Episode 22 - The social determinants of team health

Episode 24 – Patient Activation: The Missing Link in Prevention

Summary In this episode, Ollie is joined by two leading voices in the field of patient activation, Professor Alf Collins and Jag Mundra. Together, they explore why patient activation, the skills, knowledge and confidence people have to manage their own health and wellbeing, has become such an important concept in modern healthcare, and why it may hold the key to creating more sustainable health systems. The conversation traces the origins of patient activation, from the academic work of researchers, through to its application in real-world healthcare settings today. Alf reflects on his experience leading personalised care within NHS England and the role activation has played in shaping approaches such as health coaching, social prescribing and care coordination. Jag shares how his work has focused on making activation practical and scalable, including the development of a simple single-question approach that can help identify people's readiness and confidence to manage their health. The discussion explores how activation can be understood not only at an individual level, but across teams, organisations, neighbourhoods and communities. They consider the role of health coaches, social prescribing link workers, peer support, group-based approaches and digital tools in helping more people take an active role in their health. Throughout the episode, a central theme emerges: if healthcare systems are serious about prevention, they must move beyond treating illness alone and create the conditions that help people build confidence, capability and agency in their everyday lives. Takeaways Patient activation describes the skills, knowledge and confidence people have to manage their own health and wellbeing. Higher levels of activation are associated with better health outcomes and lower healthcare utilisation. Traditional activation measures have strong evidence behind them but can be difficult to implement in routine practice. Simple activation questions can help start meaningful conversations and identify where support is needed. Building agency is relevant not only for individuals but also for clinicians, teams, systems and communities. Health coaching, social prescribing and care coordination can all play a role in increasing activation. Group-based approaches and peer support can be powerful ways to support behaviour change at scale. Small conversations and simple nudges can have a significant impact on people's health behaviours. Digital tools can help extend the reach of personalised support while maintaining human relationships at the centre. Prevention requires more than services alone, it depends on helping people feel capable, connected and supported. The biggest opportunities may come from activating entire communities rather than focusing solely on individual interventions. Lasting change often starts with one simple question and one meaningful conversation.

Episode 23 - New Approaches to Chronic Pain: Hope, Health Coaching and Staying Curious

Summary In this episode, Ollie and Tim return to a topic that has shaped much of their work together: chronic pain. Drawing on recent training, emerging evidence and their own experiences in practice, they explore how understanding of persistent pain continues to evolve. The conversation focuses on newer approaches including Pain Reprocessing Therapy (PRT) and Emotional Awareness and Expression Therapy (EAET), both of which are attracting growing interest in the field of chronic pain management. Ollie reflects on his recent training with the Pain Psychology Center in the US, while Tim shares insights from learning about emotional awareness and expression approaches. They discuss how many persistent pain experiences may be driven less by ongoing physical injury and more by the brain and nervous system’s learned protective responses. Importantly, they emphasise that all pain is real, regardless of its underlying mechanisms. The discussion also explores how health coaching principles fit naturally alongside these emerging approaches. Rather than offering a one-size-fits-all solution, the focus remains on helping people develop confidence, skills and understanding so they can take a more active role in their own recovery. Throughout the conversation, Ollie and Tim reflect on the importance of remaining curious, avoiding certainty and recognising that no single technique works for everyone. As new ideas emerge, they argue that the most effective support continues to come from working alongside people, helping them discover what works for them and keeping them firmly in the driving seat of their own health. Takeaways Understanding of chronic pain continues to evolve, bringing new possibilities for recovery and self-management. Pain Reprocessing Therapy is generating growing interest as an approach to persistent pain. Many chronic pain experiences may involve neuroplastic changes within the nervous system, rather than ongoing tissue damage alone. Building confidence and reducing fear can play an important role in recovery. Techniques such as somatic tracking encourage people to become more curious about their pain experience. Emotional Awareness and Expression Therapy explores the role of unexpressed emotions in persistent pain. There is no single solution that works for everyone living with chronic pain. Health coaching provides a flexible, person-centred framework for integrating different approaches. New techniques should complement, rather than replace, existing approaches to pain management. Remaining curious and open-minded is essential as the evidence base continues to develop. Sustainable change happens when people feel empowered to understand and manage their own health. Effective support means working alongside people rather than telling them what to do. The goal is not dependence on practitioners, but helping people build their own confidence, skills and self-belief.

Episode 22 - The social determinants of team health

Summary In this episode, Ollie is joined by fellow GP Dr Ben Allen to explore what really creates healthy, high-performing teams in healthcare. Drawing on a newly published paper in BMJ Leader, co-written with Dr Natalie Jones, Ben reflects on the journey of transforming his GP practice in Sheffield over several years and the lessons learned along the way. The conversation centres around what Ben and Natalie describe as the “social determinants of team health” - the cultural, relational and behavioural foundations that allow teams to thrive. While healthcare systems often focus on targets, outputs and operational pressures, Ben argues that long-term improvement comes from investing in trust, communication, relationships and psychologically safe environments. Ollie and Ben explore practical examples from general practice, including how distributed leadership, intentional recruitment, team connection and patient engagement helped improve continuity of care, staff wellbeing and patient satisfaction. The episode also reflects on leadership, vulnerability and the importance of creating workplaces where people feel safe to speak honestly, contribute ideas and bring their full selves to work. Throughout the conversation, there are strong parallels with health coaching, person-centred care and the wider shift towards neighbourhood working and collaborative healthcare systems. Takeaways High-performing teams are built through culture and relationships, not just processes and targets. Psychological safety and trust are essential foundations for effective teamwork. Vulnerable and emotionally intelligent leadership can strengthen team culture. Distributed leadership helps teams feel more engaged, empowered and connected. Diverse perspectives improve decision-making and organisational understanding. Recruitment based on values and character can be more impactful than focusing solely on skills. Team connection and empathy are not “soft extras” - they are critical to sustainable performance. Patient engagement becomes more meaningful when organisations communicate openly and transparently. Long-term change often requires patience, intentionality and trust in the process. Investing in team wellbeing can improve continuity of care, morale and patient outcomes. Many principles of healthy teams closely align with health coaching and person-centred care. Links and resources mentioned in this episode Reimagining general practice for the NHS 10-year plan: organisational culture as the social determinant of team health:  https://eprints.whiterose.ac.uk/id/eprint/236941/1/Reimagining%20General%20Practice%20for%20the%20NHS%2010%20Year%20Plan%20.pdf [https://eprints.whiterose.ac.uk/id/eprint/236941/1/Reimagining%20General%20Practice%20for%20the%20NHS%2010%20Year%20Plan%20.pdf] Read Ben Allen’s LinkedIn blog expanding on the themes discussed in the conversation: https://www.linkedin.com/posts/ben-allen-a96460207_we-rightly-talk-a-lot-about-the-social-share-7458071880348971008-V9cr/?utm_source=share&utm_medium=member_desktop&rcm=ACoAAAikt9oB-kaAUGEn9eWV6xyHXtQSK86lXS4 [https://www.linkedin.com/posts/ben-allen-a96460207_we-rightly-talk-a-lot-about-the-social-share-7458071880348971008-V9cr/?utm_source=share&utm_medium=member_desktop&rcm=ACoAAAikt9oB-kaAUGEn9eWV6xyHXtQSK86lXS4]

Episode 21 - Healthy working lives: Reflections from the Peak Health Coaching Conference

Summary In this episode, Ollie, Tim and Caroline come together to reflect on the success of Peak Health Coaching’s fourth annual conference, which focused on health coaching for healthy working lives. They explore why bringing people together in person matters, particularly for health coaches and wellbeing professionals who can often be working in isolation. The conversation reflects on the energy, connection and sense of community created throughout the day, and why these spaces are so important for learning, reflection and shared purpose. The episode looks at the growing role of workplaces in supporting health and wellbeing, at a time when more people are out of work due to ill health and many others are struggling with presenteeism. Ollie, Tim and Caroline discuss why employers, leaders and managers need the confidence and skills to have better conversations about health, rather than relying only on reactive support. The episode also reflects on some of the key themes from the day, including mental health, chronic pain, WorkWell pilots, leadership, trust, power dynamics, storytelling and the importance of creating workplace cultures where people feel valued, heard and supported. A central message is that health coaching is not just about formal appointments or specialist roles. It is also about changing the quality of everyday conversations, building trust and creating healthier systems where people can thrive. Takeaways  Health coaches and wellbeing professionals can often feel isolated, making connection and community vital. Workplaces have a major role to play in supporting people’s health and wellbeing. A healthy workforce benefits both individuals and employers. Presenteeism is a growing challenge and can be harder to recognise than absenteeism. Employee support services only work if people feel safe, confident and able to access them. Managers and leaders need skills and confidence to have meaningful conversations about health. Storytelling can help create trust, empathy and change within organisations. Health coaching can support more proactive, preventative approaches to workplace wellbeing. Power dynamics matter, especially when health conversations happen between managers and employees. Small changes in everyday conversations can help people feel more valued and supported. Measuring workplace wellbeing means looking beyond activity and focusing on outcomes, engagement and impact. Creating healthy working lives requires culture change, not just new services.

Episode 20 - Physical activity, prevention and the role of community in health

Summary In this episode, Tim is joined by Dr Callum Leese, a GP based in the Scottish Highlands, researcher at the University of Dundee and co-founder of the community initiative Healthiest Town Aberfeldy. The conversation explores a familiar tension in healthcare - we know physical activity is one of the most powerful tools we have for preventing and managing disease, yet it remains difficult to embed meaningfully into everyday clinical practice. Callum reflects on his experience during COVID, where rising rates of non-communicable diseases highlighted a system often focused on reacting to illness rather than addressing its root causes. He describes this as a kind of “whack-a-mole medicine”, where new conditions are continually treated as they arise, rather than working upstream to prevent them. This led to the creation of Healthiest Town Aberfeldy, a community-led initiative aiming to reduce barriers to good health at a local level. The project brings together food, movement and social connection through practical, visible and locally relevant activities - from cooking groups to growing festivals - grounded in the idea that health is shaped collectively, not just individually. The discussion also explores the real-world challenges clinicians face. Time pressure, limited resources, gaps in knowledge and lack of financial incentives all play a role in why preventative conversations don’t always happen. But alongside these barriers, there are also signs of progress, including growing recognition of social prescribing and more integrated, community-based approaches. A key theme running throughout the episode is the role of health coaching. Not just in how to have better conversations, but in knowing when to have them, how to tailor them, and how to work with the complexity of people’s lives rather than reducing health to single issues. Takeaways Physical activity is one of the most effective interventions in healthcare, yet remains underused in practice Healthcare systems often prioritise treatment over prevention, leading to reactive rather than upstream care Time pressure is a major barrier, but not the only one – resources, knowledge and incentives also play a role Community-led approaches can help remove practical and social barriers to better health Health is shaped not just individually, but by the people and environments around us Rural settings bring unique challenges to health, including access, cost and opportunities for activity Seeing relatable, local examples of change can be more powerful than generic advice Health coaching is not just about what to say, but when and how to say it Tailored, personalised conversations are more effective than generic information or advice People rarely present with a single issue – health challenges are often interconnected Simple questions like “What are you doing to look after your health?” can open meaningful conversations Active healthcare professionals are more likely to have conversations about physical activity Making healthy behaviours visible can be a powerful form of advocacy