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People 1st project evaluation now completed across six STPs

16 September 2020

The People 1st training and quality improvement programme supports therapists, nurses, healthcare assistants and psychologists to put the ideas and experiences of patients and their families central to their own care.

As a result:

  • Patients become more independent and resourceful and less reliant on clinicians, using peer groups and social networks to seek support strategies beyond healthcare. They and their families feel more confident, in control, hopeful, supported, less alone, while the project provides a more effective use of NHS services.
  • Health and social care professionals experience and gain the benefit of working in partnership with patients and their families and experience more rewarding and enjoyable roles, as well being given ongoing access to all Bridges resources and community of practice. They have increased knowledge, skills and confidence in providing self-management support and enjoy improved well-being and job satisfaction.
  • Teams and organisations build in mechanisms for sustainability. Self-management becomes ‘part of the pathway’ rather than seen as the end point. Teams work more efficiently to get to the heart of what matters most to patients, and experience improved relationships between multidisciplinary team members.

Six sustainability and transformation partnerships (STPs) across the East of England region have been part of the programme, involving 650 staff from 24 trusts. 80 project champions have attended six masterclasses across the East of England region who are now expanding the reach of self-management support within their services.

The executive summary of the programme, which has just been published and can be found at the foot of this page, saw an increase in confidence among the healthcare professionals and identified the benefits of changing practice. Six case studies from each of the six STPs have also been published (please see below).

Overview of the project

HEE in the East of England funded the project, delivered by Bridges Self-Management, aimed at enabling healthcare practitioners in stroke and neurological services across the region to help patients affected by stroke and brain injury to self-manage their condition.

The People 1st project supports therapists, nurses, healthcare assistants and psychologists to put the ideas and experiences of patients and their families central to their own care. These include changes to organisational processes, for example team meetings, discharge processes, and paperwork. Collaborating from the first and every care interaction creates efficiencies within the healthcare teams and widens access to self-management to those with the most complex needs, such as stroke and brain injury.

System change

The project uses a five-stage approach to system change:

  1. Discovery – Getting to know your teams and services.
  2. Knowledge Zone 1 - One-day interactive and interdisciplinary training.
  3. Transforming – Three months to implement ideas for effective self-management support.
  4. Knowledge Zone 2 – Half-day interactive training to share learning and develop action plans.
  5. Sustaining – Implementing sustainability plans, and masterclasses, including a quality improvement tool.

Key findings of the executive summary

  • The programme resulted in tangible changes in the way that service users with stroke and neurological conditions are supported to manage their conditions.
  • Practitioners gained confidence in supported self-management and expressed satisfaction in working more collaboratively with service users, feeling that they were providing a more effective and efficient service.
  • Hard wiring supported self-management into paperwork, processes and systems was important to reinforce learning and consistency, promote sharing and to facilitate sustainability and evaluation.
  • Strong support and interest from leadership was important in enabling staff to prioritise attendance at training and in trialling and adapting aspects of supported self-management in practice. Early-stage project ‘pre-Champions’ proved instrumental in supporting training delivery and engaging attendees.
  • Service pressures and staff shortages impacted engagement and implementation, particularly impacting attendance at training by nursing staff and health care assistants.


The embedded evaluation of the programme was led by the School of Health Sciences at the University of East Anglia, by Dr Nicola Hancock and Julie Houghton and shows that the project results in tangible changes in the way in which patients with complex and multiple long-term conditions are supported to self-manage. It also results in numerous workforce transformations within teams and services, including increased confidence among staff to enable them to support self-management.    


The executive summary and reports from all six STP areas can be found below.