Advancing self-management rehabilitation support globally across acute and long-term healthcare settings

A stroke can be life-changing for individuals, families and friends. The aftermath of a stroke comprises not only physical recovery but also emotional and social recovery. Stroke rehabilitation recognises this deeper challenge and seeks to empower people to face their future.

In 2008, Professor Fiona Jones, of Kingston's Centre for Health and Social Care Research, developed Bridges, the UK's first stroke rehabilitation programme based around self-management. In line with the NHS's aim of including self-management in care practices, Bridges is a patient-centred approach to stroke rehabilitation, offering strategies for practitioners to tailor rehabilitation to patient need and preferences. It aims to build the confidence, knowledge and skills of people with a stroke, enabling them to live well.

Bridges is the culmination of Professor Jones's extensive research, which identified an urgent need to improve stroke rehabilitation strategies in the UK.

From 2009 onwards, Bridges has trained healthcare practitioners and communities nationwide to integrate the Bridges programme in ways that benefit both patients and practitioners.

In 2013, Professor Jones established Bridges Self-Management Ltd as a social enterprise to advance and implement the programme more widely. Today, the organisation employs five members of staff and 14 associate facilitators. With funding from grants, NHS Workforce Development Fund, Health Education England and other sources, Bridges has made significant headway in bringing its approach to new clinical settings and patient groups.

Bridges has now been adapted for patients with progressive neuromuscular disease, major trauma, traumatic brain injury, cancer, heart failure, diabetes, pulmonary rehabilitation, long Covid and other long-term conditions. Healthcare practitioners in the UK, Ireland, New Zealand, Australia, South Africa, Estonia, Sweden and Belgium have been trained in these areas. More than 4,500 practitioners and 380 teams across care settings (hospitals, rehabilitation centres, social care and the voluntary and charity sector) have benefited from the Bridges approach.

Bridges now co-designs system-wide projects across healthcare pathways, as well as books and digital tools supporting virtual communities of people coping with similar challenges in life.

In March 2020, during the early days of the Covid-19 pandemic, Bridges delivered webinars that were watched by 3,200 healthcare practitioners from across the world.

Professor Jones's recent research has focused on evaluating the effectiveness and impact of Bridges. Her findings establish that rehabilitation and care strategies should vary based on culture and context, and that Bridges is an efficient way to transform care.

Multiple healthcare teams and pathways of care have adopted new efficient working processes and systems after integrating Bridges into their delivery. In the Northern Ireland centre that participated in Bridges training, waiting times for paediatric services decreased from three months to just one.

In 2020, Bridges delivered a training and quality improvement programme called People 1st across the East of England. Of the 650 participating practitioners, 92% stated that Bridges helped them build better relationships with their patients and supported them in providing stronger holistic and personalised care.

In recognition of her services to stroke rehabilitation, Professor Jones received the Excellence in Stroke Care Award from the Stroke Association in 2009 and was awarded an MBE in 2017.

In 2020, Bridges became the only stroke-specific self-management programme to be accredited by the Personalised Care Institute set up by NHS England and Improvement in 2020. Thirteen years since its inception, Bridges continues to grow, inspire, and bring about positive social change.

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