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www.england.nhs.uk
Long Term
Conditions
Lunch & Learn
Health coaching for lay professionals with Anya De Iongh & Jim Phillips
10 February 2016
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
www.england.nhs.uk
Long term conditions resources
Simulation model
Unbundling recovery simulation model
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
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 …
www.england.nhs.uk
Long Term
Conditions
Lunch & Learn
Health coaching for lay professionals with Anya De Iongh & Jim Phillips
10 February 2016
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
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
“… 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?
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.
Education programs
Social prescribing
Advocacy Peer
support
Structured guidance
Self-efficacy
Information Provision
COACHING
• 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
• 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
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.
• 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
Quality
• Standardize lay coaching approaches and services
• Provide registration and certification against standards
• Support profile of coaching in a clinical qualification-led health sphere
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
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
Demographics
0
20
40
60
80
100
120
CURRENTLY EMPLOYED -FULL-TIME
CURRENTLY EMPLOYED -PART-TIME
LONG-TERMSICK/INCAPACITY
BENEFITS
NOT EMPLOYED RETIRED OTHER NOT DISCLOSED
Employment Status
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
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?
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
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/)
Thank you!
Jim Phillips
@jim_epp
Anya de Iongh
@anyadei
www.thepatientpatient2011.blogspot.co.uk
