Learning Event: Develop, Discover, Deploy - Welcome to Greater Manchester and East Cheshire

1. Greater Manchester and East Cheshire Learning Event Develop Discover Deploy

2. Welcome House-keeping Aims of the day: • Sharing learning and experience • Offering support to providers • Planning for the future

3. Donna Williamson Senior Health and Wellbeing Manager Lucy Bourne Senior Marketing Executive

4. ESCAPE-pain Contract • 1 Year Commissioned Contract • 12 Cohorts • 120 Participants • Across 3 Locations in Cheshire East • 8 Cohorts Delivered So Far • 61 Completers • 28 currently participating

5. What we thought we would face: • Issues with delivery, being a new service. • Referral pathways were already firmly established due to existing services. • Referral management system already embedded. • Experience of capturing data and around inactivity.

6. What actually happened: • Delivery model a success! • Staff confident and enjoy delivery • Introduction session key to support data capturing The Problem! • No referrals received by Physio’s! • Resistant to support programme • Health felt ESCAPE-pain was a competition!

7. Solution: • HIN Manchester attended CCG meeting • Identified MSK Leads • Arranged meeting with CCG and HIN attended meeting • Joint approach, HIN covered evidence based aspect of programme, Everybody Leisure delivery model. • Successful meeting with agreed actions! • Business Plan submitted, 3 year commissioned service in East. • Other CCG working towards SLA.

8. The Marketing

9. Referral Pathways Occupational Therapists GP Practices 2 Local Hospitals Local Services Physiotherapists Self Referrals 3rd Sector Organisations

10. Internal Marketing In house Marketing: Bunting, pull up banners, leaflets, posters, t-shirts.

11. Daily Marketing Methods Website Posters & Flyers Social Media Videos Local adverts

12. Where participants found out about us

13. Daily Marketing Methods Press Releases Good News Stories

14. Brand Ambassadors • Joan is 87 years old • She was extremely nervous, she didn’t have very good balance and wasn’t confident when walking around. • She didn’t believe that exercising would be able to have the same effect on her pain as medication did. • In just 3 weeks Joan had a reduction in pain and also started to feel better within herself. • The structure of the class made her feel extremely comfortable and she felt that being around people with similar problems to her helped her gain confidence • Since completing ESCAPE-pain, Joan no longer requires the stick that she was dependent on and can walk up and down the stairs with ease. • Her balance has drastically improved and Joan now feels confident enough to go down to the shops by herself! • Joan has now joined the gym, and along with 3 of her friends that she made at the ESCAPE-pain class, goes to the gym at least twice a week and they all travel there together. The friendships Joan has made from ESCAPE-pain have helped her a lot; they all support and motivate each other.

15. Brand Ambassadors • James suffers with scoliosis • He was told he couldn’t have the spinal operation he needed due to also suffering with Parkinson’s disease • These medical conditions were limiting his activities of daily living and he was in constant pain • James is an inspiration to us all with his sheer determination and positive outlook • James has completed ESCAPE-pain and is now attending the weekly follow on class • James also trains in the gym 2-3 times per week • James has lost 9kg in weight since the start of the programme • His strength and stamina has improved “Exercise has changed my life, my flexibility and range of movement have improved and I feel more alert. I used to have a nap in the afternoon but I don’t need that anymore. And apart from all the physical benefits, the staff and other members are so friendly that is has become a social activity too”

16. ESCAPE-pain National Update Ambra Caruso ESCAPE-pain National Programme Manager

17. A group rehabilitation programme for chronic hip or knee pain, integrating: ✓ Patient information Tailored advice on their condition, self- management, pain coping strategies, weight control; ✓ Personalised Exercise regimen Individualised, progressive, challenging Research evidence shows that ESCAPE-pain: • Reduces pain • Improves physical function • Improves mental wellbeing • Reduces healthcare and utilisation costs (£1,511 per person) • Creates benefits that can be sustained for up to 30 months after the end of the programme Originated by Prof Mike Hurley, Prof of Rehabilitation Sciences at St. George’s University in London and MSK Clinical Director at the HIN

18. The story so far

19. The story so far December 2017 - 42 active sites May 2019- 173 active sites

20. ESCAPE-pain at a glance: 170+ Sites running ESCAPE-pain 800+ Trained to deliver ESCAPE-pain £5. 20 ROI for every £1 spent (PHE) 11,000 + Participants through the programme

21. Clinical outcomes overview 2007-2019 n=278 Outcome trends have remained closely aligned with RCT results since implementation into clinical practice.

22. Reduced health & social care >£14m less bed days, less GP appts – drugs, investigations, interventions

24. 17 leisure and community delivery partners

25. We have a problem here We need to improve access

26. Our vision: two men in a pub

27. Outcomes in clinical and community settings before and after participating on ESCAPE-pain

28. n=206 n=74

29. Thank you!

30. In Greater Manchester & East Cheshire Jonathan Massey Programme Development Lead Health Innovation Manchester

31. Introduction to Health Innovation Manchester • As an academic health science and innovation system, Health Innovation Manchester is at the forefront of transforming the health and wellbeing of Greater Manchester’s 2.8 million citizens • https://www.youtube.com/watch?v=OSCDHw23jXQ

32. Health Innovation Manchester • ESCAPE-pain has been delivered across 8/11 GMEC localities • >150 people have completed the programme so far • The national AHSN network set a target for Health Innovation Manchester – our target for 2019/2020 is 528

33. Health Innovation Manchester’s offer • Funding for ESCAPE-pain training courses https://escape-pain.org/facilitator-training • Friday 17 May, Friday 7 June, Wednesday 3 July, Friday 2 August in London • Support conversations with commissioners • Tailored support - talk to us!

34. GMEC overview

35. Beyond Sport England funding • 18 cohorts allocated to GM Active + 4 additional awarded • 12 cohorts to Everybody Sport & Recreation • Originally due to end in June 2019 – now final programme should be finished in the week commencing 10th December 2019 • Additional (re-distributed) cohorts – e-mail margaret.connolly2@nhs.net by 29th May • We will look at bridging the gap where required (e.g. whilst local evaluation completed to present to commissioners for sustainable funding) - details being worked through now and will be discussed with providers

36. What we need from you • Details of when and where courses are taking place • How many people start the course • How many people finish the course

37. Versus Arthritis - Support Available

38. Capturing and Sharing Patient Stories

39. ESCAPE PAINBury Team Lee Buggie (Principal wellbeing development officer)Shelley Caulfield (BEATS team leader)Mark Redfern (Exercise referral officer)

40. ESCAPE PAIN Stats:4 Cohorts delivered (5th started 29th April)47 Participants started the course.85% completed the programme. 100% of completed participants have gone onto further exercise programs.

41. ESCAPE PAIN Positives: • Referrals from Fairfield physio • Consistent education • Free • One instructor over the 12 sessions • Continued exercise following the completion of the programme • Marketing material

42. ESCAPE PAIN Learning: • Better triage of participants • Exercise adaptations • Time of sessions • Data collection

43. ESCAPE PAIN Integrated Neighbourhood Teams ( INT ). • Surgery specific buy in • Investment in the model • Pain management teams Business Growth supporting deficit. • Oldham model / Bury model • Payment up front or part of the membership package • Complementing of wellness offer – additional specialism *Physio drop in key – reinforced gains / goals*

44. GMEC Escape Pain Market Place Barriers & Solutions Sustainability Good News Visualising Success

45. Final Thoughts Learning from the day Next Steps