Sustaining the introduction of health and well-being coaches in multi-disciplinary primary care teams to support underserved populations: Developing recommendations and guidance for patients, coaches, and primary care staff

Research question How can health and well-being coaches be better supported in primary care to address persistent health inequalities Background Health and well-being coaches (HWBCs) have shown promise in addressing these inequalities. Their work involves setting mutually agreed and personalised goals that reinforce healthy behaviours and lifestyles. There is evidence they can provide inclusive care for all sections of the population in the UK, and improve patient activation, self-efficacy and overall quality of life. At the same time the NHS have introduced the Additional Roles Reimbursement Scheme (ARRS) to develop non-clinical roles including health and well-being coaches. However, currently they are some of the least likely roles to be funded through ARRS with reports that where employed their role can be undervalued and inappropriately supported by primary care organisations and misunderstood by patients. Aims and Objectives Our overall aim is to develop understanding of how HWBCs can be embedded in primary care teams with particular focus on their potential to reduce health inequalities. This includes improving understanding and support in staff, and access and engagement amongst patients. Methods This work will explore the perspectives and experiences of health coaching in three populations a) Diverse communities, b) Health and well-being coaches, and c) Primary healthcare providers. These will be used to develop guidance for more successful integration of health coaches in primary care teams to the benefit of all sections of the population. It will be conducted in three work packages (WPs), WP1: A national survey of the utilisation and experience of HWBC amongst the three target groups named above. WP2: A series of semi-structured interviews allowing a more in-depth exploration of attitudes and perspectives of the same. WP3: Synthesise the findings of 1) and 2) to develop guidance that supports more effective inclusion of health and well-being coaches in primary care teams and improves uptake, and engagement across all sections of the population. Timelines for delivery The three WPs will be completed over the course of 18 months, with WP 1 completed by month 12, WP2 by month 14, and WP3 by month 18. Anticipated Impact and Dissemination We will produce three peer-reviewed publications (one for each work package) and present our findings at national and international conferences. Disseminate our service recommendations and patient educational materials through a range of community seminars, and via our established links with the NHS, Birmingham Health Partners, national Colleges and through our links with the UK and International Health Coaching Association and Personalised Care Institute. Finally, we will develop a follow-on grant application to explore acceptability and feasibility of an intervention to increase engagement and measure the impact of health coaching on underserved populations.