Thank you to everyone who submitted their thoughts on the draft model and framework as part of the recent online consultation. There were 9 responses received from 8 participants, all of whom are Health and Wellbeing Coaches. This post summarises the thoughts and suggestions shared and our responses to them.
Strong cases were put forward for adding additional measures to the framework to measure the following:
- The presence of someone else in the coaching session along with the coachee (for example a carer, family member, or translator) – it was agreed that this can significantly alter the coaching dynamic
- The use of contracting – establishing a contract is considered a core part of coaching, so it was agreed that the framework should indicate whether this was used or not
We were not convinced that in the following cases the extra insight gained outweighed the potential cost or impact on the coaching relationship:
- Coachee level of education / cognitive capacity – it was agreed that this would be very difficult to measure without impacting on the coaching relationship, and furthermore its effect on outcomes is fully or largely mediated by variables that are already measured in the Coachee Position section of the framework
- If you didn’t access coaching what would you do, have you accessed coaching before, reason for DNA – all potentially interesting questions, but we were not sure that they have a big enough impact on outcomes to merit inclusion
- The framework assumes that HWBCs are operating within the scope of practice for their role, as described in the PCN DES; it is not an appropriate tool for monitoring or addressing issues related to out-of-scope practice, which should be taken up with your ICB’s Quality and Safety team
The following proposed changes were not considered persuasive enough at this point:
- Specialist support is already covered in the measure ‘Involvement of other professionals in delivering the coaching’
- It was acknowledged that a lot of people don’t know what health and wellbeing coaching is, but the feeling was that the best way of addressing this is to keep using the term until it becomes normal, rather than using something more generic and less informative
- We are inclined to keep the measure around coaching methods and techniques, even though it might be difficult for some coaches to answer consistently – a frequent criticism of existing research into the impact of health and wellbeing coaching is that the research doesn’t define what the coaching consists of, so it is not known exactly what is being assessed for its impact on outcomes
- We are inclined to stick with the language around barriers to good health and wellbeing, but monitor the utility of this measure during testing, as the proposed alternatives had their own issues around clarity and interpretability
- We understand that data gathering should ideally occur in the normal course of the coaching conversation, in which case anonymous or remote feedback wouldn’t be possible – this will be covered as part of the training in how to use the framework, including how to obtain informed consent from the coachee to use their data
We agreed with the following points:
- The full framework as it currently stands doesn’t make sense for one-off coaching sessions – we will develop a cut-down version of the framework for one-off sessions
- There are a handful of measures that require revised wording to make them clearer or use more appropriate language
As we get into testing the framework with real coachees, we will likely discover that some of these calls need revisiting, and that there are other issues not raised during the consultation that need addressing. This is the purpose of testing! We’re looking forward to continuing the conversation as testing progresses – if there are any further thoughts you’d like to share please do contact us through our contact form, or (even better) post to the Health and Wellbeing Coaches forum on Future NHS.
There are still a couple of spots left for NHS-funded employers of Health and Wellbeing Coaches who would like to be involved in testing the framework with their coachees, so please do get in touch using our contact form if interested. Onward to testing!
