Greater Manchester, National


Closed Project

Please note – this is no longer an active Health Innovation Manchester project

ESCAPE-pain was a national AHSN Network adoption and spread programme during 2018-2020. All AHSNs, including Health Innovation Manchester, delivered this programme in their region between April 2018- March 2020.

ESCAPE-pain (Enabling self-management and coping of arthritic pain through exercise) is a rehabilitation programme for people with chronic joint pain that integrates core recommendations around self management, coping strategies as well as undertaking exercise.

This is an evidence-based, group rehabilitation programme for patients with knee and/or hip osteoarthritis.

Across the United Kingdom, osteoarthritis (OA) affects nearly 10 million people. It causes pain, reduced mobility, impaired physical, mental and emotional well-being, and reduced independence and quality of life. It also increases the risk of co-morbidity and mortality.

90% of people with OA are managed by GPs. It accounts for 2 million GP consultations and approximately 150,000 knee/hip replacements, making it the third largest NHS expenditure.

It causes 36million lost working days and accounts for approximately £480 per person per year out-of-pocket expenses. The total health and social welfare and societal costs is £3.2billion, which equates to approximately 1% of GDP.


The Programme

Designed for people over 45 years, who have chronic knee and/or hip pain, ESCAPE-pain runs over 12 sessions, with each session comprising of:

  • An education component – group themed discussions (led by a supervisor) that covers possible causes of pain, and advice about simple pain management and coping strategies.
  • An exercise component – group participate in personalised progressive exercise regimen to increase strength, endurance and function.
  • Behavioural change component – techniques that subtly challenge erroneous beliefs that physical activity causes and/or exacerbates joint pain.

The ESCAPE-pain programme is now increasingly being delivered to people in leisure centres and other community venues and even workplaces, offering easier access away from clinical settings.

It is less costly than usual care plans, and generates savings in both primary and secondary care. The robust evidence for ESCAPE-pain shows that people achieve a marked improvement in mobility and pain reduction, and are better able to achieve the activities of everyday life. There is also a marked impact on mood based on anxiety and depression score improvements. Notably, results from the original trial have been replicated in clinical practice, which demonstrates the programme’s efficacy.

ESCAPE-pain has already spread to over 70 sites nationally, benefitting more than 6,000 people. It will continue to spread across the country as the AHSN Network supports its wider spread during 2018-2020.

For every 1,000 participants who undertake ESCAPE-pain there are potential annual savings of:

  • £2.8 million total health an social care costs
  • £20,280 costs in medication
  • £59,560 community based care consultations
  • £5.20 return on investment for ever £1 spent.

At the end of the AHSN Network national programme, 12,781 people had completed ESCAPE-pain and sites adopting went from 51 to 280.

The longer-term future of the programme has now been secured through a partnership between Health Innovation Network and national medical charity Orthopaedic Research UK (ORUK).

Find out more about the programme in our Case Studies

Joan Allard with Everybody lifestyle coach Josie Hurst at an ESCAPE-Pain exercise class

Case Study: Joan Allard

East Cheshire

Three people taking part in an ESCAPE-Pain Class and completing leg exercises and stretches

Watch: Participants discuss ESCAPE-pain

East Cheshire

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