Self-management support starts with meaningful connection
13th May 2026
Recently, Fiona Jones, Bridges Founder and CEO, presented our work at the International Post-Covid and Post-Infection Conditions Conference. A brief exchange on the label of self-management, and a reminder that this term can sometimes feel less empowering and more isolating for people living with long term conditions, prompted further reflection from Fiona. Here, she shares some thoughts on the assumptions embedded in our language, and on the importance of reframing self management not as something done alone, but as something enabled through relationships, support, and shared understanding.
“The insight that self-management support all comes down to meaningful connection is not new. But this concept continues to be strengthened through research, co‑design with people living with long-term health conditions, and close working with healthcare teams across stroke, Long Covid, cancer services and many other healthcare contexts.
Each setting has been different. Each conversation has added something. Yet a familiar pattern continues to emerge.
When people feel listened to, respected, and genuinely involved, confidence develops. And as confidence develops, people are better able to live well with health conditions — in ways that make sense within the realities of their own lives.
This understanding has shaped how we think about our work at Bridges.
Self‑management is not something people are required to do. It is not an additional programme, pathway, or set of tasks. Instead, it is an approach to everyday care. Self‑management support is about paying attention to how we relate, how we speak, and how we share control, ideas and priorities in routine healthcare interactions.
Our recent work through the LISTEN trial allowed us to explore this more deeply in the context of Long Covid. It did not fundamentally change our thinking — but it strengthened and clarified it.
LISTEN reinforced what we have seen across contexts: when self‑management support is relational rather than task‑focused, personalised rather than prescriptive, and embedded rather than added on, people experience meaningful shifts in confidence and wellbeing — even whilst living with complex and fluctuating conditions.
It also helped further clarify Bridges’ theory of change and our route to impact.
We now know that when healthcare staff are supported to work in relational ways, and when personalised self‑management language is embedded into everyday practice, everyone benefits:
- People build the knowledge, skills, and confidence they need to live well
- Staff experience their work as more purposeful and enjoyable
- Services become more genuinely personalised, sustainable, and aligned with people’s needs
This theory is not fixed. It continues to be shaped through co‑design, research, training, and ongoing reflection.
What continues to stand out is this: Bridges is not about dose, fixed methods, or fixing or rescuing people. It is about a way of being — listening to understand, starting from curiosity, noticing small steps (or the need to pause), and creating space where ideas, hopes, and confidence can emerge.
This is underpinned by principles of self‑efficacy, and by people recognising their own successes — through their experiences and those of others.
Our theory of change is iterative rather than static, continually tested and refined through research and real‑world implementation.
Across all these contexts, a consistent finding emerges…that effective self-management support is not an individualised intervention delivered in isolation, but a relational process enabled through meaningful connection.“