An innovative rehabilitation programme delivered across Newcastle and Gateshead, is estimated to save the health and social care sector around £100k in the coming 2.5 years, along with significant mental and physical health benefits to patients.
The ESCAPE-pain programme for osteoarthritis of the hips and knees is run by the Tyneside Integrated Musculoskeletal Service (TIMS), with the initiative supported by the Academic Health Science Network for the North East and North Cumbria (AHSN NENC).
The programme originated in South London’s Health Innovation Network and was nationally adopted to be scaled and spread by the Academic Health Science Network in 2018. It is a research-based, evidenced rehabilitation programme that has been shown to help people manage their hip and knee pain through education and exercise.
Approximately 1 in 5 adults over 45 years in England have osteoarthritis of the knee and 1 in 9 adults have osteoarthritis of the hip (Arthritis Research UK). Known risk factors include obesity and physical inactivity.
With significant benefits to patients since ESCAPE-pain launched in Newcastle and Gateshead in 2018 in conjunction with the Older People’s Assembly in Gateshead and Healthworks in Newcastle – TIMS and the AHSN NENC are encouraging people to come forward for free sessions running in the region, while raising awareness amongst healthcare professionals that the free service is available.
The ESCAPE-pain programme consists of 10–12-hour long sessions over a five to six week period, combining education and exercise to address all the aspects covered in the NICE guidelines.
During the COVID-19 pandemic, TIMS was quick to offer virtual sessions to patients. As this delivery method was so successful, the service will continue to offer this provision to patients who may not be able to access face-to-face classes, due to caring, work commitments or health reasons.
Evaluations demonstrate improved function for up to 30 months following the completion of the course, compared to usual care. Participants who have completed the programme report positive behaviour change and altered perceptions of exercise. They feel more confident to use exercise and the other techniques taught in ESCAPE-pain to control symptoms and challenge the idea that exercise is dangerous when you have osteoarthritis.
As the sessions are delivered in a group format, support from other group members is very important in the process of building relationships with other osteoarthritis sufferers. This group format increases knowledge and understanding about osteoarthritis and treatment options.
Participants in ESCAPE-pain have reduced pain and therefore reduced use of pain killers, and they are empowered to better self-manage their osteoarthritis, delaying the need for surgery.
They report improvement in their day to day living, by increased walking, stair climbing, getting out of bed being easier and reduced use of walking sticks and frames. The programme has been described by some participants as life changing.
One participant filmed for a recent video, commented: “I’m out today, I’m out tomorrow, I’m out on Saturday as well! Now a couple of months back, that would have been unheard of – it’s just through coming here.”
Kath Moore, Lower Limb lead from the TIMS service is keen to reassure people with osteoarthritis that there is help out there. She said: “Osteoarthritis is a long-term condition but it doesn’t necessarily have to get worse over time. We are passionate about providing the right advice at the right time to allow people to manage their pain and maintain their lifestyle.
“When someone has been living with joint pain for three months or more, it becomes a vicious cycle of pain, so naturally they live a more sedentary lifestyle, reduce their fitness and gain weight. This has the knock-on effect of increased stress and anxiety and combined with the pain, it can lead to social isolation. Regular, appropriate exercise, leading a healthy lifestyle and managing weight will help to manage joint pains.
“The TIMS service can support this via Escape-pain classes, either as face to face sessions or virtual sessions. We aim to break that cycle and teach people how to better manage their pain, which has a huge benefit to their mental and physical health, confidence and quality of life.”
The AHSN NENC has worked with a number of stakeholders across the region, spanning NHS, public health, leisure and the third sector to explore ways to implement ESCAPE-pain within a systems approach. Training and support were offered by the AHSN, in collaboration with the Health Innovation Network to create an ESCAPE-pain workforce of trainers across the region.
Victoria Strassheim, Health Project Lead at the AHSN NENC, said: “The AHSN NENC is delighted to have supported the roll out of the ESCAPE-pain programme and it is incredibly positive to see the substantial savings in health and social care and significant benefits to patients’ lives. We’re pleased to have worked with key stakeholders across the region to encourage more GPs and healthcare professionals to access the support available for their patients.”
ESCAPE-pain is suitable for patients over 45 years old, who have experienced chronic joint pain for over six months, with a confirmed or likely diagnosis of osteoarthritis or degenerative joint changes, and who would benefit from a supervised exercise programme to gain confidence to self-manage. Participants must be independently mobile; however they can be walking aid users and rely on scooters for long distances.
The programme is not suitable for those who are medically unfit to exercise, or with unstable comorbidities such as type 2 diabetes, cardiovascular or respiratory conditions, communication difficulties or psychiatric conditions that would prevent group participation.
Patients can self-refer into ESCAPE-pain via the TIMS website at: https://www.tims.nhs.uk/escape-pain/ or call the service on 0191 445 6319 to speak to one of the team to find out more.
View the service’s new video here
The Academic Health Science Network for North East and North Cumbria (AHSN NENC) acts as the trusted intermediary between the NHS, academia and industry and is committed to:
- Supporting Economic Growth
- Improving Population Health
- Transforming Patient Safety and Quality Improvement
- Driving Digital Transformation
The AHSN NENC, is part of a national network of 15 AHSNs and receives funding from NHS England, NHS Improvement and The Office for Life Sciences to accelerate the spread and adoption of innovative devices, services and pathways through dissemination of best practice.
Find out more at www.ahsn-nenc.org.uk