Know Your Own Health

What is Health & Wellbeing Coaching and what training is required?

The role of Health & Wellbeing Coaches in the NHS is to support self-management. This is part of the Personalised Care agenda and is known as an ARRS role (Additional Role Reimbursement sheme), alongside Care Coordinators and Social Prescribing Link Workers.

The name ‘Health & Wellbeing Coach’ is possibly a bit misleading in this context as it’s not health & wellbeing coaching in any traditional sense. Although the ultimate aim is to improve people’s health and wellbeing, the role of the coach is to support people to tap into their own resources to build their knowledge, skills and confidence to self-manage effectively as the way to do this.

Calling it Health & Wellbeing Coaching or Health Coaching is therefore a short-cut. In academic terms, it is more usually known as Supported Self-Management (SSM) or Self-Management Support (SMS). Insofar as it is coaching, it might more accurately be called ‘Self-Management Coaching’.

So why isn’t it called ‘Self-Management Coaching’?

Mainly because people don’t know what that is and it is not always easy to explain. Therefore, calling it by the intended outcome of improved ‘health and wellbeing’ is easier to work with.

Also, for people who are already struggling to manage or for people at low levels of activation, Self-Management Coaching can sound off-putting as it sounds as though the individual will be expected to manage entirely on their own – which isn’t the case.

Instead, individuals are supported to:

  • take control and build their knowledge, skills and confidence to manage their physical or mental health condition(s) effectively;
  • achieve better health and wellbeing outcomes;
  • build the appropriate support networks to sustain effective self-management and make best use of clinical services.
  • What does Health & Wellbeing Coaching consist of?

    Health & Wellbeing Coaching, delivered as an intervention, usually consists of 5-6 sessions – although this is tailored to the individual and some may need more or fewer.  Where more are needed, this is usually only 2 or 3 more, although some may benefit from another full round of 5-6 sessions either straight away or later on.

    The first session is 1 hr and the rest of the sessions are 45 minutes.

    Why these specific timings?

    The first session involves ‘agenda-setting’, or ‘contracting’ and often a questionnaire or two as well as eliciting the patient’s story.  This therefore takes a bit longer than a standard session.

    In our experience, 45 minutes is the optimal time for all other sessions. More time and the session risks becoming more of a counselling session – the 45 mins keeps it focused; less time and it risks being rushed and therefore less effective – the 45-minutes ensures that the coach has time to listen and the patient has time to think.

    What does the NHS Framework guidance say?

    The guidance aligns closely with this, stating a standard 6 sessions of 45-50 minutes.

     

  • What training is required for Health & Wellbeing Coaches?

    Health & Wellbeing Coaches are required to complete a 4-day PCI-accredited training course. See Know Your Own Health's 4-day training.

    Health & Wellbeing Coaches are also required to have ongoing monthly supervision. See details of Know Your Own Health's supervision and ongoing skills development.

     

  • How are outcomes measured?

    There are a number of ways to measure outcomes:

    Outcomes questionnaires 

    Self-management questionnaires:

    The aim of Health & Wellbeing Coaching is to improve people’s levels of knowledge, skills and confidence to self-manage effectively.

    Some questionnaires that measure this are:

    Insignia’s Patient Activation Measure (PAM)

    The Chronic Disease Self-Efficacy Scale (CDSMP)

    These are essentially different from questionnaires such as the ONS4 and the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) which measure wellbeing. 

    It is worth bearing this in mind if using these as outcomes measures for Health & Wellbeing Coaching as changes in people’s confidence to self-manage effectively (as measured by PAM or CDSMP questionnaires) are less prone to fluctuation and more meaningful from the self-management point of view, than changes in their sense of wellbeing (as measured by the ONS4 and the WEMWBS), which can be affected by many things on a day-to-day or month-to-month basis. The two types of questionnaire would be expected to give similar outcomes, and often might, because someone who is self-managing well is likely to also be experiencing a greater sense of wellbeing, and vice verse; however, they are measuring different things.

    Feedback questionnaires

    Feedback questionnaires can be a helpful way of assessing the patient experience both with statements they can agree or disagree with and a free-text box.

    These give an idea of how patients are using and experiencing health & wellbeing coaching.

    You can see a sample Feedback Questionnaire in the links at the bottom of this page.

    Patient stories

    Patient stories or case studies can provide qualitative data around how people are benefiting from Health & Wellbeing Coaching. 

    Measurable and self-reported outcomes

    For example, weight, BMI, Blood Pressure, HbA1C.

    Service Usage data

    For example, number of clinical appointments in the 12 months before and 12 months after completing coaching. Although the reasons for clinical appointments are many and varied and attending necessary clinical appointments is essential, people who are struggling to manage with long term health conditions typically have higher levels of clinical service usage than those who are self-managing effectively (see Health Foundation study).