Know Your Own Health

How is Health & Wellbeing Coaching delivered

The NHS Workforce development framework for health and wellbeing coaches has been created with input from a number of different training providers and people with knowledge and expertise in the field, including Know Your Own Health. It is a wide-ranging, comprehensive and evolving framework. 

The following guidance is based on our long experience of providing supported self-management health coaching in the NHS (now called 'Health & Wellbeing Coaching').

It answers to a range of questions that coaches and Primary Care Networks often ask, with reference to the guidance given in the Framework.


  • What does Health & Wellbeing Coaching consist of?

    Health & Wellbeing Coaching, delivered as an intervention, usually consists of 5-6 sessions – although this is tailored to the individual and some may need more or fewer.  Where more are needed, this is usually only 2 or 3 more, although some may benefit from another full round of 5-6 sessions either straight away or later on.

    The first session is 1 hr and the rest of the sessions are 45 minutes.

    Why these specific timings?

    The first session involves ‘agenda-setting’, or ‘contracting’ and often a questionnaire or two as well as eliciting the patient’s story.  This therefore takes a bit longer than a standard session.

    In our experience, 45 minutes is the optimal time for all other sessions. More time and the session risks becoming more of a counselling session – the 45 mins keeps it focused; less time and it risks being rushed and therefore less effective – the 45-minutes ensures that the coach has time to listen and the patient has time to think.

    What does the NHS Framework guidance say?

    The guidance aligns closely with this, stating a standard 6 sessions of 45-50 minutes.


  • How are outcomes measured?

    There are a number of ways to measure outcomes:

    Outcomes questionnaires 

    Self-management questionnaires:

    The aim of Health & Wellbeing Coaching is to improve people’s levels of knowledge, skills and confidence to self-manage effectively.

    Some questionnaires that measure this are:

    Insignia’s Patient Activation Measure (PAM)

    The Chronic Disease Self-Efficacy Scale (CDSMP)

    These are essentially different from questionnaires such as the ONS4 and the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) which measure wellbeing. 

    It is worth bearing this in mind if using these as outcomes measures for Health & Wellbeing Coaching as changes in people’s confidence to self-manage effectively (as measured by PAM or CDSMP questionnaires) are less prone to fluctuation and more meaningful from the self-management point of view, than changes in their sense of wellbeing (as measured by the ONS4 and the WEMWBS), which can be affected by many things on a day-to-day or month-to-month basis. The two types of questionnaire would be expected to give similar outcomes, and often might, because someone who is self-managing well is likely to also be experiencing a greater sense of wellbeing, and vice verse; however, they are measuring different things.

    Feedback questionnaires

    Feedback questionnaires can be a helpful way of assessing the patient experience both with statements they can agree or disagree with and a free-text box.

    These give an idea of how patients are using and experiencing health & wellbeing coaching.

    You can see a sample Feedback Questionnaire in the links at the bottom of this page.

    Patient stories

    Patient stories or case studies can provide qualitative data around how people are benefiting from Health & Wellbeing Coaching. 

    Measurable and self-reported outcomes

    For example, weight, BMI, Blood Pressure, HbA1C.

    Service Usage data

    For example, number of clinical appointments in the 12 months before and 12 months after completing coaching. Although the reasons for clinical appointments are many and varied and attending necessary clinical appointments is essential, people who are struggling to manage with long term health conditions typically have higher levels of clinical service usage than those who are self-managing effectively (see Health Foundation study).