Sunday, 18 October 2015

Can coaching approaches transform care systems?

When we think of transforming health and social care, what comes to mind first? Perhaps it's the hi-tech things like robots doing delicate surgery or delivering routine care with cool efficiency; maybe it's gene therapy to enable us to prevent or treat tragic inherited conditions, even medicines unthought of to provide cures we don't dare hope for yet. And I expect some of that will indeed define part of the future, depending on cost.

But would that really be so transformational for most of us, who live with more common conditions, who have perhaps slowly and gradually learned that no magic cure will change our lives? Yes, medicines and treatments might make a difference but even the so called "cures" leave their impact on long term wellbeing.  And ultimately it's wellbeing we seek. 

In the modern world we have learned to seek quick fixes, we look for solutions outside of ourselves and we get angry when that doesn't arrive. What an exhausting, soul destroying process that can be.  

Interestingly at a recent Citizens Wellbeing Assembly, run by the Health and Social Care Academy and Health and Social Care Alliance Scotland as part of the national conversation on a Healthier Scotland, we asked people what keeps them happy, healthy and well. The answer is rarely medication or even health and care services, it's family, it's connection to others, it's meaningful work, it's music, it's's love and laughter. It's easy to see the themes emerge. Now of course health and care cannot in itself create those things, but what's important is that services are set up to pose the question of what matters to 
you to keep you well and then to organise the services and treatments offered to enable this, to sign post, to connect and indeed sometimes to get out the way.

Transformed services as I understand it will have the individual, their family and community at the centre and services will be part of several options to support wellbeing. That will create a very different engagement with services and within ourselves too. That won't happen without learning to do things differently. Particularly in healthcare, we currently train staff in a fix-it model, with the professional in the role of expert and the service user as passive recipient. We all need to learn to do this differently. 

My experience in this field has taught me that a coaching approach will be an important part of this transformation. Developing person centred coaches is a vital part of enabling this transformation to happen, both in individuals and within the health and care systems.

But why coaching? It is an enabling process that starts from the premise that we all have 
the potential for growth and transformation, it is asset-based and person-centred at its core and is life enhancing for those involved. One such example is an eight week course I have developed, building on my wide experience and learning from projects like the Esther network in Sweden and Buurtzorg in Holland aimed at developing coaches and supporting a person-centred integrated health and care service. Participants report this work is life changing and inspiring, they feel less stressed, more resilient as managers and practitioners, they have already achieved significant impacts through their change projects and ultimately learn the key is in relationship not just with others but with yourself. As one person said they have person-centredness in their DNA.    

So if you ask me how do you transform health and care services, my answer is develop people to build their awareness, their active listening, their deep understanding of person centredness and improve their resilience; make person-centred coaching the linchpin of our future services and we won't just improve the wellbeing of those receiving care, we will improve it for staff as well. 

Audrey Birt 
Independent Coach and Consultant in Health and Social Care and Associate Director of the Health and Social Care Academy.
For more information about this work email me on

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