Health coaching cuts hospital admissions

There can be little doubt that improving the management of long-term conditions (LTCs) is one of the NHS’s biggest priorities. Around one in three people in the UK are currently living with a chronic condition, and a staggering £7 of every £10 spent on the health budget goes towards supporting them. It is estimated that by 2018, nearly three million people will have three or more conditions at once. The impact on the health service, both in terms of cost and the ability to deliver quality care, is significant; demand is dramatically outstripping resource. The impact on the patient, however, is even more critical. Health outcomes are suffering as, all too often, patients become disengaged from their care and are forced to endure unnecessary hospital treatment, or sustained unemployment, because their condition has not been managed optimally. The Health Secretary has vowed to free patients with chronic diseases from the “merry-go-round of doctors’ surgeries and hospitals” – but, without meaningful change, the situation will only get worse. To progress, we not only need to change the way the NHS works, but we must also transform how patients interact with their healthcare, and redesign care pathways to put patients at the centre. The current model of managing LTCs is unsustainable. The tipping point is fast approaching. It is time for the NHS and patients to think – and behave – differently. Technology will undoubtedly sit at the centre of the solution.

Technology: the great enabler

The discussion has now moved beyond debating whether technology can play a part in transforming patient care. To succeed, it must. Tomorrow’s healthcare model must optimise technology, harness the power of information and share it across the health and social care system in ways that join up care, connect organisations and empower patients. Moreover, if the NHS is to deliver patient-centric services built upon the principle of ‘no decisions about me, without me’ – and in the process, facilitate more effective management of chronic disease – the integrated use of innovations such as telehealth and health coaching must become the rule rather than exception. The recently-published NHS Mandate outlines an NHS Commissioning Board objective to drive a substantial increase in the use of technology to help people manage their health and care. It encourages CCGs, providers and local councils to collaborate to overcome the practical barriers that prevent services working together effectively – and in particular, challenges local commissioners to stimulate the development of innovative, integrated service provision across primary, secondary and social care. The Mandate promises to make ‘significant progress’ in helping patients with LTCs to benefit from telehealth and telecare, enabling them to manage and monitor their conditions at home – reducing avoidable hospital admissions and improving health outcomes. With the emergence of a new NHS commissioning landscape, CCGs and Local Authorities must indeed work in partnership to ensure that local health and social care budgets are not eroded by the inefficient management of long-term conditions. The most proactive will take advantage of innovative technologies that already exist. At a national level, tools to assist shared decision-making between patients and clinicians are being implemented as part of the QIPP Right Care programme – and are, at present, providing patients with vital information across key diseases areas. Although this provides a powerful platform to nurture informed patients, it is widely recognised that, in isolation, educating patients is not enough to bring about true behavioural change. Individuals diagnosed with long-term conditions commonly require ongoing support as they seek to adapt their lifestyles. Health coaching, therefore, is emerging as a valuable integrated adjunct to shared decision-making that can help patients manage long-term conditions.