A crucial time to put ‘People1st’

1 Apr 2020 0 comments Topic:

As I write, we are in the midst of the COVID-19 crisis, and a time of unprecedented pressure on our health and social care services. Our exemplary NHS professionals are rightly front and centre stage, both in their clinical environments and in the national psyche, fundamental in the struggle against a pernicious invader. So, I struggled to consider whether the time was right to complete my previously planned blog about the ‘People1st’ project.

For context, ‘People1st’ is a collaborative quality improvement project, involving the roll-out of the Bridges supported self-management training programme in stroke and neurorehabilitation services across the East of England, with an embedded evaluation led by myself and Senior Research Associate, Julie Houghton, at UEA. We have worked with the Bridges team, Health Education England, and governance and clinical teams from 24 Trusts in the region. A logistical, as well as academic, challenge! In essence, the evaluation aims tocapture the implementation, mechanisms of impact and potential sustainability of the Bridges approach.

I have been questioning what possible value I could add by writing about the project at this momentous time for health services? But then a narrative thread emerged for me- that much of the discourse about professional values and ideals emerging from clinical staff engaged in People1st is currently reflected in the public dialogue.

I found myself revisiting the words and phrases that have emerged so readily from the clinicians engaged in our People 1st work, as they’ve progressed through the training and considered its impact on themselves and their services.  These health service staff, from a wide range of disciplines and roles, spoke often of how the Bridges approach to supported self-management enabled them to enact their professional values. To remember why they became health professionals in the first place. To find out what matters to an individual at a time of crisis in their life. To uphold an ethos of person-centred care that was sometimes lost in a target-driven, tick-box NHS.

The authenticity of their words, captured pre-COVID-19, resonates loudly in our new world. These are the shared words and phrases of excellent care. And, recently, such language has been reflected in the public discourse around the NHS and its staff like never before. We hear and read about professionalism, integrity, the value of the NHS and its people, their determined and committed service.  A public understanding of the values and integrity of our health professionals is echoing around the country, like the sound of applause on Thursday night.

Both in crisis and in calm, the intrinsic personal values that drive health professionals to ‘do the job’ are those that drive excellent care and, therefore, patient benefit. And recognition of that has never been stronger, certainly from the public, and, we can only hope, from those who sit in power. Unlike Thursday’s applause, which inevitably faded as we moved in from our doorsteps, may that recognition and insight resound long after the threat from COVID-19 has passed.

There has never been a better time to put People1st.


Dr Nicola Hancock

Lecturer in Physiotherapy

Faculty of Medicine and Health Sciences, University of East Anglia



Early indications from the People1st evaluation show that when everyone makes a small change to build self-management support into teams and services:

  • Patients and their families feel more confident, in control, hopeful, supported and less alone
  • Healthcare professionals have increased knowledge, skills and confidence in providing self-management support and enjoy improved well-being and job satisfaction
  • Teams and services work more efficiently to get to the heart of what matters most to patients, and experience improved relationships between multidisciplinary team members.


Please click here for a one-page summary of the People1st project.




Julie Houghton, Senior Research Associate, University of East Anglia

All rehabilitation teams who contributed to the People1st evaluation

Fiona Jones and Lucinda Hollinshead at Bridges Self-Management






  • Inspiring People to Live Well and Work Differently.

    As a team we share the same ethos and philosophy that drives our passion to create the best experience and environment for patients to live well. Bridges provide opportunities for both patients and professionals to work collaboratively to enhance self-management skills, knowledge and confidence.
    You can reach us by email admin@bridgesselfmanagement.org.uk