David Sweeting and Kieran Morling, Specialist Musculoskeletal Physiotherapists, East Coast Community CIC

April 12, 2019

We both work with patients suffering with persistent musculoskeletal pain, many have maladaptive coping strategies that contribute to their symptoms. We felt frustrated with the difficulties we experienced in activating these individuals towards more positive strategies and wanted to try a new approach. Using health coaching techniques has made working with them both less stressful and, ultimately, more effective.

Health Coaching is now a fundamental part of our daily work, to the point that it is effectively the norm. Our organisation has now trained well over 300 individuals and we are driving the health coaching agenda, with a view to it becoming truly embedded.

Having completed the ‘Train the Trainer’ programme, we were lucky enough to be in a position to start delivering the two day course on a regular basis almost immediately. This allowed us to rapidly become comfortable with the material and to develop a great working partnership. The course is so effective and well-designed that we have not felt the need to make any real adaptions.

We always review our performance as trainers by checking in with each other about how things are going and reading the course feedback forms. We have made efforts to reinforce the learning our attendees get from the course. This began with some refresher sessions. Attendance was poor, so we replaced these with writing short items for our organisation's communication bulletin.

It is difficult to quantify the impact on the NHS, but our experience suggests it is likely to be beneficial in terms of improving outcomes, reducing the number of ineffective appointments, and improving staff resilience.

We have subjective evidence that the initiative is changing the way that our staff communicate with and manage patients. A questionnaire was sent to all those trained and 75% said they had made changes to their practice and noticed benefits. Some comments included:

“I am using methods to break down barriers and allow the individual to find their own solutions.” “I try to use self-management techniques in everyday practice.” “Individuals are more likely to stick to their goals.” “Patients are taking a little more responsibility for their care.” “Empowers patients.” “Encouraging me to feel less as if I am totally responsible in the partnership for change.”

Our organisation set up a full time role for an individual to work as a Behavioural Coach in Primary Care. A total of 836 patients were seen by the Behavioural Coach over a 12 month period with 100% of patients seen for weight management or hypertension achieving some improvement. The post and the coaching approach were universally popular with patients and colleagues. Our evaluation identified some important learning points and areas for potential improvement, but conclusions were that this is an effective role.

David and Kieran’s tips:



  • Ensure you have real commitment from the top of your organisation
  • Don't expect your trainers to do everything in their spare time, allow adequate time and support
  • Be patient and persistent
  • Have an open mind and willingness to change
  • Just do it!

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