A health coach does not diagnose illnesses or prescribe medication. The role of a coach is complementary to that of a general practitioner.
WHY HEALTH COACHING?
- It is estimated that only around 10% of patients apply the lifestyle recommendations they get from their doctor.1
- Clinicians do not receive training in behaviour change.2
Behaviour change is key to preventing and managing long-term conditions such as high blood pressure, diabetes, obesity and asthma.
THE IMPORTANCE OF PREVENTION
According to the 2005 global report by the WHO on the prevention of chronic diseases, in the UK “at least 80% of premature heart disease, stroke and type 2 diabetes, and 40% of cancer could be prevented through healthy diet, regular physical activity and avoidance of tobacco products.”3
To quote more recent numbers, according to the Office for National Statistics, nearly one in four deaths in England and Wales in 2013 were from causes considered avoidable. That is almost 115,000 deaths that could have been avoided through good quality healthcare or wider public health interventions including lifestyle improvements.4
The focus clearly needs to shift from treatment to prevention. Yet the statistics show that patients struggle to implement the lifestyle advice they get from their doctors.
Changing your diet, doing more exercise, quitting smoking, reducing stress levels, losing weight, prioritising self-care – this is all easier said than done. This is precisely where the health coach comes in – to give you the time, attention and support you need to implement behaviour change.
THE ROLE OF HEALTH COACHING WITHIN THE CURRENT HEALTHCARE SYSTEM
In the USA, various providers offer health coaching to private individuals as part of health programmes. The goal is:
- to increase patient and client engagement
- to improve wellness
- to reduce risk5
“This trend is likely to be indicative of future developments in the UK given the global challenge of chronic disease.”6
Long-term conditions account for about 70% of overall NHS spending and are therefore a significant strain on financial resources and staff. Health coaching has been put forward as an innovative way to support people in taking more responsibility for their health and wellbeing in order to reduce their dependence on the NHS.
More and more people believe that patients should be viewed as experts in their own wellbeing and partners in the healing process rather than passive recipients of solutions delivered by healthcare providers. Health coaching is based exactly on this principle: it focuses on helping clients to develop sustainable habits to achieve long-term health and wellbeing.
“Doing things to people instead of with them can be profoundly disempowering. It encourages patients to believe that professionals have all the answers and that they themselves lack relevant knowledge and skills, and hence have no legitimate role to play in decisions about their healthcare. 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.”7
In 2004, the Department of Health released the Public Health White Paper Choosing Health. The most widely discussed topic at the time was the smoking ban. Equally important was the proposal to introduce health trainers as a new public health workforce in England. Health trainers have since been helping patients across the country, especially those from low-income communities. Representatives of this new workforce are based not only in NHS provider organisations, but also in local authorities, the voluntary and community sector and the private sector. If you haven’t heard of health trainers before, you can have a look at the website of Health Trainers in East Riding of Yorkshire.
In addition, many GPs, nurses and other health care professionals have been trained in health coaching skills. It is encouraging that as a result of the 2004 proposal and the ensuing programmes rolled out within the NHS, we can start to see a gradual shift of paradigm within the healthcare system. “There is a move away from a paternalistic healthcare model where clinicians ‘do things to’ and make decisions for people towards helping people take more control of their health and care.”8
The White Paper Equity and Excellence: Liberating the NHS and the 2011 Health and Social Care Bill both proposed policies which aimed to “put patients at the heart of the NHS, giving patients, carers and the public a stronger collective voice, greater choice and control, and more involvement in decisions about their care, supported by an information revolution that aims to transform how information is provided.”9, 10
I am hopeful that the public healthcare system in the UK will be developing in the right direction. NHS England’s Five year forward view, published in October 2014, stresses the absolute importance of prevention and patient empowerment.11 As a private health coach, I am extremely pleased to be helping my clients gain more control over their health. I see it as my mission to support them in developing sustainable habits, which will continue to improve and protect their health well after they have completed their programme with me.
1 Haynes, R.B. et al. 2002. Helping patients follow prescribed treatment: clinical applications. JAMA. 288 (22), pp.2880–2883.
2 Newman, P. 2016. Health coaching: empowering patients through conversation. [accessed 30 May 2016]
3 World Health Organization. 2005. Preventing chronic diseases: a vital investment. WHO global report. WHO Press. [accessed 23 May 2016]
4 Office for National Statistics. 2015. Avoidable mortality in England and Wales: 2013. [accessed 24 May 2016]
5 Moore, M. 2013. Health Coaching Summit. NHS Institute. Conference at Westminster Hall 26th February 2013. Cited in NHS. Health Education East of England. 2014. Health Coaching for Behaviour Change. Better conversations, better care. Interim Progress Report. [accessed 20 May 2016]
6 NHS. Health Education East of England. 2014. Health Coaching for Behaviour Change. Better conversations, better care. Interim Progress Report. [accessed 20 May 2016]
7Coulter, A. 2011. Engaging patients in healthcare. Maidenhead: Open University Press.
8 Training GP trainees in health coaching. Feasibility and impacts. [accessed 21 May 2016]
9 Department of Health. 2010. Equity and Excellence: Liberating the NHS. London: Stationery Office.
10 Department of Health. Health and Social Care Bill 2011. [accessed 15 May 2016]
11 NHS 5 year forward view. 2014. [accessed 30 May 2016]