Slides from a lunch and learn webinar hosted by NHS England's Long Term Conditions Team, on the topic of health coaching by lay professionals. The speakers and Anya de Longh and Jim Phillips.

1. www.england.nhs.uk
Long Term
Conditions
Lunch & Learn
Health coaching for lay professionals
with Anya De Iongh & Jim Phillips
10 February 2016

2. www.england.nhs.uk
LTC Framework
Commitment
to Carers
Frailty
Health Ageing
Guide
Fire Service as
an asset
Care Homes
Quick Guides
Care & Support
Planning
Navigating Health
& Social Care
Self Care
Ambitions for
End of Life Care
Our Declaration
Delivery Models
Planning for Change:
• Capitated Budget
• Contracting
• Simulation Modelling
Patient and
Service
Selection
Planning for Change:
Workforce
Whole Population
Analysis;
Understanding your
population
LTC Dashboard LTC Toolkit

3. www.england.nhs.uk
Long term conditions resources
Simulation model
Unbundling recovery simulation model

4. www.england.nhs.uk
7
Using behavioural
change to open minds
#A4PCC – Action for Person-Centred Care
Person with
long term
condition
o Make a declaration at
www.engage.england.nhs.uk/survey/ltc
-declaration
o Tell your teams about our work
o Encourage them to make a declaration
o Ask them to feed back thoughts and
ideas
o Use our hashtag – #A4PCC – when
you see work that is relevant to
person-centred care for people with
LTCs
o Let us know of any events, activities or
social media opportunities that we can
join forces with you

5. www.england.nhs.uk
Date Topic Led by and details of session Venue
11 March Fire Service as an Asset: providing
telecare support in the community
Learning Outcomes
• To better understand the role that
the Fire and Rescue Service can
provide as a community asset to
support health needs
• Enhancing the quality of life for
people by supporting them to stay
in their own home, even in a crisis
Steve Vincent – West Midlands Fire
Service & Simon Brake from Coventry
Council
Via WebEx
22 March Self-management in the community Peter Moore, The Pain Toolkit Via WebEx
LTC Virtual Learning Community Lunch & Learn webinars:
Sharing and Learning …

6. www.england.nhs.uk
Long Term
Conditions
Lunch & Learn
Health coaching for lay professionals
with Anya De Iongh & Jim Phillips
10 February 2016

7. Health Coaching in the
community: the role of non-
clinical staff and people with
lived experience as coaches
Jim Phillips
Self-management coaching Service Manager and
Director, QISMET
Anya de Iongh
long term condition patient, Patient Leader and
Self-Management Coach

8. Overview of Webinar
• Examples of coaching services
• Discussion of different referral routes and how
it fits with traditional clinical services
• Comparison with similar non-clinical support
roles
• Core competencies of coaches
• Quality standards
• Further resources

9. “… a patient-centred approach wherein patients at least
partially determine their goals, use self-discovery or active
learning processes together with content education to work
towards their goals, and self-monitor behaviours to increase
accountability, all within the context of an interpersonal
relationship with a coach.
The coach is trained in behaviour change theory, motivational
strategies, and communication techniques, which are used to
assist patients to develop intrinsic motivation and obtain skills
to create sustainable change for improved health and well-
being.”
Wolever R Q et al. A systematic review of the literature on health and wellness coaching: defining
a key behavioural intervention in healthcare. Global Adv Health Med 2013;2(4):34-53.
What is Health Coaching?

10. Lay Coaches
• Lay coaching can exist as a stand alone service
• Coaching can become part of a clinicans role - for use within
consultation, focus on specific health related behavours or
condition specific, bound by service framework within clinics (eg.
East of England work)
• Focus on self-management support, rather than traditional health
remit.
• Lay self-management / health coaches don’t comment on or advise
about the specifics of a health condition, but can support with skills
of self-management
• Non-clinical service set-up enables a stronger focus on what is
important to the individual even if not health-related.
• Dedicated coaching services can work more intensively with
someone, and follow-up more effectively
• There is a debate about the necessity of lived experience in the
self-management coach role.

11. Education
programs
Social
prescribing
Advocacy
Peer
support
Structured
guidance
Self-efficacy
Information Provision
COACHING

12. • Be aware of and maintain appropriate boundaries
• Manage and make effective use of time
• Appropriate use of goal setting
• Appropriate use of problem solving and goal follow up
• Understanding of the bio-psychosocial model of health
• Use a solution-focussed approach
• Create and maintain a safe and positive relationship
• Support and encourage behaviour change by using
motivational and coaching skills during goal-setting and
goal-follow-up
• Working understanding of social learning and self-
determination theory
• Be responsive to the needs of the client
Core Competencies
of non-clinical self-management coaches

13. • L2/3 counselling/life
coaching
• People who have come
through the service or other
similar self-management
programmes such as Expert
Patient Programme
• Open recruitment (avoiding
traditional application
processes that puts some
people off)
Prior learning is assessed through a skills role play that covers in
condensed form the four stages of the coaching model.
Recruiting self-management coaches

14. Training
• Full training is 35 hours with additional mandatory training for Safeguarding
and Information Governance (in accordance with the employing
organisations policies and procedures and may include addition training on
issues such as lone working etc.)
• Trainees have ongoing continuous assessment through the training and
observation of practice sessions.
• Coaches should have one observed session with a client and receive
feedback.
• Coaches are encouraged to keep a reflective learning log.
• All full time coaches are required to attend a minimum of an hour individual
supervision at least once per calendar month.
• All coaches are required to do one case study per annum. This will be an in
depth review of one client combined with one observed session with the
client or for one session to be recorded.
• Coaches should attend a minimum of two skills review sessions per annum.

15. • Non-clinical nature of the role and
conversations mean…
“I’ve never told anyone this before”
“I’d never say this to my doctor”
Safeguarding boundaries

16. Quality
• Standardize lay coaching
approaches and services
• Provide registration and
certification against
standards
• Support profile of
coaching in a clinical
qualification-led health
sphere

17. My Health My Way
• Commissioned by Dorset CCG
• Provided in the community by partnership led by a third sector
organisation, with community and mental health NHS Trust, acute NHS
Trust and technology company
• Menu of options including one to one coaching, group courses and online
support across Dorset, Poole and Bournemouth
• Remit to support local people with long term health conditions and their
carers
• Measured using the Health Education Impact Questionnaire (HEIQ)
• One to one sessions held in community or local NHS venues or over the
phone
• Average of 6-8 45 min sessions
• Team of 5FTE + bank
• On average, coach has up to 100 people, but actively working with 30
people

18. Demographics
0
20
40
60
80
100
120
140
160
180
200
LESS THAN £15,000 £15,001-£25,000 £25,001-£35,000 £35,001-£50,000 £50,001-£70,000 MORE THAN £70,000 NOT DISCLOSED
Total Household Income

19. Demographics
0
20
40
60
80
100
120
CURRENTLY EMPLOYED -
FULL-TIME
CURRENTLY EMPLOYED -
PART-TIME
LONG-TERM
SICK/INCAPACITY
BENEFITS
NOT EMPLOYED RETIRED OTHER NOT DISCLOSED
Employment Status

20. Live Well and Feel Better
• One to one coaching by GP referral and open
access online support
• Commissioned by High Weald, Lewes and Haven’s
CCG
• Inviting patients off the GP lists at each surgery –
they are actively identify from disease register
• Coaches are specific to a GP surgery
• Coaching support is only available to patients at
that practice
• Practice based, GP led service

21. Different referral routes
Coaching
support
Self-Referral
GP referral
HCP/practice
staff referral
Third sector
/ community
As part of
care
pathway
Relationship to Primary Care – do GPs see it as another external NHS service, or an
integral part of their surgery’s offering?

22. Coach model for Dorset
Listen to the
clients story
Identify what's important, what
they want to change
Express as a goal
Follow up and dealing
with barriers

23. Further Resources
• My Health My Way (www.myhealthdorset.org.uk)
• Know Your Own Health (www.kyoh.org)
• Quality Institute for Self-Management Education and Training (www.qismet.org.uk)
• Symphony Project (www.symphonyproject.org.uk)
• Live Well Feel Better (http://standrews.lwfb.org.uk/)
• East of England
(https://eoeleadership.hee.nhs.uk/Health_Coaching_Training_Programmes)
• Health Foundation Person Centred Care Resource Centre
(http://personcentredcare.health.org.uk/)

24. Thank you!
Jim Phillips
Jim.phillips@qismet.org.uk
@jim_epp
Anya de Iongh
anya.deiongh@cantab.net
@anyadei
www.thepatientpatient2011.blogspot.co.uk