This is a guest blog from Carol Pickering, executive coach and organisational development practitioner, and Mary Cross, health coach, trainer and learning & development specialist at Health Coaching Academy, in which they share their top six tips for health and care professionals wanting to conduct high quality, personalised care conversations over the phone.
Can good, personalised care conversations happen over the phone?
In short, yes! Over the years we have trained a wide range of health and care professionals who want to have more effective and compassionate personalised care conversations  with their patients face-to-face, virtually, and on the phone. We know that the most powerful personalised care conversations happen, when a coach-approach is taken, which involves adopting the mindset and core skills of coaching, or for this audience, health-coaching, to have more person-centred conversations.
During our many training sessions, we talk with health and care professionals about what they find challenging, and a frequent topic is whether you can have a quality personalised care conversation by phone. The good news is that you can! However, to enable you to have even more impactful phone conversations that make a difference to your patients, here are six top tips that you can start using in your phone conversations today:
1. Check your mindset
How do you feel about having a conversation by phone? If we see it as a poor second to a video conference call, or an in-person conversation, this can unintentionally affect our mindset and influence how we sound and what we say early on. However research has shown  that using a coach-approach conversation by phone has many benefits, so showing up with a mindset based on a belief in, and understanding about, what a compassionate, patient-led, personalised care conversation, over the phone can do, will come across to the patient and create readiness for them to feel confident in you and the coach-approach process.
2. Breathe, reset, and tune in to the patient
A day in the life of a health and care professional can feel relentless, with pressure to speed through your caseload. Taking two minutes between sessions to ‘reset’ ourselves before we ‘tune in’ to the patient, can pay dividends. This can be as simple as doing a short breathing exercise , just two or three breaths, to become present, as we step onto the threshold of the patient’s world, as like us, they will have things going on today.
This ‘reset’ can serve as a reminder to both listen to ourselves and to our patient, so that we can acknowledge what is happening for them at the outset, and before we ask what they most want from their session. It will also reduce any tension you may be holding, especially in your stomach, shoulders, and jaw. Diaphragmatic breathing helps to reduce anxiety and nervousness, relaxes your vocal cords, and communicates confidence through a well-paced voice and delivery. This and smiling as you speak will add warmth and help to build trust early in the call.
3. Check their availability
When the patient answers the call and after you have said briefly who you are, it can be worthwhile checking if they are still available to speak. Having an appointment does not always mean the patient is ‘available’ for a coaching-led, personalised care conversation. We can check by asking something like- ‘Is now still a good time for you? Are you somewhere you can talk privately?’ They may be distracted by something that is happening now. Checking with them enables us to make an agreement  to go ahead and continue the call and opens their mind to a conversation.
4. Turn up the dial and listen with your whole self
When taking a coach approach, we are trained to look at body language as well as listen to the words being spoken. There are no visual cues when having a coaching-led conversation on the phone. Instead, it becomes critically important that we tune in to what the patient is saying, to pace, energy, and tone of voice and to what is not said. Closing our eyes to listen may well enhance our ability to do this. It minimises distractions and helps us to pick up subtle changes and demonstrate our understanding of what really matters to the patient.
It also helps us pick up on emotions. According to a 2017 study by Michael Kraus, a social psychologist at Yale University, having no visual cues can be an advantage rather than a constraint. Kraus says ‘… facial expressions can mask a person’s true feelings – something that … is harder to do with the voice – while language plays a key role in how people understand and label their emotions. The upshot… is what people say, and the way they say it, offers the clearest insights into the emotions of others.’ 
Another advantage to relying solely on auditory cues is that we may be less judgemental. Professor David Clutterbuck suggests, “It can be more egalitarian. There is some evidence that people feel more comfortable about power gaps arising from gender, race, or hierarchy.” 
5. Establish the coaching relationship
The ability to build an effective relationship quickly with a stranger is a crucial set of skills in healthcare. You want it to feel like a good conversation. Three important and related elements are rapport, role clarity and clarifying expectations. Let’s start with rapport. In addition to checking in with them (see 3 above) we can smile. Much has been written about the benefits of smiling on the phone. The evidence is that our smile can be heard in our voice tone by the receiver. It helps to signal friendliness, warmth, and interest, put patients at ease and increase trust. It can also trigger a more positive mood and outcome.
Next, role clarity. If we can give a short soundbite that explains our role and the purpose of the call, this will give a sense of direction and purpose that builds confidence in our competence and the coaching process, that underpins an effective personalised care conversation.
Finally, exploring the patient’s expectations ensures they understand what the aims of personalised care conversations are and what the use of health coaching can and cannot do, and the respective roles we each play in creating successful outcomes.
6. Use silence
When faced with silence on the phone, we can feel anxious. Many of us are uncomfortable and jump in quickly to fill it. We wonder: Has the connection dropped? Has our question landed badly? Is the patient upset? What are they thinking? If we can pause instead and become more comfortable with silence, we give the patient time and space to hear themselves think more deeply about our questions and to discover answers for themselves.
If it feels right to respond we can check in with: ‘What is going on for you?’ or ‘What is going through your mind?’ If we sense they are upset, we can ask how they are feeling and what they need from us. They may need a moment before continuing. It can help to return to where they were when they were silent and invite them to reconnect with what was important for them just then and what that means.
We hope you have found this article beneficial. There is much more to successful personalised care conversations and utilising a health coaching approach than we can cover here. If you would like to know more, please click here or follow us on LinkedIn where we share more resources.
PCI resources for personalised care and remote settings
Looking for more resources on providing high quality personalised care in remote settings?
The PCI offers a 30-minute eLearning module on delivering personalised care in remote consultations, and a 10-minute ‘Remote Consultation’ interactive Virtual Patient Scenario. Both of these resources are free to access, available 24/7 online and provide CPD points.
About the authors
Carol Pickering, executive coach and organisation development practitioner
Carol brings expertise in health and executive coaching, leadership and team development, organisation development, and facilitation. She has been working with HCA since 2018. Carol enables individuals and teams to develop their skills to empower patients and service users to feel heard and be motivated to take responsibility for their health. Carol enables professionals to develop their strengths; see and define what they want to be better at; and develop the confidence, commitment, and their path to change. She has worked with clinicians, professionals and leaders across health and social care and has over 20 years’ experience as a change agent and coach in the NHS. She also works as an academic coach associate at Lancaster University Management School’s Department of Executive Education with executives undertaking part-time postgraduate studies.
Mary Cross, health coach, trainer, learning & development specialist
Mary Cross has been working with HCA over many years. She is a highly experienced coach, trainer and facilitator. Mary specialises in the development of health care professionals, clinicians, leaders, managers and their teams. Her 25 years as a learning and development professional has given her a breadth of experience across the NHS and Social Care, along with private sectors. She is a chartered member of the Institute of Personnel and Development and an accredited coach and accredited coach Supervisor.
We would also like to thank Danny Barr, health and wellbeing coach at Ashfield Medical Centre, who contributed his experience of health coaching by phone.
HCA have been pioneering training in the health, care and voluntary sectors for over a decade and HCA are proud to not only be an approved supplier of NHS England, but also both a Personalised Care Institute accredited and a European Mentoring & Coaching Council accredited training provider, meaning high quality and trust are at the heart of everything we do.
 The NHS’s Universal Personalised Care report, says: Personalised Care means ‘people have choice and control over the way their care is planned and delivered, based on ‘what matters’ to them and their individual strengths, needs and preferences.”
 See Fredrik Fogelberg’s LinkedIn article: Coaching Goes Online: Progress or Curse about the benefits of remote coaching (https://lt.linkedin.com/posts/fredrik-fogelberg-4bbb5a9_coaching-goes-onlineprogress-or-curse-activity-6929801726891839488-GFpM) & www.greenfieldsconsultancy.co.uk/gf/wp-content/uploads/2017/05/Are-you-there_-_-Coaching-at-Work.pdf
 In coaching we refer to ‘contracting’ with the patient about how you will work together, confidentiality, roles, goals and what they can expect.