The For Kidneys Sake podcast series is brought to you by Imperial College Healthcare NHS Trust and North West London Integrated Care Board (NWL NHS).

In this episode of For Kidneys’ Sake, consultant nephrologists Prof Jeremy Levy and Dr Andrew Frankel speak with Dr. Madhvi Joshi, a GP and certified health coach, about the power of personalised care and health coaching in managing chronic conditions such as kidney, heart, and metabolic diseases. Dr. Joshi explains how shifting from a directive approach (“what’s the matter with you”) to a collaborative one (“what matters to you”) helps unlock patient motivation, improve adherence, and build more meaningful partnerships. She discusses how understanding patients’ life contexts, values, and readiness for change can transform both outcomes and satisfaction for patients and clinicians alike.

Dr Joshi highlights practical frameworks such as the GROW model (Goals, Reality, Options, Will Do) and the 5As of behaviour change (Assess, Advise, Agree, Assist, Arrange) to guide conversations. She also shares a compelling case study demonstrating how lifestyle adjustments, compassionate dialogue, and shared goal setting led to significant improvements in health and well-being for a patient with multiple cardio-renal-metabolic risk factors. The discussion underscores that true progress comes from empowering patients as active participants, helping them navigate their health journeys with curiosity, empathy, and hope.

Key Takeaways

1. Personalised Care – Focus on What Matters to the Person

Shift from a disease-focused to a person-focused approach by asking, “What matters to you?” instead of “What’s the matter with you?”. This means seeing beyond clinical data to understand the patient’s life, values, and priorities. When people feel heard and understood, engagement and adherence naturally improve.

2. Coaching Mindset – Be Curious, Compassionate, and Non-Judgmental

Adopt a collaborative mindset rather than a directive one. Use curiosity to explore readiness for change, compassion to recognise challenges, and non-judgment to create trust. Coaching helps patients find their own solutions and apply knowledge in a way that fits their lives — turning advice into sustainable action

3. Structured Tools – Use GROW and 5As for Lasting Change.

Practical frameworks like GROW (Goals, Reality, Options, Will Do) and 5As (Assess, Advise, Agree, Assist, Arrange) guide conversations and support realistic goal-setting. They help clinicians and patients co-create clear, achievable steps — moving from one-off advice to measurable, lasting behaviour change.

Resource Links:
NICE GUIDELINES [NG203] chronic kidney disease: assessment and management Overview | Chronic kidney disease: assessment and management | Guidance | NICE

Northwest London CKD guidelines for primary care

The purpose of this podcast is to inform and educate health care professionals working in the primary care and community setting. The content is evidence based and consistent with NICE guidelines and North West Guidelines available at the time of publication.

The content of this podcast does not constitute medical advice and it is not intended to function as a substitute for a healthcare practitioner’s judgement.

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