1. 10 July 2014 Welcome Overview of our Health Coaching Workshop Karen Bloomfield, Leadership and Organisational Development Manager

2. www.hee.nhs.uk www.eoeleadership.nhs.uk/healthcoaching To increase understanding of health coaching and its application To network, share experience and explore how health coaching is used in different settings To consider interim findings and evaluation to inform further development of health coaching To consider how health coaching aligns with other organisational strategies and across the system To start to develop a plan on how to increase the impact of health coaching in your organisation Aims

3. www.hee.nhs.uk www.eoeleadership.nhs.uk/healthcoaching 10.30 Welcome, Introductions and overview of the day 10.45 Overview and Interim Report Penny Newman, Clinical Lead, Health Coaching Programme 11.15 Sharing progress to date and learning with each other Karen Bloomfield, Leadership and Organisational Development Manager 11.45 Identifying the impact from Health Coaching Alison Carter, The Institute for Employment Studies 12.45 Lunch 13.30 Targeting your training and using the models Andrew McDowell, Director, The Performance Coach 14.15 Pulling it all together – the House of Care Penny Newman, Clinical Lead, Health Coaching Programme 14.45 Essentials for on-going development and sustainability/ Next steps Andrew McDowell, Director, The Performance Coach and Penny Newman, Clinical Lead, Health Coaching Programme 15:30 Close

4. www.hee.nhs.uk www.eoeleadership.nhs.uk/healthcoaching Please tweet ……. #EoEHealthCoaching @eoeleadership

5. www.hee.nhs.uk www.eoeleadership.nhs.uk/healthcoaching  Who’s in the room ? Role (Trainer, Co-ordinator, Clinician) Geographical base/ workforce partnership Norfolk/ Suffolk : Essex : Beds/ Herts : Cambs/Pboro Organisational / client base Acute: Primary Care: Community: Mental Health:CCG

6. www.hee.nhs.uk www.eoeleadership.nhs.uk/healthcoaching 5 mins discussion What would make your day Fab or Drab ? Post its please…

7. 10 July 2014 Overview and Interim Report Dr Penny Newman GP, Consultant in Public Health Director of Service Integration, Colchester Hospital NHS University Foundation Trust Clinical Lead, Health Coaching Programme

8. www.hee.nhs.uk www.eoeleadership.nhs.uk/healthcoaching Penny slides

9. 10 July 2014 Sharing progress to date and learning with each other Karen Bloomfield, Leadership and Organisational Development Manager

10. www.hee.nhs.uk www.eoeleadership.nhs.uk/healthcoaching 20 min discussion What’s your interest in Health Coaching? Then on flip chart note a few points … What’s working well about Health Coaching in your organisation so far? And not so well ? What do you need to more of …..?

11. 10 July 2014 The Impact of Health Coaching Dr Alison Carter Institute for Employment Studies

12. www.hee.nhs.uk www.eoeleadership.nhs.uk/healthcoaching Impact/Evaluation mechanisms Reflective practice by clinicians when using their health coaching skills Co-ordinators are encouraged to conduct their own local evaluations to measure results Programme team are conducting post-training and follow-up surveys on programme quality and application of learning Independent IES evaluation on impact of health coaching in five clinical practice settings

13. www.hee.nhs.uk www.eoeleadership.nhs.uk/healthcoaching IES Evaluation Not a randomised controlled trial (RCT) Exploring whether health coaching is a useful approach for clinicians and their patients Case study approach in five organisations Evaluation sites North Norfolk CCG Cambridgeshire Community Services NHS Trust Norfolk and Suffolk NHS Foundation Trust Norfolk and Norwich University Hospitals NHS Foundation Trust Hawthorn Drive (GP surgery)

14. www.hee.nhs.uk www.eoeleadership.nhs.uk/healthcoaching At each case study site Describe the intervention and process of implementation and contextualise it Explore views on usefulness for clinicians and their patients Explore views on any changes to thinking or practice Support local identification of relevant outcome data and examine local evidence of impact (health outcomes and consequences for organisations)

15. www.hee.nhs.uk www.eoeleadership.nhs.uk/healthcoaching 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 in progress with 25 clinicians & 5 co-ordinators – Interviews with 5 local stakeholders Quantitative Patient experience surveys Analysis of relevant local outcome data (clinical and management) where available

16. www.hee.nhs.uk www.eoeleadership.nhs.uk/healthcoaching Professionals Awareness Awareness of campaign Understand the challenge of behaviour change Willingness to train Initial Training Individuals receive health coaching training Teams/ organisations engage with programme “Mind-set” Willingness to coach Greater self belief in coaching skills Increased use of coaching Increased coaching skill More variety in patients coached Tool to use in specific situations Integration with existing style/practice “Practice”

17. www.hee.nhs.uk www.eoeleadership.nhs.uk/healthcoaching Professionals Awareness Awareness of campaign Understand the challenge of behaviour change Willingness to train Initial Training Individuals receive health coaching training Teams/ organisations engage with programme “Mindset” Willingness to coach Greater self belief in coaching skills “Practice” Increased use of coaching Increased coaching skill More variety in patients coached Tool to use in specific situations Integration with existing style/practice Evidence? Focus groups with clinicians and Follow-on interviews with clinicians and stakeholders

18. www.hee.nhs.uk www.eoeleadership.nhs.uk/healthcoaching Patients Initial outputs “mind-set” Increased… Awareness of opportunity for self management Self belief Willingness and intention to change behaviour Initial behaviour outputs Changed health behaviours Adoption of self management principles Impact on outcomes Reduction in appointments Health indicators Improved self- assessment of well-being

19. www.hee.nhs.uk www.eoeleadership.nhs.uk/healthcoaching Patients Initial outputs “mind-set” Increased… Awareness of opportunity for self management Self belief Willingness and intention to change behaviour Initial behaviour outputs Changed health behaviours Adoption of self management principles Impact on outcomes Reduction in appointments Health indicators Improved self- assessment of well-being Evidence? Patient experience surveys Management /clinical information

20. www.hee.nhs.uk www.eoeleadership.nhs.uk/healthcoaching

21. www.hee.nhs.uk www.eoeleadership.nhs.uk/healthcoaching Early observations Implementation progress has varied enormously Targeting services or patient groups & selecting the 'right' clinicians for training Creating the 'right' environment to allow the skills to be used & anticipating adjustments to clinical environments A highly valued approach for individual clinicians who can provide stories of success with patients Not yet articulating success criteria or measurement

22. www.hee.nhs.uk www.eoeleadership.nhs.uk/healthcoaching Measurement Challenges Impact may take some time Deciding what to measure Identifying comparison groups can be difficult No follow up appointments makes pre- and post- intervention comparisons difficult

23. www.hee.nhs.uk www.eoeleadership.nhs.uk/healthcoaching Organisation Evaluations What are you trying to achieve with health coaching in your organisation? Clinical practice and/or wider strategic goals? What will success look like? How will know you know when you have got there? Can you use data already collected by the organisation or will you develop and implement something new?

24. www.hee.nhs.uk www.eoeleadership.nhs.uk/healthcoaching Organisation Evaluations (2) WHY are we evaluating? WHAT was the purpose of the coaching? WHO is the evaluation for? HOW much resource do we have for the evaluation? WHO should be involved in the evaluation? WHERE will we look for impact? Do we really need RoI?

25. www.hee.nhs.uk www.eoeleadership.nhs.uk/healthcoaching Top tips Plan before coaching starts Tell people you will be evaluating Focus on key indicators Get perceptual data from multiple sources Organisation benefits are always asked about ‘Stories’ can be powerful

26. 10 July 2014 What are your Evaluation issues? What would help you? alison.carter@employment-studies.co.uk

27. 10 July 2014 Lunch Run photo slide deck

28. 10 July 2014 Targeting your Training and using the models Dr Andrew McDowell, Psychologist and Director of the Performance Coach

29. A Health Coaching Approach Mindset – Principles and beliefs inherent in a coaching approach Skills – General coaching skills that can be used widely in health consultations Techniques – Specific coaching techniques and conversation frames that can be applied in health consultations Opportunities – What are your top tips for seizing opportunities to have coaching conversations with patients 29

30. Review of Models What do I remember about this technique or concept? How have I used it? In what areas do I believe it can be applied? 30

31. Notes 31

32. TOPIC Initial understanding GOAL Outcome for the session REALITY What is happening now? OPTIONS What is possible? WILL / WRAP-UP Plan and support commitment 32 Source: Whitmore The TGROW Model

33. Components of Managing Health – Diamond model Control Learning Motivation Confidence Managing Health 33 Questions: 1.Where are you now and what has contributed to that? 2.Where would you like to be and what are the reasons for that? 3.What can you do that is within your control to move this forward? Source: McDowell

34. 1.Define the behaviour 2.Antecedents 3.Consequences 4.Eliciting personal meaning 5.Eliciting goals 6.Eliciting resources 7.Way forward Raise Awareness Increase Responsibility ABC Health Coaching model 34 Source: McDowell

35. Situational (Where are you?) Behavioural (What are you doing?) Cognitive (What are you thinking?) Affective (What are you feeling?) Interpersonal (Who are you with?) Physiological (How does your body feel?) Antecedents & Consequences 35 Source: McDowell

36. Managing interferences Performance = Potential – Interference Desired Behaviour = Could do it – What’s in the way The Inner Game Coaching conversation 36 Last 3 Questions What gets in the way MOST? What gets in the way LEAST? Where would you like to START? Source: McDowell, adapted from Gallwey

37. What do you feel you are ready to change? What is currently happening regarding this behaviour? What would you like to achieve? What’s helped you to achieve this in the past? What are your options now? What else could you do? Which do you think might work for you now? What specific goal could you set? What would support you to achieve this goal? What would you need to do to achieve this? What ELSE would you need to do?.... What do you need to do to remember this? Solution focussed coaching questions 37 Source: McDowell

38. 1. How important is ……….. to you? On a scale of 1–10 (1 = not important, 10 = very important) 2. How confident are you about make a change? On a scale of 1–10 (1 = not confident, 10 = very confident) 3. Tell me about how you scored yourself? 4. What would help to move you higher on the scale? 5. How high on the scale would you need to be to change? 6. What makes your “current score”(e.g., 5) not an “lower score” (e.g., 2) ? Quick Motivational Interview 38 Adapted from: Miller & Rollnick

39. Don’t Change AnythingMake Some Changes Good Outcomes 1. What’s working for you now? Easier, less effort Less stressful Less time required Can do what I like 4. What benefits would you expect from changing things? What’s in it for me? What short & long term benefits will I get? Not so Good Outcomes 2. What’s the downside of what you are doing now? Short term negative consequences Long term negative consequences 3. What’s the downside of changing things? Harder, more effort to break habits More stressful More time & planning required Decision making – Motivational Interviewing 39 Adapted from: Miller & Rollnick

40. TechniqueApplication TGROW Diamond Inner Game ABC Solution focussed Brief MI Decision making matrix Techniques and application

41. About the Performance Coach The Performance Coach is proud to offer a range of innovative services to help organisations and individuals with an interest in leadership development, performance coaching and health coaching. We pride ourselves at being the ‘best’ at collaborating with our clients, closing the ‘knowing/ doing’ gap and sustaining performance improvement over time. For further information: Dr Andrew McDowell, The Performance Coach M: 44 (0) 7984 464 407 T: 44 (0) 203 637 0970 E : andrew@theperformancecoach.com W: http://www.theperformancecoach.comandrew@theperformancecoach.comhttp://www.theperformancecoach.com The Performance Coach, Marble Arch Towers, 55 Bryanston Street, London, W1H 7AA 41

42. 10 July 2014 Pulling it altogether – the House of Care Dr Penny Newman GP, Consultant in Public Health Director of Service Integration, Colchester Hospital NHS University Foundation Trust Clinical Lead, Health Coaching Programme

43. www.hee.nhs.uk www.eoeleadership.nhs.uk/healthcoaching Pennys slides

44. 10 July 2014 Essentials for on-going development and sustainability/Next steps Dr Andrew McDowell and Dr Penny Newman

45. www.hee.nhs.uk www.eoeleadership.nhs.uk/healthcoaching Pennys slides

46. Thanks for being part of discussions today … next events include … 17 th September – Facilitation workshop 30 th September – Trainers/Co-ordinators workshop 11 th November – Overall Health Coaching conference 10 July 2014