This article explains how Bridges to Health is presented and used within Ardens Manager, including what the measure represents, how it is derived, appropriate use cases, and important guidance on interpretation.
What is Bridges to Health?
Bridges to Health is a population health segmentation approach that groups patients according to their overall health complexity, care needs, and service utilisation risk. For further information, please see the Bridges to Health research paper.
Rather than focusing on a single condition, Bridges to Health provides a holistic view of patient need, supporting:
Identification of patients with complex or escalating needs
Understanding of population complexity
Planning proactive, preventative, and integrated care
Bridges to Health is particularly useful for population health management, neighbourhood teams, and integrated care models.
Bridges to Health in Ardens Manager
Within Ardens Manager, Bridges to Health is presented as a risk segmentation view at register and population level.
Patients are grouped into categories that reflect increasing complexity and care need:
Healthy
CYP & Maternal (children, young people, and maternity)
Acutely ill
LTC (one or more long-term conditions)
Serious disability
End of Life
Organ failure
Frailty/Dementia
Each patient is assigned to one category only, representing their highest level of identified need based on current coded data.
These groupings allow users to quickly understand the distribution of health need across practices, PCNs, or ICBs.
How can Bridges to Health be used in Ardens Manager?
Bridges to Health supports population health management rather than individual diagnosis or treatment.
1. Risk stratification
Segment populations by complexity and care need
Identify cohorts with higher levels of frailty or multimorbidity
Understand variation across practices, PCNs, or ICBs
2. Prioritisation for review
Use Bridges to Health to help prioritise patients for:
Proactive care and care coordination
Multidisciplinary team (MDT) discussion
Long-term condition reviews
Frailty or holistic assessments
3. Population insight and service planning
Inform neighbourhood and place-based care models
Support capacity planning for community services
Understand demand for preventative and integrated care interventions
Important: Bridges to Health should be used to support prioritisation and planning, not as a substitute for clinical judgement or individual assessment. Groups are based on available coded data and missing or incomplete coding may affect categorisation. The model only reflects current data and is not a future prediction.
How to access Bridges to Health in Ardens Manager
Bridges to Health data can be viewed within Ardens Manager at condition, register, and population level.
Open a report view
From a dashboard or condition overview, select View on the relevant report or register
Access the Risk section
Within the register view, select the Risk tab from the horizontal menu
Locate the Bridges to Health chart within the risk section
Apply Bridges to Health filters
Select Filter at the top of the screen
Expand the Risk section
Select Bridges to Health
Choose the required category or categories
Select Apply to update the view
Review the filtered cohort
The register updates to show patients matching the selected Bridges to Health grouping
Counts, benchmarks, and charts refresh automatically