ESCAPE-Pain is an evidence-based, group rehabilitation programme for patients with osteoarthritis. The programme incorporated chronic pain management to support participants’ physical and mental approaches to their pain and develop effective coping mechanisms. Although the project support has ended with EMAHSN it has been sustained with a partnership between Health Innovation Network (HIN) and Orthopaedic Research (ORUK) and is still being offered across the country.

Solutions / actions taken

Osteoarthritis affects over 8.75 million people in the UK and is a major source of disability with a large socio-economic burden. The prevalence of arthritis and musculoskeletal conditions is set to increase due to rising obesity and the ageing population. ESCAPE-pain offered a rehabilitation programme for people with chronic joint pain, integrating self-management and coping strategies with an exercise regimen individualised for each participant. It helped people understand their condition and taught different approaches to support activities of daily living, taking them through a progressive exercise programme so participants understood how best to manage their pain.

The programme was delivered over six weeks via a twice weekly group session that lasted 45-60 minutes (with 15-20 minutes of structured exercise and 40-45 minutes of individualised exercise).

ESCAPE-pain was recommended as the preferred intervention for musculoskeletal conditions by Public Health England in a Return on Investment (ROI) tool which showed a positive ROI of £5.20 for every £1 spent, released across health and social care.

Key lessons learned

Several key lessons were learnt throughout the delivery of the ESCAPE-Pain programme. These include the importance of:

• Buy in and shared aspirations from the wider healthcare system – ICS, commissioners, charities, local authorities, NHS and private providers (including physiotherapy and private chronic pain management organisations) were all influential in the adoption of the programme
• Telling the patient story – The patient story is extremely powerful to get across the impact this programme can have on a person’s life
• Recognition of timeframes – This programme needs a four month implementation phase to enable training, set up and completion of the six week course
• Framing the narrative carefully – Presenting the breadth of evidence for the programme as a compelling story. This will enable providers to better understand the added value compared to existing services.

Impacts and outcomes from the project

• In 2019/20, 437 people completed the ESCAPE-pain course in the East Midlands
• £226,195 was saved in the health and social care sector as a result of the programme in 2019/20
• Prior to COVID-19, ESCAPE-pain was being delivered in 8 sites across the East Midlands and providers are taking steps to offer virtual classes
• 27 clinicians and leisure centre staff have been supported to be fully trained up to deliver ESCAPE-pain
• The programme is being offered in a range of different settings such as hospitals, physiotherapy departments, gyms, local leisure centres, and community halls
• ESCAPE-pain virtual programme has also been launched in four sites providing support to patients during COVID-19, 16 facilitators have received virtual training
• NHS England has fully endorsed ESCAPE-pain and is supporting the spread and adoption of the programme via the Academic Health Science Networks (AHSNs) and the NHS Innovation Accelerator (NIA) programme
• ESCAPE-pain won the MSK Care Initiative of the Year award at the HSJ Value Awards 2020.