30 September 2014 Welcome Overview of our Health Coaching Workshop Karen Bloomfield, Leadership and Organisational Development Manager
Aims To share experience and provide a resourceful and supportive network opportunity for embedding Health Coaching To assist in the process of embedding Health Coaching in your organisations through learning how to roll out a new innovation To consider and build a plan for next steps as an individual, organisation and network
10.00 Registration 10.30 Welcome, Introductions and overview of the day Karen Bloomfield, Leadership and Organisational Development Manager Where are we now? 10.45 Coffee 11.15 11.30 12.15 Why are we here? Health coaching with our patients Penny Newman, Clinical Lead, Health Coaching Programme and Trainers Sharing our plans and learning with each other Discussion in Workforce Partnership groups and feedback Andrew McDowell, Director, The Performance Coach and Karen Bloomfield, Leadership and Organisational Development Manager Barriers and how organisations are overcoming them Alison Carter, Principal Associate Fellow, The Institute for Employment Studies 13.00 Lunch How do we get there? 13.45 14.45 Embedding, Enhancing and Sustaining Health Coaching in Clinical Practice Penny Newman, Clinical Lead, Health Coaching Programme and Trainers Action Planning Andrew McDowell, Director, The Performance Coach 15:30 Close and Tea/Coffee available
Who s in the room? Role (Co-ordinator, Trainer, Clinician, WFP representatives) Geographical base/ workforce partnership Norfolk/ Suffolk : Essex : Beds/ Herts : Cambs/Pboro Organisational / client base Acute: Primary Care: Community: Mental Health:CCG
Please tweet. #EoEHealthCoaching @eoeleadership
30 September 2014 Why are we here? Health Coaching with our patients Dr Penny Newman GP, Consultant in Public Health Director of Service Integration, Colchester Hospital NHS University Foundation Trust Clinical Lead, Health Coaching Programme
Why embed Health Coaching in your various roles? Role Clinician Improvement area consultations Leader the system Manager your service Educator Innovator and researcher your staff NHS
Improving lives - NHS Constitution The core function of the NHS is emphasised in this value the NHS seeks to improve the health and wellbeing of patients, communities and its staff through professionalism, innovation and excellence in care. This value also recognises that to really improve lives the NHS needs to be helping people and their communities take responsibility for living healthier lives.
Renewable energy Third, we stand on the cusp of a revolution in the role that patients and also communities will play in their own health and care. Harnessing what I ve called this renewable energy is potentially the make-it or break-it difference between the NHS being sustainable or not.. we should recognise that achieving change in the NHS is not merely a techno-rationalist activity, it s health as a social movement Simon Stevens, NHS Confed, 2014
Person centred coordinated care I can plan my care with people who work together to understand me and my carer(s), allow me control, and bring together services to achieve the outcomes important to me. National Voices
LTCs: A burning platform Lifestyle causation Multiple comorbidity Age and poverty related Unaffordable
How are clinicians managing? Clinicians cannot meet every need Half of patients leave primary care visits not understanding Only 9% of patients participate in decisions Adherence rates for medications and lifestyle changes are ~ 50% and 10% Drs interrupt within 12 seconds The GMC experienced 104% rise in complaints 2007-2012, with 54% about clinical care or communication Bennett, H Coleman E, Parry C, Bodenheime, GMC Annual report 2013, Rhoades DR, Fam Med 2001
Clinician training Typical disease management interventions often employ healthcare professionals who do not necessarily value patient empowerment, who may not have exposure to or adequate training in the science of behavioural change, and who may not have the complex interpersonal skills to facilitate behaviour change effectively. This leaves those trained in the conventional medical model vulnerable to using approaches that are expert driven, authoritarian, and advice-giving as opposed to taking stances that are supported by the latest research in behaviour change models. Wolever R 2013
Learnt dependency Paternalism breeds dependency, encourages passivity and undermines people s capacity to look after themselves. It may appear benign, comfortable and reassuring, but it is a hazard to health. (Coulter, 2011)
The impact is overwhelming
Health Coaching redefines the clinician/patient relationship Role of patient A patient centred approach wherein patients at least partially determine their goals, use self-discovery and 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. Role of clinician The coach is a healthcare professional 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 wellbeing. Wolever 2013
The aim of EoE Health Coaching programme Listen with compassion To equip a range of clinicians with the right skills, knowledge and behaviours: Supplement core clinical skills Promote self-care, motivation and responsibility in patients Support self care A tailored consultation Diagnose and fix Improve patient satisfaction Provide a tailored approach to different patient's needs. Review and encourage Guide and advise
Health Coaching integrates Coaching relationship Behaviour Change Assistance Self determined goals and accountability Clinical Skills 18
Health coaching competencies The application of a personalised patient centred approach based on empathy and rapport Enhancing core consultation skills with great coaching Goal setting and action planning to align both patient and clinician priorities Managing the process and relationship holding both agendas simultaneously Integrates behaviour change techniques with clinical expertise Greater self awareness and belief in patients potential Reflecting on the consultation and the wider system
Trainers Patient stories Please tell your story in 3 minutes What did you do differently? Which competency(s) did you use? What happened as a result? Three words to describe the impact of health coaching.
30 September 2014 Sharing our plans and learning with each other - Discussion in Workforce Partnership groups and feedback Dr Andrew McDowell, Psychologist and Director of the Performance Coach and Karen Bloomfield, Leadership and Organisational Development Manager
Next Steps in the roll out of Health Coaching Accreditation of Health Coaching Trainers Health Coaching Training Materials Ongoing Support for Trainers 22
Accreditation of Health Coaching Trainers Accreditation process EMCC Foundation Skills EQA Award (Health Coaching) Completion of 2 co-delivery sessions and submission of delivery competencies review Approved to deliver the core 2 day programme Undertake ongoing CPD with TPC to use TPC materials All who have completed these requirements will receive feedback by October 3 All still to complete will receive feedback within 2 weeks of their submission of their delivery competencies 23
Health Coaching Training Materials Materials are currently being produced: Resource guides Slide deck and delivery notes Revised to be simplified and shorter based on trainer feedback Expected 17 October Materials will be co-branded TPC and NHS EoE Guidelines for how to order materials Resource guides, A3 laminates, range of approaches Expected 17 October 24
Ongoing Support for Trainers From the existing contract: 4 x Trainer CPD sessions over the next 12 months e.g., December, March, June, September Dates will be provided by end October Additional support Guidelines for requesting additional support from TPC will be distributed expected 17 October 25
Sharing our plans and learning with each other Discuss and share respective roles in relationship to Health Coaching 1. What are we currently doing that is working well in our organisation/workforce Partnership and what are we learning from this? 2. How can we share our learning further across Workforce Partnerships? Prepare one/two key points to feedback from each question, but also capture the overall discussion 27
30 September 2014 Barriers and how organisations are overcoming them Dr Alison Carter Institute for Employment Studies 30 September 2014
IES Evaluation Exploring whether health coaching is a useful approach for clinicians and their patients Case study approach in five organisations - North Norfolk CCG - Cambridgeshire Community Services NHS Trust - Norfolk and Suffolk NHS FT - Norfolk and Norwich University Hospitals NHS FT - Hawthorn Drive (GP surgery)
Evaluation methods Qualitative Scoping Focus groups with (18) clinicians Interviews with (3) experts Organisational case studies Interviews with co-ordinators & team leaders (9) Focus groups with (41) clinicians Follow up interviews with clinicians & coordinators (20) Interviews in progress with 5 local stakeholders Quantitative Patient experience surveys Analysis of relevant local outcome data
What is your experience of overcoming barriers?
Barriers faced Clinicians Selecting patients who are ready Length of appointment Keeping up skills and confidence Poor understanding about what it is Organisational culture & environment Organisations Releasing staff for training (General Practice) Targeting services and clinicians Infrastructure and finance for more training Maintaining momentum Evidencing local outcomes
Benefits identified for clinicians Reduced clinical time per patient Reduced caseload: expedites discharge Reduced demand on the service Less pressure and responsibility for patient progress Patients say thank you more often Professional pride at making a difference Motivational Tools e.g. for goal-setting Skill set for everyday holistic treatment
Benefits identified for patients Increased confidence Increased patient empowerment Gives power/control back Enjoy life more Family able to help spot future problems More efficiency means reduced waiting times Prevents re-admissions Less medication More personalised advice/care Reduces dependency Increased satisfaction
Benefits identified for NHS Higher compliance Reduction in episodes of care Quality and consistency Quicker discharge Less re-admissions Reduction clinical time Higher caseload possible (8% increase) Clearing caseload faster (45% reduction) Cost savings (clinic visits 50% cheaper than home visits)
Overcoming the barriers Clinicians Training/CPD on days off Getting immediate boss and colleagues on-side Sharing patient success stories Fewer, longer appointments Change of employer Organisations Use of clinical super-users Securing senior support Mainstreaming Getting the organisation ready Clinician/developer leadership Cross-organisation collaboration and support
Any questions? Alison.carter@employmentstudies.co.uk or alisoncarterdba@aol.com
30 September 2014 Embedding, Enhancing and Sustaining Health Coaching in clinical practice Dr Penny Newman GP, Consultant in Public Health Director of Service Integration, Colchester Hospital NHS University Foundation Trust Clinical Lead, Health Coaching Programme
Creativity is about conceiving new ideas - innovation is about implementing them. People are often highly creative You will know people with or have had your own good ideas for a new procedure, technique or process that might improve things in the workplace or potentially outcomes for patients did you follow through? was your idea implemented? or did it just remain a good idea?
Driving Innovation in Organisations Creating Developing Adopting Diffusing evidence informed a sustainable resource best practice in Education through the workforce & organisations Improved Patient Outcomes Research Informed Care Excellent Clinical Practice
PDSA cycle What changes are we going to make based on our findings? Act Plan What exactly are we going to do? What were the results? Study Do When and how did we do it?
System change the House of Care 44
NHS Change Model
NHSI spread and adoption tool People Active leadership and networks offer support at all levels including key influencers, staff are motivated, there is an incentive, good team working and peer support, user's voice is heard Innovation The benefits are clear, there is sufficient evidence, the innovation is presented in a meaningful and relevant way, it can be adapted to my setting, the skills and resources have been identified, we can capture and share the benefits Context This innovation will make an important contribution to help achieve a strategic priority, the local experience is positive, it is timely, stakeholders are engaged, the infrastructure supports this innovation, the disruption the innovation will cause to existing systems has been considered and planned for?
Spread & Adoption Tool (15 min) Thinking about your various roles e.g. in your clinical practice, as trainers, as system leaders, managers and researchers, what can you do to help secure/sustain health coaching in your practice, organisations and systems? Using the statements as prompts, rate those you consider most important between 1 10 (where 10 is the most important) there may be others Develop proposals how you can embed health coaching Share your plans with 3 bullets (2 mins per group)
30 September 2014 Action Planning Dr Andrew McDowell, Psychologist and Director of the Performance Coach
Next steps What do you see as the main value of embedding a health coaching approach in your organisation? 50
Next steps What are the next steps you are planning to take? 51
Action planning 3 2 Three key actions that I am planning to take in the next week that will move the health coaching agenda forward in my organisation Two broader plans I intend to initiate in order to embed the health coaching approach in my organisation One message or idea I want 1 to use to position health coaching effectively in my organisation 52
30 September 2014 Thanks for being part of discussions today next event 11 November Talking with Patients, Health Coaching for Behaviour Change and Patient centred care conference