Bridges in BNSSG ICSS

Bridges in BNSSG ICSS

In 2025, Bridges delivered self-management practitioner training and self-management support refresher workshops to 99 healthcare professionals in Bristol, North Somerset and South Gloucestershire (BNSSG) Integrated Community Stroke Services (ICSS) to strengthen staff capability in delivering personalised self-management support.

The project built on earlier workforce development completed in 2020-21 and aimed to spread and scale the Bridges approach across the service.

Impact

This project has confirmed evidence of impact of Bridges at three levels: people using the service are supported to take more ownership of rehabilitation; staff feel more confident, connected and less pressured to fix everything; and the service has clearer routes for sustaining consistent personalised self-management support.

• people using the service are supported to take more ownership of rehabilitation

• staff feel more confident, connected and less pressured to fix everything

• the service has clearer routes for sustaining consistent personalised self-management support.

Bridges strengthened staff confidence, capability and consistency in delivering personalised self-management support across BNSSG ICSS in staff working across stroke service pathways.

• Confidence rose from 23% before training to 86% after training

• 96% reported development in their knowledge and skills in personalised self-management support

• 89% expected this to lead to a positive impact on daily practice

Confidence shifted practice from “doing for” to “doing with”

The clearest impact was a step-change in staff confidence to integrate personalised self-management support within all their clinical interactions. Training created space for staff to practise open, curious conversations, test Bridges language in real clinical work, and reflect on what changed for patients and families. This helped staff move from a directive approach to rehabilitation towards coaching, collaboration and shared responsibility.

“I’m definitely using self-management language more in practice. Started asking hopes and fears and feel my own confidence has improved in this area with positive experiences to reflect on.“

“Now I’m more of a coach than a teacher and I and work collaboratively. It has really made me think about how you can help people recognise their full potential and take the next steps of their journey.“

Personalised conversations increased engagement and motivation

Staff described stronger skills in listening, prioritising the person’s story, and focusing on what mattered most. This translated into people working on more meaningful goals, promoting better engagement in rehabilitation and greater confidence for people to generate their own solutions.

“By prioritizing patients’ priorities, more engagement is likelier with in felt responsible for setting the agenda in rehab sessions, focusing on clinical goals and the physical outcomes that I thought were most important.

I now start sesmproved outcomes as a result.“

“By prioritizing patients’ priorities, more engagement is likelier with improved outcomes as a result.“

Staff experience improved, which led to less pressure and more purpose

 Bridges did not only influence patient-facing practice; it also changed how staff perceived their roles. Staff described less pressure to “fix”, more opportunities for shared responsibility, and more rewarding, human interactions between each other and with patients. This is particularly important given wider concerns about staff stress, burnout and morale.

“There is less pressure on me to feel the need to fix things, responsibility is shared more. It gives me more job satisfaction and motivated my patients more knowing they came up with the solution.”

“Bridges means days are more rewarding, genuine and more varied and less formulaic for me. It ‘softens’ the service so it’s less cold – more human.”

Bridges became more embedded and sustainable across the team

Stage 2 provided a refresher for staff trained previously to strengthen their integration of Bridges in practice. Participants reported that whilst for many Bridges was already embedded in practice, the refresher and implementation activities helped make it more visible, consistent and practical through team processes, goal-setting tools and champion support.

“The team is thinking in this (Bridges) way and that the service we provide is co-designed with people with lived experience and people centred.“

“We are going to incorporate Bridges into Talking mats for goal setting discussions and devise a pre goals questionnaire to support goal setting for people with cognitive and communication challenges.“

Testimonials