Joint pain programme ESCAPE-pain and young people’s Type 1 diabetes initiative win awards

Trainer helps woman exercise

A national programme to tackle chronic joint pain and a local initiative supporting young people with Type 1 Diabetes have won at the prestigious Health Service Journal Value Awards.

Chronic joint pain programme ESCAPE-pain and the Youth Empowerment Service (YES) that supports 14-19 year olds with Type 1 diabetes, have won prizes at the Health Service Journal Value Awards.

ESCAPE-pain won the MSK Care Initiative of the Year. Since being on the programme , Ann, 68, is no longer in constant pain. She said: “Osteoarthritis was really impacting on my daily life as I had to ask for help to do everyday tasks around the home. My life has significantly changed since I completed the course and I’ve continued to do the exercises and now I no longer have any pain and I live a very active life.”

ESCAPE-pain (Enabling Self-management and Coping with Arthritic Pain using Exercise) is a national programme offering face-to-face and online exercises to help people suffering from chronic joint pain. Driven by the NHS’s Health Innovation Network, in south London, and backed by Sport England and in association with Versus Arthritis, roll-out of the programme has been supported by the national Academic Health Science Network. Prior to Covid-19, the programme was running in 295 sites and has helped 19,300 participants since it started.

ESCAPE-pain programme originator Professor Mike Hurley said:

“The judges were clearly impressed with the general ethos of the programme about self-management, its effectiveness and benefits that it brings to individuals and the healthcare system as a whole. We hope the award gives a boost to ESCAPE-pain that we believe can make a major contribution to the post-Covid-19 NHS ‘reset’.

Guy’s and St Thomas’ Youth Empowerment Skills (YES) programme, which is supported by the HIN, runs vital programmes for 14-19 years-olds with Type 1 Diabetes. It won the HSJ Diabetes Care Initiative of the Year.

YES programme Lead Dr Dulmini Kariyawasam, consultant at Guy’s and St.Thomas’ Foundation Trust , said:

“We are absolutely delighted to have been named as the winners in the Diabetes Care Initiative of the Year 2020! The positive impact of this award will help to create a long-lasting legacy and bolster our efforts to expand the YES programme across London giving every young person living with Type 1 diabetes in London access to the programme.”

“The HIN seeks to speed up the spread and adoption of evidence-based innovation in health and care so both these award-winning projects highlight the value of our work to improve lives. A huge well done to both teams. ”Health Innovation Network Chief Executive Zoe Lelliott

The Health Innovation Network’s Diabetes team Project Manager, Ellen Pirie, said:

“Young people suffering with Type 1 Diabetes face many challenges and the YES programme offers them practical support on issues such as food, sexual health and handling a diabetic seizure. There are also opportunities to go on social outings and try out new skills such as driving and rock-climbing and it’s this peer support network building that I know participants really benefit from.”

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ESCAPE-pain resources to support people with chronic joint pain during Covid- 19

ESCAPE-pain: supporting people with chronic joint pain during Covid-19

The ESCAPE-pain programme is usually delivered as a face-to-face class to groups of about 10 people in Physiotherapy Outpatient Departments, leisure or community sites in over 290 venues across the UK. However, the Covid-19 epidemic has meant these venues have been forced to suspend face-to-face classes.

This has encouraged the team to find innovative new ways of supporting people with knee and hip pain who are now confined to their homes. Which includes, a new public ESCAPE-pain Facebook page has been launched where participants can visit to share stories, ask for guidance, and seek and provide peer support.

In addition the ESCAPE-pain smartphone app and online is now free-to-use and the hope is that is through the programme people can remain active and manage their joint pain during this time through the following resources:

  1. ESCAPE-pain Online can be viewed on a range of mobile devices but is best viewed on a computer;
  2. The ESCAPE-pain app is available on Android devices from the Google play store.

Note – Both tools require users to register and then follow a six-week programme, with two sessions each week, using exercise and educational videos and measuring the user’s ability at the start and end so they can see their progress.

To support home exercise further, the exercise and educational videos from the app are now also freely available on the ESCAPE-pain website so that people don’t need to create an account to view them, or for people who don’t wish to follow a structured programme and just want a reminder of how to do an exercise.

ESCAPE-pain has changed my life a great deal actually and I am just over the moon about it.
  1. The exercise videos are designed so that the exercises can be done in a home setting using everyday household items like chairs or steps. They are simple and easy to follow with audio instructions. Just click on each video to get started. You don’t have to do them all, choose a few you find easy, then add or drop exercises as you want. If you want to view the exercise in full screen mode, click on the bottom right hand corner of each video where you can see a small square. Why not also look at our top tips (on the same page) of how to exercise safely in your home?
  2. The educational videos can be viewed at any time to learn more about your joint pain. They give simple advice and information to help people learn about how to better manage their condition. Just click on each video to get started. If you want to view the video in full screen mode, click on the bottom right hand corner of each video where you can see a small square.
  3. It is recommended that people read through the ESCAPE-pain support tools guidance which contains top tips for getting the best out of the digital tools. In addition, some ESCAPE-pain sites have started delivering virtual ESCAPE-pain classes. So, if you’re one of those people who would benefit from the interaction and would find it more motivating then follow the @escape_pain Twitter account to find out where and when these are happening.

For more information, and support contact hello@escape-pain.org.

Reduced pain and improvement in physical function are only some of the positive results of the programme. Watch the latest participant video below.

BBC news broadcasts special feature on ESCAPE-pain programme

As part of National Arthritis Week, BBC London have featured the innovative rehabilitation programme, created by Prof Mike Hurley, Clinical Director at Health Innovation Network.

The special report included the fact that over 1,000 people have been trained to deliver this programme at 230 sites, including at least one in every region in England. In a boost to out-of-hospital care, an ambition of the NHS’ Long Term Plan, these trained professionals include fitness instructors delivering the programme in community halls and leisure centres, as well as hospital-based physiotherapists. ESCAPE-pain’s rapid growth over the past two years has been supported by the NHS’ innovation bodies, Academic Health Science Networks, NHS England, charity Versus Arthritis, and Sport England.

It is estimated that over 14,000 people will have taken part in ESCAPE-pain programmes across 230 sites in the UK.ESCAPE-pain is for people with chronic knee and hip pain (known as osteoarthritis, a musculoskeletal condition) and has been shown to make marked improvements to quality of life for people living with the condition. The success of ESCAPE-pain has also led to a newpilot programme for back pain being launched.

Around 8.75 million people aged 45 years and over (33 percent) in the UK have sought treatment for osteoarthritis. Despite the risk of side effects and high costs, treatment for osteoarthritis has traditionally been the prescription of painkillers, typically non-steroidal anti-inflammatory drugs (NSAID), with little practical support.

ESCAPE-pain’sfocus on education and exercise offers people and GPs options to better manage pain associated to osteoarthritis.The programme runs for a total of 12 sessions over six weeks with participants attending two, hour-long classes a week.The classes teach people the skills they need to self-manage and reduce their pain.Each class starts with a brief discussion about pain and how it can be reduced and is then followed by an individualised exercise programme.

ESCAPE-pain creator Professor Mike Hurley said:

“Chronic joint pain is miserable. It creates a vicious cycle of severe pain, leading to prolonged rest, which leads to further muscle weakness, which leads to physical instability and fatigue. This inactivity increases the risk of co-morbidities such as diabetes and cardiovascular disease. These physical health issues and disability then contribute to social isolation, feelings of helplessness, anxiety and depression, and long-term use of pain killers that people don’t like taking and haven’t been proven to work in the longer term.

“I wanted to find a better way to help people living with chronic pain and with ESCAPE-pain, we’ve shown that a combination of education, self-management, coping strategies and individualised exercise regimes can achieve better outcomes.”

David Rawlings, exercise referral specialist at gym and leisure centre, Leisure at Cheltenham, has been running the ESCAPE-pain programme at the centre with physiotherapists from Cheltenham General Hospital for over three years.

David said:

“People love it and for some it literally is life-changing. Some of the participants we have had on the course had stopped going out and participating in family life or in their community.  After attending ESCAPE-pain they become more active, are able to manage their pain and their arthritis better and build the confidence to move and become more active again.”

Jenn Holeman, senior musculoskeletal physiotherapist at Cheltenham General Hospital leads the ESCAPE-pain programme at the leisure centre said:

“I would recommend the ESCAPE-pain programme 100 percent both professionally and personally.  It is great and I think all areas should be taking it up.  It saves the NHS money because rather than 30 minute one-to-one physiotherapy sessions up to 16 people are having group sessions with one physiotherapist and gym instructor twice a week and it relieves the pressure on GPs because it cuts down on the amount of patients seeking treatment for their symptoms.”

Recent independent evaluations have also reinforced how much money the NHS saves by taking this approach, showing that every £1 invested returns over £5 in wider health and social value through people needing to use services and medication less. Overall it equates to an estimated £1.3 million total savings in health and social care for every 1,000 participants who undertake ESCAPE-pain.

Now, Londoners with chronic back problems have been given the opportunity to access a similar self-management programme. This pilot programme available at four London Trusts and over 150 people have benefitted to date.

Matt Whitty, deputy director of Innovation and Life Sciences, NHS England and NHS Improvement says that the ESCAPE-pain programme is a: “great example of a proven, low-cost innovation that transforms lives.”

“It will mean more people with chronic joint pain getting better care in their local communities and being able to live more independently with a higher quality of life. Responding to needs through this sort of cross sector working is crucial to how we will deliver the NHS Long Term Plan,” he continued.

Sarah Worbey, health and inactivity national partnerships lead at Sport England adds:

“The Sport England Active Ageing fund supports innovative approaches that aim to tackle inactivity among older people, the ESCAPE-pain programme fits perfectly into this.

“We are pleased to have partnered with the Health Innovation Network and Versus Arthritis to enable this programme to be tested through community and leisure settings, for those who are the least active and need it the most.

“It is encouraging for us to hear how participants are making important lifestyle changes and becoming more physically active through their participation in the programme.”

Data gathered from over the last three years from more than 5,000 ESCAPE-pain participants shows consistent improvements in pain levels, quality of life, and movement.

Almost three quarters of the participants who took part in the programme (70 percent) reported to have improved their ability to take part in daily activities, 66 percent reporting pain reduction and 59 percent having a better quality of life and mental wellbeing.

Further information

Learn more about ESCAPE-pain and find a class near you here.

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ESCAPE-pain programme reaches 200 sites

ESCAPE-pain programme reaches 200 UK sites

This month the ESCAPE-pain programme launched its 200th site in the UK. It now operates in every region in England, with sites also operating in Wales and Northern Ireland. Over 13,000 people have attended the programme to date.

Originally rolled out by physiotherapists in hospitals, ESCAPE-pain is now also offered to people in leisure centres and gyms, church halls and community centres.

ESCAPE-pain is an evidence-based rehabilitation programme for people with chronic knee and/or hip pain, also known as osteoarthritis. It integrates exercise, education, and self-management strategies to help people live more active lives and manage their pain better. It offers an opportunity to reduce the number of GP consultations for knee and hip pain and reduces prescriptions of painkillers for these people.

The programme was developed by Professor Mike Hurley and is hosted by the Health Innovation Network. Nationwide scale-up is currently being supported by NHS England and Versus Arthritis.

ESCAPE-pain has been shown to:

  • Reduce pain, improve physical function and mental wellbeing.
  • Sustain benefits for up to two and a half years after completing the programme.
  • Reduce healthcare utilisation (medication, GP appointments, secondary care) equating to an estimated £1.5 million total savings in health and social care for every 1,000 participants who undertake ESCAPE-pain.

You can find your nearest ESCAPE-pain programme here.

How to find out more and hear personal real-life experiences here.

To find out more about ESCAPE-pain visit their website or follow them on Twitter @escape_pain

 

ESCAPE-pain: “The transformation has been huge as a result of this class”

ESCAPE-pain: “The transformation has been huge as a result of this class”

Chris, who was diagnosed with osteoarthritis of the hip, was immobile and on medication when he was referred to the ESCAPE-pain programme. Hear about the life changing effect that attending the classes has had on him.

ESCAPE-pan is the gold standard, evidence-based group rehabilitation programme for people with knee and/or hip pain, also known as osteoarthritis.

Over 9 million people in the UK estimated to have osteoarthritis, and many of them live with chronic pain and take medication as a result of the condition. Theaward-winning exercise rehabilitation programme, ESCAPE-pain,integrates simple education, self-management and coping strategies, with an exercise regimen individualised for each person.It also aims help people understand their condition better, and to realise that exercise is a safe and effective self-management strategy, that can be used to reduce knee and hip pain, and the physical and psychosocial effects of joint pain.

The ESCAPE-pain programme, which is delivered in over 190 sites nationally, was originated by Professor Mike Hurley, Clinical Director for the Musculoskeletal theme at the Health Innovation Network. To find out more about ESCAPE-pain, read here.

Or if you are an exercise instructor or clinician in south London, interested in becoming an ESCAPE-pain trainer? Why not sign up to our training session today.

References
https://www.versusarthritis.org/about-arthritis/conditions/arthritis/

Joining Q: Frequently Asked Questions

Health Innovation Network (HIN) has partnered with The Health Foundation to help grow the Q community across south London.

What is Q?

Q is a diverse and growing community of people with experience and understanding of improvement who are committed to working collaboratively to improve the quality of health and care across the UK. Over time, Q will grow to be a community of thousands, including people at the front line of care, managers, researchers, patients, commissioners and policymakers. Our aim is to connect a critical mass of people in order to expand and accelerate improvement in the quality of care.

Q will make it easier for people with expertise in improvement to share ideas, enhance their skills and make changes that benefit health and care. Q is also the name for the infrastructure we are creating to support individuals with their improvement work and make it possible for the community to connect, share and collaborate.

What is the difference between Q and other initiatives, networks or programmes?
Q is intended to complement and underpin other initiatives, networks and programmes, not compete with them. Q supports people to deliver their existing improvement work rather than being an additional project. Q is aimed at individuals and will provide a long-term infrastructure to support them throughout their career, regardless of where they are employed. Q is not a taught development programme, but a network of support for those already knowledgeable in and undertaking improvement work.

Q supports other initiatives and programmes by:

  • making it easier to understand what improvement work is being done, by whom, and where across the UK
  • providing resources and platforms to connect and support across existing networks, working with and through others wherever appropriate
  • making it easier to collaborate on areas of shared interest
  • contributing to influencing the policy, organisational and cultural context to be more supportive of improvement.

Where did Q come from? Is patient safety part of Q?
Q began as an initiative to recruit ‘5,000 Safety Fellows’ following a recommendation of the widely respected 2013 Berwick report A promise to learn, a commitment to act.

Recognising those with improvement expertise was part of the report’s recommendations about how best to improve safety in the wake of failings of care at Mid Staffordshire Hospitals NHS Trust. The report made the case for a system devoted to continual learning and improvement.

In 2014 NHS England approached the Health Foundation to lead the design and delivery of the initiative. The Health Foundation’s UK-wide remit and funding means Q brings together those committed to health and care quality across all four countries in the UK.

The decision was also made to expand beyond patient safety to cover all domains of quality in line with the Institute of Medicine’s (IOM) definition: safe, effective, patient centred, timely, efficient and equitable. During the design phase of Q, we also formally extended Q beyond the NHS to all public, third-sector, community and private organisations and individuals with a role to play in supporting health as well as caring for people when they are ill.

In April 2016, sponsorship transferred over to (the then newly established) NHS Improvement.

Who funds Q?
Q is co-funded by the Health Foundation and NHS Improvement. Previously Q was co-funded by NHS England. On 1 April 2016, the Patient Safety team transferred to NHS Improvement, along with co-funding commitments to Q.

Are there other sponsors?
In line with the Health Foundation’s UK-wide remit, Q has benefited from advice and support from leaders and founding members in all four countries since its inception in 2014.

Early conversations are underway with Healthcare Improvement Scotland, Department of Health Northern Ireland and NHS Wales with the intention of them becoming ‘system-level partners’. By becoming formal partners alongside the Health Foundation and NHS Improvement, Scotland, Wales and Northern Ireland will reinforce their support for improvement and for sharing across organisational and professional boundaries. It will make it easier to maximise synergy between Q and other initiatives within each country. The aim is to formalise partnership arrangements in spring 2017.

Who designed Q?
To ensure the design of Q meets the needs of those of the community, in 2015 we collaboratively designed the initiative together with 231 founding cohort members.
In addition, throughout the design process we have involved eminent leaders of improvement and wider stakeholders. To date, we have engaged more than 500 people in the design of Q.
More about this process can be found in Building Q – learning from designing a large-scale improvement community.
Q will continue to evolve, being shaped and grown by members of the community and partners.

What is the Q Improvement Lab?
The Q Improvement Lab’s mission is to explore ways to build a more sustainable health and care system in the UK for now and the future. In a stressed and pressured sector, the Lab will provide time, space and opportunity to tackle complex problems.
Emerging from Q, the Lab will bring people together to explore, develop, test and spread ideas that can significantly improve health and care for people in the UK. The Lab will provide space – physical space, virtual space and headspace – for people to work together on high priority challenges that many stakeholders want to solve. A small team will support the process and invest time in curating and sharing the findings, as well as seeking to influence at a wider system level, building capacity for change across the sector. Through our planning and research phase for the Lab it became clear that having a dedicated, physical space for the Lab is crucial. As part of the pilot Lab, we have dedicated space at King’s Cross in London.

After the community voted, the first theme the Lab will explore is empowering people to manage their own health and care needs. They will be exploring the following topic -‘What would it take for peer support to be available to everyone who wants it to help manage their long-term health and well-being needs?’

Over the coming months we will identify a particular topic within this theme to explore over a nine-month period, starting in spring 2017.
We envisage that over the next few years we will establish a small number of Labs across the UK where members of the Q community come together, facilitated by a small team with specialist skills, to make progress on complex challenges facing the health and care system.
For more information, please visit q.health.org.uk/q-improvement-lab/.

What is the difference between Q and Generation Q?
Generation Q is the Health Foundation’s fully funded 18-month taught leadership and quality improvement programme. It provides senior leaders working in and with the health service (including charity organisations and policymakers) with a postgraduate certificate in Leadership (Quality Improvement) from Ashridge Business School (with the option of completing an MSc).
Q is not a taught programme, nor does it come with funded time. It is a long-term community of those with improvement expertise. There are fellows from Generation Q who have also joined Q – you can be both a Q member and a Generation Q fellow.

Being a member of Q

What are the benefits of joining the community?
People who join Q will join a diverse community of other improvers – a ‘home’ to turn to for inspiration and support. Q provides ways for members to learn, share and get advice from a wider network of peers, offering flexible development in a way that taught courses aren’t easily able to provide.
Members are added to Q’s online directory, hosted and promoted by the Health Foundation. We will offer access to online learning resources in exchange for your commitment to share what you learn.
There will be opportunities for sharing ideas, enhancing skills and collaborating on improvement projects, based on what the founding members identified as most useful. This will include Do-It-Yourself online resources, networking events nationally and locally, masterclasses and exchange activities (including site visits). Some of these are designed and organised through the central team, while others are managed through regional improvement organisations or self-organised by members.
Q is still relatively new, with some of the activities and opportunities still being designed as the community grows from hundreds to thousands. We are piloting activities together with members to ensure they genuinely add value. Individual activities and the portfolio as a whole will continue to evolve in line with feedback from the community.

What is expected of people who join Q?

The success of Q is largely dependent on the community. There is no minimum time commitment, but generally speaking the more you’re able to contribute, the greater the benefit. Some members will take a more active role in the community, while others less so and we expect individual involvement will vary over time.
We worked in collaboration with the community to develop a ‘compact’ that describes the expectations of those in the community and encourages a creative and safe environment for learning and improvement. The compact can be found on the Q website.

How long will I have Q membership?
People join Q as an individual, not a team or organisation. This means members remain part of the community when they change role, circumstance or organisation. Members of the community can share and collaborate with other members throughout their improvement career, even if they move abroad.

How much does it cost to join Q?
There is no membership fee to join the Q community. Travel and expenses are not covered by Q.
There will be times when we will cover travel and out-of-pocket expenses in relation to Q activities for those who are not in paid employment. This will need to be pre-approved and in line with the Health Foundation expenses policy.

What time commitment is required?
There is no minimum time commitment for members of Q. It has been designed to help support busy people with their current improvement work and ongoing development and to promote their visibility as a leader of improvement. Q should support members to tackle the challenges they are working on, rather than feel like an extra project.

Joining Q

Who is currently in Q?
We have 799 members in the community at the moment with numbers expected to reach the thousands during 2017. This number includes the 231 who helped to co-design Q, along with 216 who joined as part of a targeted pilot to test how we will grow the community in 2016.

352 members have joined as part of a phased approach to growing the community which is being rolled out across the UK. They joined from the North East and North Cumbria, West of England and South West.

We have recently closed the application window in the following areas – Scotland, Yorkshire and Humber, UCLP, North West Coast and the West Midlands and look forward to welcoming new members from these areas in June 2017.

We have partnered with a number of organisations that are helping us to grow the community. These are Healthcare Improvement Scotland, Public Health Wales, Health and Social Care Northern Ireland and the Academic Health Science Network in England. Our partners are helping to promote Q, and will also be delivering activities and opportunities for members at a local level.

When will opportunities to apply open up?
There will be phased opportunities to join Q during 2017. Anyone who feels they meet the criteria and is based in the area can apply and there will be no cap on numbers.

During May-June 2017, applications were open in the following locations:

  • Wales (through NHS Wales and 1000 Lives Improvement)
  • Wessex (through Wessex AHSN)
  • Greater Manchester (through Greater Manchester AHSN)
  • East of England (through Eastern AHSN)
  • Kent, Surrey and Sussex (through Kent, Surrey and Sussex AHSN)

In August we will be opening applications in Northern Ireland, East Midlands, Oxford, and the Imperial College Partners and Health Innovation Network AHSN areas in London.

We anticipate opening up opportunities more widely at the end of 2017/early 2018.

What is involved in applying to join Q?
To join the community you will need to complete an application via an online portal – AIMS. As part of the process, you will be asked to reflect on your knowledge and experience of improvement and how you can benefit and contribute to the community. The application process should take one to two hours and you can pause and return to the process at any time.

Why are there selection criteria?
We worked together with the founding cohort and others to develop selection criteria for joining Q. The decision to have selection criteria was made after much debate. It is there to ensure those who join share an understanding of improvement and are able to contribute equally and as trusted advisers.

We are looking for people who have experience, knowledge and commitment to the collaborative improvement of health and care. We hope to attract people with many different sorts of experience and people whose knowledge has been gained in a number of ways (taught courses or on-the-job learning). Those applying should be able to articulate and reflect on the approaches used personally and by others involved in improving quality. They should also have experience of playing a role in efforts to improve quality across team boundaries.

Who assesses applications?
Applications will be assessed by a small panel of people who understand improvement led by our partner organisations and supported by the team at the Health Foundation and NHS Improvement. The partner organisations will assess applications from their area of the UK. For example, if someone based in the West Midlands submits an application then our partner organisation West Midlands AHSN will be lead assessing it, together with the core project team.

Further information

For more information about Q process, click on the button below to download The Health Foundation’s ‘Decision Tree’.

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If you have any questions or would like more information on Q community, please contact us.

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