Guest blog – Dr Ollie Hart “Collaborative Care”


“I never hear patients tell me that a medicine changed their life”

I am a GP in Sheffield, and like many GPs I spend much of my time dishing out little green pieces of paper for people to exchange for tablets.

Very rarely do patients ever tell me that ‘medication changed their life’, and if they do it’s usually for the worst. But yesterday I had the wonderful experience of hearing from a number of people who described health care approaches that really had changed their lives.

The first story was a patient of mine Jim, who had been living with chronic back pain for many years. He had sustained an injury whilst working as a firefighter and never recovered. He lost his job, his mobility , social life, self esteem and will to live. As many of you know this is a familiar pattern for people afflicted with longstanding back pain, they get caught in an overwhelming cycle of deconditioning and depression. Together we had tried medicines, physiotherapy, and expert opinions, but little had changed. Yesterday I heard Jim explain about how he had climbed out of his hole and was now working and helping others improve their health. The trigger for this change was not a medicine, a clever operation, or a special treatment, but a health trainer. We are lucky enough to have piloted a health trainer service in our practice., and now they are a mainstream part of our team. Health trainers offer support and self management coaching to people with long-term health issues. Health trainers are not health care professionals, but they are trained in coaching skills to complement their own life experiences.

The health trainer who had ‘got alongside’ Jim had a lived experience of self managing chronic pain. Health trainers don’t have to be expert patients but I think it helps.

The second patient that stuck in my mind was a mum of 4 children, who looks after both her children and her husband who has longstanding mental health problems, aswell as diabetes, and doesn’t work. English is not her first language, and she has never been confident about health issues. We would very commonly see her with her children with minor common ailments. During her last pregnancy she had developed gestational diabetes, and been referred to a health trainer to understand diet and lifestyle issues. With their support she had attended cooking classes and learnt a lot about managing by mixing with others in a similar situation. What was great about Bismah’s story was seeing how her confidence had grown not only towards health issues, but for life in general. In fact she now organizes a mother and child session at a softplay centre. She has negotiated a special discount rate for families that would not normally be able to afford to go, and has become a central character in her community.

These stories are typical of many other life changing experiences that I have witnessed. When people who are overwhelmed with their health issues and life in general, the coaching approach of a health trainer is often the most successful way of moving forward. I’m not saying it works for everyone, people need to be ready to accept this type of help, and engage.

It doesn’t have to be a health trainer, the skills of a coaching approach can come from many sources. It might be a practice nurse, a volunteer health champion, or community support worker in the local council. The name is less important than the skills, and supporting community network that goes with it.


I do think there is much that we can do as GPs, Primary care services, and health care systems to ensure this sort of approach is central to our care. If we value it, support it, practice it and encourage our patients to engage, it makes a huge difference. Encouragingly a systematic approach to collaborative care and support planning is central to the Royal College of GPs new collaborative care and support planning program.

The support from lead organizations, and willing on the ground I think we can see our systems support the live changes that are enjoyed by people like Jim and Bismah.

*The opinions expressed are the bloggers own and do not necessarily reflect the views of the World Health Innovation Summit.
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