Self-management programmes have been advocated within UK health and social care policy for a number of years due to the evidence that they can improve patient outcomes, quality of life and reduce service usage. However, programmes rarely exist for complex conditions such as stroke, brain injury and other neurological conditions. The Bridges self-management approach is an evidence-based, training and support model for healthcare practitioners, inspiring changes to their behaviour and interactions with patients, so they are less directive and more collaborative and person-centred. Since its beginnings in stroke, the Bridges approach has been adapted and spread to different conditions and environments, however, the pathways leading to this spread are not clearly defined and little is known as to how successfully the approach has been sustained in practice. The aim of this study is to identify the factors that influence spread and sustainability of the Bridges Self-Management approach within stroke and neurological services in England.
A multiple case studies design will be used, gathering qualitative and quantitative data from a range of clinical staff, managers and patients, through an ethnographic approach. Data will be triangulated and analysed using an appropriate implementation theory, such as Normalisation Process Theory.
This research has implications in understanding how best to implement and sustain delivery of evidence based self-management support across pathways, by providing staff with the knowledge and skills required and aiding them to respond to the increasing number of patients living with complex, long-term conditions.
Since obtaining my undergraduate degree in 2003, I have worked clinically as Physiotherapist in a range of environments, both within the NHS and voluntary sector. Completing my general rotations, I discovered my passion for working with patients with neurological conditions within the community environment. For 9 years, I was Team Lead for an Early Supported Discharge Team, providing intensive, home-based rehabilitation, facilitating patients with stroke to have a more rapid discharge from hospital.
Through my clinical work, I was fortunate to receive training in and utilise the Bridges Self-Management approach, so understand the potential the approach has to positively change patient/practitioner interactions.
Following completion of my MSc studies in 2017, I sort further research experience, moving into a Research Assistant post in 2019, inspiring me to start my PhD in 2020.