Health Education England

Find out more about Health Coaching

Why is change needed?

It is predicted that three quarters of all deaths by 2020 will be from chronic disease. People with long-term conditions account for 50% of all GP appointments, 70% of all inpatient bed days and 70% of overall NHS spend. The number of people with three or more long-term conditions is predicted to rise by a million to 2.9 million by 2018. Literature and research indicates that:

  • Clinicians cannot meet every need of their patients with chronic conditions
  • Half of patients leave primary care visits not understanding what their doctor told them
  • Though shared decision-making is associated with improved outcomes, only 9 per cent of patients participate in decisions
  • Average adherence rates for prescribed medications are about 50 per cent, and for lifestyle changes they are below 10 per cent.

New approaches to working with patients are required which increase patient confidence, self care, decision making, and lifestyle change.

What is health coaching?

Health Coaching is an approach that guides and prompts people to be active participants in behavioural change through a transformation in their relationships with their clinicians. Health coaching is an umbrella term for multiple applications of a coaching approach:

  • In health improvement, it is "a behavioural intervention that facilitates participants in establishing and attaining health-promoting goals in order to change lifestyle-related behaviours, with the intent of reducing health risks, improving self-management of chronic conditions, and increasing health-quality of life" (Van Ryn & Heaney, 1997)
  • As an aid in decision-making it "is based on strong provider communication and negotiation skills, informed, patient-defined goals, conscious patient choices, exploration of the consequences of decisions, and patient acceptance of accountability for decisions made".
  • In long-term conditions it is the application of executive coaching skills, specific psychological interventions and clinical skills to enable patients to change their relationship with their health, by tapping into their potential to self-manage, raising their awareness and responsibility, and increasing their confidence and motivation to act to achieve their goals" (McDowell, 2013).

Health coaching competencies

Coaching starts with the premise that problems can't be solved with the same thinking that created them. To create new thinking and motivation to act, the relationship and conversation between the health coach and patient or client needs to:

  • Support and help people create a new world view and prioritise their health
  • Create new insights and enable them to be translated into new actions
  • Be based on trust, rapport and empathy
  • Use open questions, generative listening and reflection as opposed to telling
  • Create positive emotions to build motivation and confidence through a focus on what's good versus what's wrong
  • Provide timely and personalised health education and information.

How Heath Coaching fits with the Delivery Model for Long-Term Conditions (Domain 2)

The 'House of Care' model has been adopted as the delivery model for Domain 2. It recognises the importance of commissioning, the roles of individuals, their carers and healthcare professionals, and organisational processes working together to ensure person-centred, coordinated care for people with long-term conditions, along with parity of esteem for mental health.

Health Coaching is integral to the "House of Care" and can be adopted within a care planning consultation to augment clinical skills at a basic level as well as creating clinical champions for change. Patients with more complex problems may need to be referred to more specialist health coaches and services.

More information is available on this model in the resources section of this website.

More information 

Programme Leads: 

Dr Penny Newman, Medical Director, Norfolk Community Health and Care NHS Trust (Monday - Wednesday) National Innovation Fellow, Health Coaching, NHS England, Health Foundation, UCL Partners & Health Education East of England (Thursday - Friday)

Karen Bloomfield, Head of Leadership and Organisational Development. For more information about the Health Coaching for Behaviour Change Programme, contact Karen Bloomfield,