Our aim is to enable people to thrive by feeling more motivated, confident and in control of managing their own health and care.

Great conversation is more than just exchanging information – it can transform relationships and health behaviours to benefit patients, staff and the NHS.

Talking to people in a way that acknowledges their expertise, and puts them in the driving seat, helps people better manage their own health and helps the NHS by reducing demand and costs.

To achieve great conversation, we advocate a health coaching approach, based on the science of behaviour change.

Read patient stories about communication
Download the call to action booklet Download the resource guide Join the Slack community

Seven simple tips for a behaviour change conversation

Detrimental health behaviors cause 60% of deaths and long term conditions are responsible for 70% of NHS costs. Only about a third to a half of people take their medications correctly. People know they need to look after their health, but often don’t know how, or how to change bad habits.

For people to make a change in their health behaviour, conversations with health professionals (and peers) needs to cover where they are now, where they want to be and what they can do to get there with support.

Change is more likely when the conversation is underpinned by high rapport and a positive relationship, created by great listening, understanding and a sense of partnership.


The conversation should include:

  1. Preparation - Reducing distractions to be present and planning how to have the conversation
  2. Goals - Exploring what the person wants to achieve and why it’s important to them
  3. Active listening - Being respectful and curious about the other person’s experience
  4. Reflection - Using open questions to help the person explore and broaden their perspective
  5. Ownership - Inviting the person to generate their own ideas about what can be done
  6. Action - Encouraging the person to take small steps in the right direction
  7. Feedback – Monitoring progress and recognising achievements

“Conversation doesn’t just reshuffle the cards. It creates new cards”.

Theodore Zeldin, How talk can change our lives

What is the evidence?

Dr Ruth Q. Wolever is the leading researcher on health coaching globally and she has kindly offered us her insight. Ruth is Director of Vanderbilt Health Coaching, Associate Professor, Physical Medicine and Rehabilitation, Dept of Psychiatry Vanderbilt Schools of Medicine and Nursing. Thank you Ruth!

"Despite its many problems the NHS is headed in a brilliant direction. Physicians, nurses and allied health practitioners are frustrated with the burgeoning workload and seemingly less-engaged patients as the personal, social and financial impact of chronic disease rises. Patients feel dismissed, uncared for, and even blamed for challenging issues.

But the NHS recognizes one of the real problems - that providers do not have the right tools to be successful in helping patients engage in effective lifestyle change processes that are sustainable. Rather than leaving providers with the outdated impression that they are supposed to educate patients and tell them what to do (exercise more, eat more fruits and vegetables, drink less, etc.), the NHS is training providers in health coaching skills based upon the latest science in how human motivation and successful behaviour change works. By doing this across large systems, they will reap the benefits of the rapidly growing science showing these processes empower patients to more effectively engage in partnerships to self-manage their lifestyles, promote health and mitigate chronic disease”.

Why is health coaching vital for patents and the NHS? Read chapter 1 of the resource guide >

What do systematic reviews tell us? Read Ruth Q Wolever’s analysis >

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