NHS Manchester University

Evidence and links

SAGE & THYME foundation level workshop


Research papers/abstracts

Connolly M, Perryman J, McKenna Y, Orford J, Thomson L, Shuttleworth J, Cocksedge S. (2010).  SAGE & THYME: A model for training health and social care professionals in patient-focussed support. Patient Education and Counseling; 79: 87-93.

Connolly M, Thomas JM, Orford J, Schofield N, Whiteside S, Morris J, Heaven C. (2014).  The impact of the SAGE & THYME foundation level workshop on factors influencing communication skills in health care professionals.  Journal of Continuing Education in the Health Professions; 34 (1): 37-46.

Griffiths J, Wilson C, Ewing G, Connolly M, Grande G (2015).  Improving communication with palliative care cancer patients at home - a pilot study of SAGE & THYME communications skills model.  Eur J Oncol Nurs: DOI: http://dx.doi.org/10.1016/j.ejon.2015.02.005

Connolly M, Thomas J, Barr N, Ramsbottom S (2023).  SAGE & THYME works fine online.  Patient Education and Counseling: 109 (suppl):121.  DOI: https://doi.org/10.1016/j.pec.2022.10.277


Journal articles

Brand S, Coyne E, Tomlin M, Rigby M (2014).  Training renal staff to feel confident to respond to distressed patients.  J Renal Nurs: 6 (6); 289-292.

Connolly M (2016).  Listening skills 1: how to improve your listening skills.  Nursing Times: 112 (45/46); 10-12.

Connolly M (2016).  Listening skills 2: developing listening skills through practice.  Nursing Times: 112 (45/46); 16-18. 

Griffiths J (2017).  Person-centred communication for emotional support in district nursing: SAGE and THYME model.  British Journal of Community Nursing; 22 (12): 593-597.

Martin ASH, Costello J, Griffiths J (2017).  Communication in palliative care: the applicability of the SAGE and THYME model in Singapore.  International Journal of Palliative Nursing; 23 (6): 288-295.

Petley R (2017).  How a model of communication can assist nurses to foster hope when communicating with patients living with a terminal prognosis.  Religions; 8 (10): 277

Ang SH (2019).  Promoting effective nurse-patient communication in palliative care using the SAGE & THYME model: can it be implemented cross-culturally?  The Open Nursing Journal; 13: 153-155.


Reports and textbooks

The SAGE & THYME model and its training has been picked up by a number of textbooks, independent reports, articles and strategy documents:

Getting It Right - End of life care in advanced kidney disease

Communication skills in end stage respiratory disease

Chartered Society of Physiotherapy Frontline Magazine

Department of Health: One chance to get it right

Macmillan report: How we can support and empower NHS staff to deliver a good experience of care to patients

The Royal Marsden Manual of Clinical Nursing Procedures (9th edition, March 2015) - chapter 4 on communication.

York Teaching Hospital Staff Matters newsletter (March 2016)

Respiratory Nursing at a Glance - Wendy Preston and Carol Kelly (2017).  Wiley Blackwell, Chichester

Oxford Textbook of Communication in Oncology and Palliative Care (2017), Oxford University Press, Oxford -  chapter 24 on SAGE & THYME model


Care Quality Commission (CQC) Reports

The SAGE & THYME training has been highlighted as good practice in the following CQC reports:



The Hearing Aid podcast recorded in March 2019 on 'communication wih relatives' talks about how SAGE & THYME can be used in conversations - access it here. (You need to provide your email address and name to be able to play the podcast).



A webinar (presented by Mike Connolly and Simon Cocksedge and hosted by Joanne Thomas) on the evidence behind each element of the SAGE & THYME model and on the impact of the SAGE & THYME foundation level workshop can be accessed by clicking here.

A webinar (presented by Mike Connolly, Sue Heatley (Central Manchester University Hospitals NHS Foundation Trust) and Vicki McLoughlin (Salford Royal NHS Foundation Trust) and hosted by Joanne Thomas) on how to generate senior support in your organisation for SAGE & THYME training can be accessed by clicking here.

Note that there are more webinars available to SAGE & THYME facilitators - these can be accessed in the secure trainer area of this website.


Independent evaluation

The University of Manchester has conducted an evaluation on using the SAGE & THYME foundation level workshops to improve the psychological support provided by district nurses to patients in palliative home care - a paper will be submitted for publication on the findings - see download on right hand side.

South Central Strategic Health Authority has evaluated the SAGE & THYME foundation level workshop training for over 2,500 health and social care staff.  The findings were presented at the International Pstcho-Oncology Society (IPOS) conference in Brisbane, Australia in November 2012 - see download on right hand side.

Nottingham University Hospitals NHS Trust presented the findings of their evaluation with renal staff on 2 May 2014 at UK Kidney Week (jointly hosted by the British Renal Society and the Renal Association) in Glasgow - see download on right hand side.

Leeds Teaching Hospitals NHS Trust presented the findings of their evaluation on teaching the SAGE & THYME model to renal staff on 11 June 2014 at the Trust's annual Nursing and Midwifery conference - see download on right hand side.

Imperial College Healthcare NHS Trust has investigated whether staff could recall what was taught in the SAGE & THYME foundation level workshop a few months after receiving this communication skills training.  They found that 3-6 months post-workshop, over 60% of staff reported remembering "a lot" of what was taught during the workshop and over 30% reported that the training had impacted on their practice "a lot"  - see download on right hand side.

Leeds Teaching Hospitals NHS Trust Department of Clinical and Health Psychology has evaluated the SAGE & THYME foundation level workshop to determine whether participants use the training in their day-to-day practice using semi-structured interviews.  All of the participants in the study said that the workshop had influenced their practice in some way.  The research was conducted by Emma Waters and commissioned by Dr Gary Latchford in 2015 - see download on right hand side.

NHS Tayside has produced a report evaluating data collected from the questionnaire in the delegate pack completed at the end of the workshop, and also 6 months after the workshop (to determine the impact of the training at Kirkpatrick level 2).  In their follow-up data (response rate of 28%), they found that 95% reported SAGE & THYME to be of some help, although 27.3% had never used the model in practice – some reasons are given (e.g. not had the opportunity).  In addition, those that had used the SAGE & THYME model (either partially or fully) in general found it easy to use.  Interestingly, those people who felt that they already had a lot of the skills taught, still found the workshop helpful/confirmation that they were doing the right thing.  Examples of how SAGE & THYME has been used in practice are given.  Finally, the factors that hinder the model’s use are what we would expect (e.g. lack of time/opportunity) - see download on right hand side.

The University of Northampton Institute of Health and Wellbeing has evaluated the SAGE & THYME foundation level workshop, as one component in a series of multi-professional and multi-agency training courses run, to ensure the delivery of high quality services to frail and older people in Northampton.  The Northamptonshire Local Education and Training Council (LETC) received funding from Health Education England to run and evaluate a suite of training courses (including SAGE & THYME) centred around: prevention and enabling self-care; geriatric assessment and personalised care planning; management of long term conditions; and end of life care.  The SAGE & THYME foundation level workshop was delivered by the Northamptonshire Healthcare NHS Foundation Trust.  The University’s report highlighted that the SAGE & THYME (S&T) workshop “engenders a sense that this was a well presented, easy to follow communication course which could be applied to practice easily”.  A summary of the main findings from the report that relate to SAGE & THYME can be downloaded from the right hand side of this page.



SAGE & THYME e-seminar for NHS Kidney Care - 18 July 2012 (link to the webinar is no longer available)


SAGE & THYME for Advance Care Planning and End of Life Care conversations workshop



An evaluation of the workshops with over 400 participants has been carried out.  This showed that the workshop significantly increased from pre to post workshop, staff confidence in starting a conversation about advance care planning or end of life care and also in responding to concerns raised during such a conversation.  Participants also showed a significant increase in perceived confidence in conducting an advance care planning/end of life care conversation.  In addition, 74% of participants said they would definitely change their practice as a result of the workshop and 88% would definitely recommend the workshop to others.  Download the full report from the right hand side of this page.


Reports and textbooks

Palliative and End of Life Care Strategy for Northern Ireland

Advance Care Planning in End of Life Care (first edition) - Keri Thomas, Ben Lobo.  Oxford University Press, Oxford, 2011.

Advance Care Planning in End of Life Care (second edition) - Keri Thomas, Ben Lobo and Karen Detering.  Oxford University Press, Oxford, 2017.


Evaluation of SAGE & THYME Communication Skills Training - E Waters


Imperial College Healthcare evaluation


Leeds Teaching evaluation poster Jun 2014


NHS Tayside evaluation


Nottingham University Hospitals renal staff evaluation


Research with District Nurses


SAGE and THYME ACP workshop evaluation report


South Central SHA evaluation


The University of Northampton evaluation summary