Using NLP in the NHS

ANLP Accredited Trainer, Andy writes:

We love hearing about the way in which our students have been using their Neuro-Linguistic Programming (NLP) coaching and mentoring knowledge within the NHS to empower both staff and patients.

Andy went along to the Cuckoo Lane Practice in Ealing to chat with Carol Sears and Julie Belton. He discussed how the various NLP qualifications and training days they’ve been on have been the difference that makes the difference.

“It has definitely helped because I was very much a traditional nurse wanting to lean forward and help and sort things out for people, but I have really learnt to sit back and use a coaching model as it is so much more powerful than leaning in and doing stuff for people” – Carol

Carol and Julie are fairly unique in Primary Care in that they are both nurse practitioners, owners of the Business and they run a nurse-led Practice, employing GPs to work alongside nurses and nurse practitioners to provide an Outstanding service. They are the only Practice out the 79 in the Ealing CCG to be awarded the Outstanding ranking by the Care Quality Commission (CQC) and were recently featured on the BBC health website, as well as both receiving the Queen’s Nursing Institute (QNI) award for outstanding service.

They have both attended our NLP Practitioner and NLP Master Practitioner training over the last few years and we’re delighted to find out just how much they’re using these skills to enhance their day-to-day working life and to know the difference it’s meant to them personally as well.

“You see it playing out in so many scenarios. With regards to our leadership model, we’ve had members of staff where I know that some of the coaching techniques have really worked to grow them in a working environment. Using supportive techniques worked and it has been a real success story. I think that it [coaching] works with patients, and it certainly works as a model for staff” – Julie

The full interview is below:

To start with, I asked Carol how she found using NLP within the Practice over the last few years having first met us in 2013 and deciding to embark on the NLP Practitioner training initially and then the Master Practitioner training a couple of years later.

“Most of my work is clinical and I use a coaching and mentoring style during all sorts of clinical consultations.” explained Carol. “I have worked with patients who have ongoing issues and I have seen them at the end of sessions and gone through different techniques that I learnt during the NLP Practitioner course and the Master Practitioner course.

I put a lot of time into one particular patient who is a young woman with a lot of long-term health conditions who was finding that she was very anxious and low about how her life was panning out. She would get very, very down when she had an exacerbation of her condition.“

I asked Carol what the difference had been to the patient’s long-term health by investing that extra time with her.

“As far as I can see, she definitely copes with the exacerbations in a much more mature way, somebody who can see them as a slight problem and then gets on with them.

She does not get deeply depressed.

She could be somebody who would be on long term antidepressants and perhaps ends up seeing a health psychologist, but they are so few and far between, you cannot get appointments for Health Psychologists. So, I have helped her create coping mechanisms.”

Carol went on to say

“The other type of patient I use an NLP and Clean Language coaching style with are those with mild depression. I find that this is a really quick way of getting people into their headspace, where they can think through what they need to do, putting the ball firmly back into their court. “

Both Julie and Carol had been on a ‘coaching for health’ course with another training provider. “I felt that what I learnt with you guys on the NLP Training was better” said Carol, “because I really experienced it and that makes you understand things much more.”

“That is really important to us,” I replied, “that you do experience it. Then you know how it changes the way you are filtering things and if you just make small changes this can make a big difference to how you feel.”

Carol replied “It has definitely helped because I was very much a traditional nurse wanting to lean forward and help and sort things out for people, but I have really learnt to try and sit back and use a coaching model as it is so much more powerful than leaning in and trying to do stuff for people.”

I went on to ask what difference sitting back made rather than leaning in and helping.

“We have loads of people sat in the waiting room waiting to be seen.” explained Carol. “I think it puts me into a better head space, to deal with the patient and I can actually concentrate and focus, just for those few minutes on the person in front of me. It helps me, as well as the patient.”

It was clear to me that it was a very useful tool for Carol as a nurse practitioner from a clinical perspective and I also wanted to know what difference it made to Julie, who deals with more of the operational and strategic side of the business, as well as seeing patients.

“We want to run a Practice where we are there for patients,” said Julie, “so I am always very mindful that we have the same in ethos in every member of staff. It is not just Carol and I being up and ready, it is about trying to add that little bit of sparkle and help everyone be the best that they can be.

As an organisation, we have got quite a flat structure, we wanted to take as much ego out of the set-up as possible and that is quite untraditional as generally practices are quite hierarchical. That has its positives and negatives; having a flat structure makes us very approachable because I think that when you are very approachable, people very much pull together.

There is not day nor an hour often where there isn’t some form of ‘mini crisis’. We have had about three already today between staff not being able to come in, a patient issue etc. It never ever stops so Carol and I will get together and say ‘Right, how do we look at this from an NLP perspective…’“

Carol agreed “It’s about saying to ourselves ‘Let’s take a step back’.”

“NLP has definitely honed those kinds of skills,” continued Julie. “It has given us both the confidence and skills to gently challenge each other on that kind of level to say ‘right, hang on a minute, why did that happen, or why did that get on your nerves so much’. ‘Yes that’s because of that’.”

We use it every single day. It’s just our way of being, we often say ‘From an NLP Perspective…’ It challenges us both, ‘I am feeling a bit annoyed about this’, ‘What is that about’ ‘that’s ok, I am going to be kind to myself and I am allowed’. We do that a lot. I think that it’s the empowerment, the support, it’s about our twice daily huddles.”

I asked what they meant by a huddle and it turns out that this was a twice daily team building, an idea that Julie had modelled from a lawyer friend of hers. They have their meetings standing up so that people stay engaged, minutes are taken and the energy stays high.

“The language in the huddle is really important,” explained Julie .“We get feedback sometimes where staff might say ‘I don’t understand what that meant?’ It is about a metaphorical huddle to bring people together. Everyone comes to the huddle and it’s known that everyone is there and it’s about our time to say ‘how are you?’, ‘happy new year’ or ‘this has happened and guys we need to think about that’.”

She continues, “It’s an opportunity for every member of staff to speak, so it’s not just about us feeding the messages, it’s about people thinking ‘actually I am not happy about that’, it is very positive and people can bring an issue up so we can all go ‘oh right, ok, we can do something about that’ recognising that we have heard them and that we are working on that. It is still about giving people that opportunity.”

I asked Julie and Carol how this affected the way that the led the Practice.

“With regards to our leadership model,” said Julie “we’ve had members of staff where I know that some of the coaching techniques have really worked to grow them in a working environment. Using supportive techniques worked and it has been a real success story. I think that it [coaching] works with patients, and it certainly works as a model for staff.”

Carol added “We use NLP with the appraisals for planning forward about their professional development, ‘What do you want?’, ‘What would you like to have happen?’ and ‘How can you make that happen?’ ‘What is the time frame?’ they are accepting they are empowered to set their goals.”

I was pleased to hear that their experience in using NLP and Clean Language enabled them to get the best out of people that they were working with professionally and clinically.

“Yes.” said Carol. “very much so. Personal development, clinically, and professionally and personally.”

Feedback is one of the fundamental elements of NLP, both knowing how to give and receive feedback and offering it in a way that allows you to know what has been seen/heard, what you thought based on that evidence and then the impact it had.

I asked them both “There can be a tendency to store what you want to say internally, then get frustrated, annoyed and angry and that comes out through behaviours. How have you found having more of a feedback led practice?”

“It is part of the culture,” replied Carol. “We have been doing it for quite long time, so I think it is very deeply embedded in the culture. There are still some people, who sometimes find feedback is difficult, especially if it ‘poor’ feedback.

We did have a difficult situation in the past with clinical feedback,” explained Carol. “Telling a colleague that they had made a mistake. But we did it and I think I would have found almost impossible had it not been for my NLP work.”

“If there is a complaint about any member of staff,” added Julie, “They will come and talk to me about it and what happened from each perspective, I don’t even need to ask. We are so open, it is straight out with what happened and what can we do differently.”

She went on to say “NLP also improved my email communication, I like to keep them brief and think about the language in the email and the way it is set out, the auditory and visual words, capturing all audiences, so I am being mindful and I do not tend to write long emails because often if you want the message, I find that brevity is the key. Plus, people have got so much to read.”

Carol told me that for Christmas she had been given an Alexa and she found it really difficult to use, as it just would not listen to what she was saying.

“We have to be very clear, very concise and very precise in what you ask Alexa to do” said Carol “It made me think, that is what I need to do, I need to be better at that when I am asking people to do very specific tasks. I shared this at the huddle about styles of communication. It made me think about my style of consultation and how I can improve it. I have actually done a few tasks this morning in an Alexa style.”

Julie added “I think you are absolutely right and sometimes you are providing instruction, particularly when you have got lots of members of staff. You are providing an instruction then I can see from utilising my sensory acuity if they have really understood what I am asking. That is quite a good check.”

I asked them about the awards that they have gone on to win over the last couple of years, alongside being ranked as Outstanding by the CQC.

“Last year we were both awarded Queen’s Nursing Institute (QNI) award for outstanding service. It was signed by the Queen herself, which was very nice” replied Carol.

“And we got Nursing Team of the year as well, which was the year before” added Julie.

Carols NLP Certificate alongside the Queen's Nursing Institute (QNI) award for outstanding service
NLP Master Practitioner certificate alongside the Queen’s Nursing Institute (QNI) award for outstanding service

It was clear to me from the awards and certificates on display in the waiting room and in their own Practice rooms, just how much these meant to them both and that they wanted to share these successes with the team. I noticed as well that they both had their NLP Master Practitioner certificates hanging on the wall.

Both Carol and Julie had been on our NLP Practitioner and NLP Master Practitioner training courses plus their Practice Manager had attended our 3-day self-coaching course as well.

”It’s clear to me that that the three of you have a high-level of emotional intelligence and awareness, knowing more about yourselves. How do you find this helps your staff?” I asked.

“I think we mirror that emotional intelligence and that we have staff, many staff, with lots of emotional intelligence” replied Julie.

“We do look to bring that out in people,” added Carol. “We are aware that learning is more than just opening a book or going on a course. It is about embedding that learning and understanding why that particular learning is important for that particular person and the organisation. It is fab building a strong team of good people around you.”

“We constantly give back, and give thanks for working hard. We never go home without saying thank you to a volunteer” said Julie.

Carol added that they have an achievements board in the staff part of the reception area, their ‘GOB’ Board – Good to Brilliant, which she showed me.

“I think that nursing culture can be quite coy about their achievements. So it is about celebrating all our successes” she added.

“It’s a mindset thing isn’t it,” I replied. “So many people have a tendency of leaving work thinking of all the things that they have not achieved, all the emails that have not been answered, all the patients that they had wished they had done something differently with, said something differently. Not enough people celebrate the achievements to recognise that movement has happened and there have been lots of aspects of the day that have been brilliant, and things have worked.

Jo and I often say to celebrate the achievements. It is important to celebrate, even if celebrating your achievement means you made it here for this workshop today, despite everything else that is happening in your life right now, celebrate that achievement!”

Julie agreed and added “Not everyone has that ability to celebrate achievements and I would say that there aren’t many days that we would go home without having a little dance, or finding something positive. We generally turn something in to a positive thing.“

I wanted to know what Carol and Julie thought they gained through learning NLP and the models it gives and how they got them to become a part of their communication skills.

“You want them to be intuitive,” replied Carol. “It’s a bit like from novice to expert, because when you first start using those tools that you learn in the Practitioner they feel cumbersome, like when you first learn to drive, and you want them to become more intuitive. Now I have got some things that I can do intuitively and some things I still have to look at.”

“It is about practice, practice, practice” added Julie.

“It’s also about keeping me buoyant,” said Carol, “otherwise I think if I carried on working as many hours as I am working at the moment, I might lose my buoyancy and drown. I have worked here for 28 years, that is a long time. That is a lot of patients, that I have known for that length of time, which is very long period of time to know somebody.

When I started working here it was run by two very kind, very caring female GPs who had that very nurturing model as well, so that was the way, I was sort of brought up”.

“And in a way, they burnt out as well,” said Julie. “I sit on that fence to say that I want to be the kindest person, and I want everyone to live and be buoyant and not feel that they can’t carry on because it’s too much.”

“You are yourselves in your roles with your work identities and you are also yourself outside of work as well. Your family lives and personal lives, when you don’t have those professional boundaries in place they can sap your energy.” I replied

“I did your professional boundaries course, which I find very good, really, really helpful and I thought it was a really powerful course, really really good course. It helped me work on those sorts of things. I knew it was my weakness, because I am such a nurturer by my nature. It was a very good course for me to do.” said Carol.

As our chat came to an end, I asked them to sum up what NLP meant to them

“Emotional intelligence” said Carol.

“Empowerment” replied Julie.

It was a pleasure to see them both and to find out about all the great work they do in Primary Care in West London.