Patients, Users & Beyond

Patients, Users & Beyond

Digital health coaching: a new hope for the NHS



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iPLATO Healthcare has recently announced a partnership with Health Navigator, bringing health coaching to NHS patients living with long-term conditions. Tobias Alpsten, CEO of Health Tech Specialist iPLATO tells us why digital health coaching could save time and money as well as improve patient experience

The prevalence of longterm health conditions is on the increase, with latest figures showing that there are now 4 million people in the UK diagnosed and living with diabetes alone. Patients suffering from longterm conditions can struggle to manage their disease effectively and yo-yo in and out of hospital and GP settings, accounting for 50 per cent of all GP appointments and 70 per cent of all inpatient bed days.

At a time when the NHS is under mounting pressure because of rising demand and tighter budgets, it is becoming increasingly clear that the need to introduce new and innovative models of care is intensifying.

Technology has of course become essential to the way we live our life. Smartphone usage is prevalent and 76 per cent of the over 50s own a mobile phone. The internet is just a touch away and healthcare providers need to recognise the role technology can play in enabling and facilitating self-care. Clinicians cannot meet every need of their patients – especially when they have chronic conditions – so we need to educate patients in self-care, in order to relocate staff to where they are needed the most.

A new way of learning and coping

One of the solutions that is proving effective is clinical health coaching. It is a relatively new concept for the NHS, though it is well established in other parts of the world where data shows it to be a highly effective model of care.

Health coaching can have a significant impact on unplanned hospital admissions, as well as a reduction in GP appointments and out-of-hour emergency calls. For patients, coaching increases their understanding of their conditions and motivates them to make key behavioural changes such as smoking cessation, medication compliance, adoption of regular exercise and a healthy lifestyle. It also signposts them other available support services when necessary.

iPLATO Healthcare and Health Navigator recognise that caring for those with complex needs requires a partnership with patients over the longer term rather than providing single, unconnected ‘episodes’ of care in a GP appointment setting or emergency admission. Following approval by the relevant CCG to fund the health coaching programme, patients will be invited by their GP practice to enrol in tailored sessions. Holistic coaching is delivered both face-to-face and over the phone at a time and place convenient to patients. This provides an increased sense of control by eliminating some of the barriers and intimidations that are often present with shorter consultations with healthcare professionals such as GPs or emergency staff. This results in higher levels of engagement with patients.

This year, in a trial programme with NHS Vale of York Clinical Commissioning Group those patients supported by Health Navigator’s Proactive Health Coaching had 20-40 per cent fewer non-elective admissions and 20-40 per cent fewer A&E attendances. This clearly demonstrates that helping patients thrive in the presence of longterm diseases requires a paradigm shift in healthcare delivery models, ultimately moving to one that is empowering and increases patient activation, confidence and healthy behaviours to improve outcomes and reduce the UK’s spiralling healthcare costs. This need is echoed in the NHS Five Year Forward View which highlights that ‘long-term conditions are now a central task of the NHS’.

By supporting patients with weekly coaching calls from NHS nurses, the randomised control trial is already showing high levels of improved patient experience, a reduction in attendances at A&E and fewer admissions to hospital. The aim is to improve patient confidence and knowledge in managing their longterm health conditions such as diabetes, coronary heart disease (CHD) and Chronic Obstructive Pulmonary Disease (COPD) to ultimately improve their quality of life.

The results also provide evidence of relevance, spread and replicability, with the initiative being easy to imitate nationally. And, crucially, it also provides the ability to be scaled up to cover a wider range of health conditions.

Implications for the future

Looking forward, the vision is to build on proposals to ‘liberate’ the NHS by putting patients at the centre of decision making about their own care, enabling them to have more control over their condition and therefore co-creating better outcomes for them and for wider health and care systems.

With recent figures showing the number of people with long-term conditions is predicted to rise to 2.9 million by 2018, it’s clear there needs to be a much greater sense of urgency about how we’re going to deal with this issue, not only in financial terms but the impact on individual patients. We need to work collaboratively and appreciate that digital patient-facing technology and innovative health care delivery models may well be the answer to saving our much-loved NHS.

About the author

As iPLATO’s Chief Executive Officer, Tobias Alpsten is responsible for setting overall strategy and for leading marketing, support, product management and engineering for his company. Committed to evidence based interventions in healthcare, Tobias works with leading institutions including UCL, Imperial College, the Department of Health and Public Health England on increasing the evidence base for health technology through research.

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