Innovative Exercise Programme To Help People With Joint Pain Stay Active

ESCAPE-pain, a powerful exercise programme designed to help beat the crippling pain of knee and hip osteoarthritis, has proved so effective in the East Riding that it will be continued for 800 people annually (from September).

The East Riding Clinical Commissioning Group (CCG) has commissioned the local authority’s East Riding Leisure Centres to provide ESCAPE-pain: the Centres were amongst the first to run the programme 18 months ago, with the support of the Yorkshire and Humber Academic Health Science Network (AHSN).

East Riding Leisure Centres have also been chosen to pilot ESCAPE-pain for back pain by the CCG due to the success of the knee and hip programme.

Yorkshire & Humber AHSN has been supporting CCGs, leisure providers, NHS Trusts and other organisations for the past two years to adopt the group rehabilitation programme which delivers the NICE core recommendations of exercise and education for the management of osteoarthritis. NICE ensure the standard of outcomes for people using the NHS.

During the time that the programme has been supported by the AHSN, it is estimated that a £241,108 has been saved in the East Riding in health and care costs, (across the whole Yorkshire and Humber region a total of £1,562,624 has been saved), with 158 people (1,025 people across the whole region) completing the six-week programme[i]. The savings figure is an extrapolation from the estimated reduction in health and care utilisation per person over 2.5 years after completing the programme.

Participants were assessed on four outcomes: 67% said they had improved mental health, 61.6% could move more, 60.2% suffered less pain, while over 50% said they now enjoy a better quality of life as a result of completing the programme.

During the early days of the COVID-19 pandemic, the programme was adapted by East Riding Health and Wellbeing service who held three live ‘virtual cohorts’ to keep it running.

ESCAPE-pain is an award-winning exercise programme tailored to the individual and based on an assessment taking into account their capabilities, supported by education sessions including information on the condition they are suffering from, possible flare-ups, managing medication, and nutrition. By attending two sessions per week for six weeks, participants learn to take control of their pain, manage it and return to a more physically active life.

Osteoarthritis costs the NHS £4.7bn annually[ii]. It affects around a third of the population aged 45 and over in the UK – around 8.75 million people[iii].

Nicola Parker, Healthy Lifestyles Development Officer and the programme lead for East Riding Health and Wellbeing service said:

“We have an ageing population particularly at our coastal resorts and we know that joint pain can be a major factor for older people. So, we have been delighted at the outcomes and success of ESCAPE-pain.

“We were also pleasantly surprised how well the live virtual classes worked, and we will continue those especially for people in rural areas although from September we shall be re-starting the face-to-face classes again at eight leisure centres across the East Riding”

Ulf Clausen, Local GP and musculoskeletal conditions lead for East Riding of Yorkshire CCG said:

“As a GP, I see many patients who are in a downward spiral of progressive disability from osteoarthritis and back pain. For many, surgery is not an option, and previously there were a limited number of interventions I could offer in the community. 

“ESCAPE-pain focuses on the most important interventions for these conditions.  We deliberately chose to provide this programme in the vibrant atmosphere of leisure centres.  Patients have told us the programme has helped them become less reliant on medication to manage their pain, on family members to help with daily tasks, and have regained their independence.  Many patients continue to meet up and access leisure facilities, even after the programme has ended.”

Oliver Barnes, Yorkshire & Humber AHSN project lead for ESCAPE-pain, said: “This was a national project funded by NHS England. The Yorkshire & Humber AHSN regional team managed very successfully to develop partnerships to embed ESCAPE-pain in 48 sites across the region, including hospitals and community clinics, leisure centres, and community settings – even a golf club”. 

“The AHSN’s remit is to spread knowledge of best practice in the NHS and this is a very good example of how this has been sustained and can benefit even more people, helping relieve pain and provide a better quality of life for many.

Professor Mike Hurley, who developed ESCAPE-pain, said: “The news of the East Riding commission is absolutely brilliant and great repayment for all your hard work. We will be telling the world and his wife about your successes!”

Robust evaluation has shown that ESCAPE-pain makes savings in medication costs, community-based care (including GP appointments), and secondary care services. An independent report undertaken by Public Health England said ESCAPE-pain has a positive financial ROI of £5.20 for every £1 spent[iv].  

For a greater insight into the impact, ESCAPE-pain programme has had for participants, watch our video about the pilot with East Riding Leisure Centres.