Social Impact

The Bridges programme is an innovative and successful model of integrated self-management support which includes co-produced patient-held tools, training for the community health and social care workforce, change management consultancy services and monitoring and evaluation expertise.

It is the first individualised stroke self-management programme in the UK shown to change attitudes, beliefs and practice amongst the health and social care workforce and improve confidence and functional capacity of stroke patients using the programme.

We are a solution which fulfils a gap in the current market by integrating self-management support into existing practice which can either replace or supplement traditional group-based education programmes delivered directly to patients. In doing this, Bridges has an advantage by making use of key existing resources (i.e. patients and staff) rather than being delivered as an add-on to current practice.

Bridges is a cost-effective solution for supporting people living with long-term conditions that account for a significant proportion of NHS spending. There is potential to:

  • Reduce the need for ongoing rehabilitation, health and social care
  • Lower the incidence of readmission
  • Create earlier discharge from statutory services that can happen when practitioners feel more confident to support people and families to self-manage their everyday lives living with a long-term condition
  • Have fewer attendances to primary care and need for onward referral to additional services, reduced utilisation of medication (for example, analgesia for post-concussion headaches), and improved productivity in terms of effective return to work strategies
  • Integration into usual services may be more effective than providing a separate intervention in addition to current care, is less costly, and helps to promote a shared understanding amongst staff of the value of starting to support self-management behaviours with patient groups.

We believe there are two main areas of impact following integrating self-management support using the Bridges approach;

1A workforce equipped to support self-management and integrate shared decision making into their practice. Staff at all levels are empowered to work differently including those in support roles to feel confident to support people with long-term conditions. This will lead to a potential reduction in healthcare utilisation.

2A wider and more diverse group of patients and families will have the confidence to manage their long-term conditions. Studies and public health data shows it is often people from BME groups, and people with low health literacy who do not access group self-management programmes. Our programme uses tools which have been co-produced with stakeholders from these groups, and self-management support is tailored to align with the needs of more individuals.


We have delivered self-management training since 2008 reaching more than 120 different teams in health and social care, trained over 2000 practitioners, using Bridges with more than 15,000 people with stroke, brain injury and other long term conditions.

We have carried out more than 20 different research and service improvement projects since 2008 and published and presented our work in many different health and social care conferences across the UK, New Zealand, Australia, and the US.

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