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Referrals

ESCAPE-pain is a group-based, rehabilitation programme for the management of chronic knee, hip or back pain. ESCAPE-pain has attained many awards and endorsements, and is associated with Versus Arthritis and supported by NHS England.  The programme is widely available  across the UK.

This information is intended for those who might refer people into the ESCAPE-pain programmes:

  • ESCAPE-pain for knees/ hips: designed to benefit people with chronic knee/ hip pain.
  • ESCAPE-pain for backs: designed to benefit people with chronic low back pain.

Why refer into the ESCAPE-pain programmes?

ESCAPE-pain for knee/ hip OA

  • The programme offers an opportunity to reduce the number of GP consultations for knee and hip pain, and reduce prescriptions of painkillers for this group.
  • Other benefits – supported by clinical evidence (link):
    • Reduces pain.
    • Improves physical function.
    • Improves mental well-being, self-confidence and self-esteem.
    • Reduces healthcare and utilisation costs.
  • The Telegraph published an arthritis feature that recommended ESCAPE-pain (for knees/hips) as an ideal pathway for osteoarthritis (chronic joint pain).

ESCAPE-pain for backs

  • The programme was piloted in 2019, to test whether the model and principles behind the evidence-based ESCAPE-pain (for knee/ hip osteoarthritis) would be effective in the self management of non-specific low back pain.
  • The evaluation showed that ESCAPE-pain for backs delivers effective care, managed in line with NICE guidelines, that significantly improves participant outcomes.
  • All pilot sites saw mean improvements in participant clinical outcome measures, found ESCAPE-pain for backs beneficial for participants and have since adopted the programme into regular practice.
  • Participants valued the programme and felt the group environment was a great way to connect and share experiences. Read the evaluation report.
  • Facilitator training is now available to providers interested in implementing the ESCAPE-pain for backs programme.

How to refer into the programmes

If you would like to refer into either programme please consult each of our site maps (ESCAPE-pain for knees and hips and ESCAPE-pain for backs) to find out what provision there is in your area and how participants can access the programme. We advise contacting your local ESCAPE-pain sites directly to find out what their local referral process is.

How do the referral pathways work?

It is up to local services to determine what their referral pathways will be according to local context. In the majority of cases, patients are triaged into the ESCAPE-pain programme, either directly by the MSK triage service, or via the GP, physiotherapy provider, or an Orthopaedic Surgeon. We also strongly encourage self-referral to the programme and can supply resources and recommend ways to generate public awareness for commissioners who wish to engage the public in this way.

As part of your referral pathway, consider what local services and facilities are available to help sustain behaviour changes after participants complete the 6-week programme. Often, providers signpost participants to the local gym or leisure centre, or other self-management, on discharge or programme completion.

Participant eligibility criteria

ESCAPE-pain for knee/hip OA

  • Patients over 45 years of age with chronic joint pain (at least 3 months’ duration).
  • Clinical  diagnosis of osteoarthritis.
  • No contraindications to carrying out a regular exercise programme.
  • Would benefit from a group-based rehabilitation programme with exercise.
  • Independently mobile and able to participate in a group-based exercise programme with minimal supervision.

Tool: Information for Referrers

ESCAPE-pain for backs

  • Adults (over the age of 18).
  • Non-specific LBP for >3 months or recurrent episodes (with or without radicular (sciatic) pain).
  • No contraindications to exercise.
  • Identified as medium risk using STarT back. However, if a participant is identified as low and would benefit from the programme and wishes to participate in the programme, consideration can be given for their inclusion.
  • Would benefit from a group-based rehabilitation programme with exercise.
  • Independently mobile and able to participate in a group-based exercise programme with minimal supervision.

Tool: Information for Referrers

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