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 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.
To raise awareness of the service and its many benefits, we have recently launched a series of new films for patients, clinicians and GPs.
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 sessions running in the area, 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.
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 dispel the idea that exercise is dangerous when you have osteoarthritis. With reduced pain and therefore reduced use of pain killers, people are empowered to better self-manage their osteoarthritis, delaying the need for surgical intervention. They report improvement in their function as demonstrated by increased walking, stair climbing, getting out of bed being easier and reduced use of walking aids. The programme has been described by some participants as life changing.
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.
The collaboration with TIMS brings to a close the AHSN NENC involvement with ESCAPE-pain. Since the adoption of the programme by AHSN NENC in 2018, 174 facilitators have been funded and trained by the AHSN NENC in the region, across 47 sites, through 20 organisations.
Over 700 participants have been through the programme with a predicted £1,132,488 saving to the health and social care system (savings are based on £1,512 per person over 2.5 years). Public Health England demonstrated that ESCAPE-pain produces £5.20 return on investment for every £1 spent on the intervention.
Victoria Strassheim, Health Project Lead at the AHSN NENC, said: “We are 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.”
More information on ESCAPE-pain in Newcastle and Gateshead:
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.