Supporting individuals with health coaching in Greater Manchester

The Greater Manchester Working Well Early Help (GMWWEH) programme offered free personalised support and advice to individuals with a disability or health condition across Greater Manchester (GM).

Jointly commissioned by the GM Combined Authority and the GM Health and Social Care Partnership, it was delivered by Maximus and Pathways CIC – and part-funded by the European Social Fund.

The scheme was targeted at those at risk of falling into long-term sickness absence, offering tailored support from a variety of sources, including:

Dedicated health and wellbeing coaches
Our in-house mental health team
Our musculoskeletal practitioners
Expert local practitioners (including CBT practitioners and physiotherapists)
A digital platform hosting 550 self-help articles, videos and podcasts across 27 health and wellbeing topics

Running from 2019 to 2022, the service worked collaboratively alongside 45 GP practices at the heart of GM’s devolved, integrated health and work ecosystem – and supported more than 11,000 residents.

The challenge

The GM Population Health Plan identified employment as a key priority in delivering better health outcomes for the local residents – recognising a strong association between worklessness and poor health, along with the need for prevention and earlier intervention.

The Greater Manchester Combined Authority (GMCA) identified a “co-dependent relationship between health and work” and stated that “good quality work supports good health, and inclusive economic growth relies on a healthy, productive workforce”.

The commissioning officer at GMCA said:

“We were looking to pilot a new approach to preventing people from becoming long-term unemployed by intervening at the point that they will become long-term sick while still employed.”

Our approach

In addition to traditional occupational health solutions, our health and wellbeing coaching model specifically identified and supported participants in making key lifestyle changes.

Individuals with a Patient Activation Measure (PAM) score of Level 1 or Level 2, and therefore identified as being passive and lacking confidence in their own health and wellbeing, were assigned to health coaches – receiving dedicated support to help them make small, impactful and sustainable lifestyle changes. PAM is a validated, licensed tool which measures people’s knowledge, skills and confidence in managing their own wellbeing.

Health and wellbeing coaching: The process

The health coaching allowed more time for the Vocational Rehabilitation Consultants (VRCs) to focus on other support aspects relating to employability, while also empowering participants to improve their wellbeing.

Results

In order to capture baseline and post-intervention scores, we utilised validated tools including the Short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS) and the Euro Qol-5D Visual Analog Scale (EQ-5D VAS).

SWEMWBS was used as a measure of mental and emotional wellbeing, while EQ-5D VAS was used as a quantitative measure of health, based on the participant’s judgement.

Feedback

The GMWWEH employability team felt the relationship with the health and wellbeing coaching team was responsive, agile and successful. Communication was punctual, informative and supportive – and the relationship was always engaging and progressive.

The commissioner said:

“Based on case studies and participant feedback, we believe it has been a valuable addition to the service.

“Many people who were off work sick (or recently unemployed) have multiple health issues which, once addressed, would improve their chances of returning to work or finding a new job.”

Vocational Rehabilitation Consultants conducting case reviews commented that the addition of health coaching resulted in a well-rounded service offering holistic support to the participants, maximising the benefits of dual-sector expertise and delivered in a professional manner.

One Vocational Rehabilitation Consultant said:

“Those participants who accessed the coaching service demonstrated better preparation and understanding of the requirements to manage their own health and wellbeing, as well as being motivated to implement the suggested changes.

Feedback from participants on the health and wellbeing coaching aspect of the service was outstanding. Participants stated they felt they were listened to and supported.

Lyndsey, one of the Greater Manchester Working Well Early Help programme participants, said:

“It has helped me discover things I wouldn’t have known, such as how housing and my environment can impact on my wellbeing.

I feel like someone ‘had my back’ and understood my day-to-day situation. The service is non-judgmental and person-based; I don’t have to explain myself, which gives me time to focus on what I can do.”

Going forward

Asked whether health coaching would be considered in future, the commissioner said:

“Absolutely, for a programme targeted at the right participants. Other commissioned employment programmes already have embedded health coaching elements – as the link between work and health has been firmly established.”

Maximus has gone on to deliver health coaching as part of other contracts, including the Restart Scheme – which we are currently delivering on behalf of the Department for Work and Pensions. Aimed at getting people back into work, the Restart Scheme has already seen more than 500 participants referred to our health coaching services as part of a comprehensive support package.