GP practice in place to manage their condition and 6% of people didn’t know if they had one or not. Of those that have a plan in place, 95% find it helpful.”
Richard Pell, Flippin’ Pain campaign director, at Connect Health
and inpatient beds, Chloe reiterated: “Only 20% of health outcomes are attributed to healthcare, and in fact it is socioeconomics and health behaviours that account for 70% of health outcomes. As healthcare professionals, we
We know that in the 2022 primary care survey, 31% of people asked, didn’t have an agreed plan with a healthcare professional from their GP practice in place to manage their condition and 6% of people didn’t know if they had one or not. Of
those that have a plan in place, 95% find it helpful. Dr. Chloe Stewart, national specialist clinical advisor in personalised care/MSK.
46
www.clinicalservicesjournal.com I August 2023 Dr. Ollie Hart, GP, director, Peak Health
Coaching, gave an insight into his own journey into health coaching. He started as a GP with special interests, running a pain clinic and looking at “how you can help people to live well for themselves and take control.” Discussing a paper he co-published in the British Journal of Pain in 2014, Ollie said: We concluded that a health coaching programme promoting self-management in chronic pain can be successfully implemented in primary care, and it can be instrumental in helping clients to actively participate in identifying their own problems, setting achievable goals and managing the challenges of everyday life.” He presented the evaluation of a health
coaching service in North East England, using data from patients with conditions including COPD, pre-diabetes and low mood. The findings revealed overall health improvements and a
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