The ESCAPE-pain programme

Delivering self-management exercise programmes to patients with osteoarthritis

Status: Completed


Osteoarthritis is the most common form of arthritis in the UK, it affects almost a third (29%) of people over 45 in the East of England and despite physical activity being one of the most effective treatment options they often avoid exercise for fear of damaging their joints further.

Only a small proportion of osteoarthritis patients require a surgical intervention. Most cases are managed in the community with medication including painkillers, but exercise is recommended as being key to support patients to lead as active a life as possible. Additionally one in four GP appointments are estimated to be related to joint pain, presenting an opportunity to free up capacity.


ESCAPE-pain is a national AHSN adoption and spread initiative to offer patients the reassurance and support they need to exercise safely over a six-week exercise and education course.

Each cohort is encouraged to share their progress, concerns and experiences to support each other through the programme. They learn when to push themselves and when to rest, helping them build strength and live in less pain.

At the end of the programme, participants are signposted to services to help them continue to progress. There is also an app and online version of the course to allow participants to use the ESCAPE-pain programme if they are not able to get to the classes in person (such as during the recent COVID-19 outbreak).

“ESCAPE-pain is a brilliant mix of information and exercise – it’s sociable and fun, with excellent guidance. Starting next week, I’m going back to my gym and, for the first time in a long time, I’ll not just be using the pool. The class has made me confident in using all the equipment and knowing what level of exercise is right for me.”

Patricia, ESCAPE-pain participant at Cambridge University Hospitals NHS Foundation Trust.


Health Innovation East have supported its adoption across 17 locations in the Eastern region and worked with partners to secure the recruitment of over 200 participants.

Evaluation by ESCAPE-pain shows that the programme improves physical functions, over two-thirds reported an improvement in their ability to take part in daily activities and 67% reported pain reduction.

In addition to physical symptoms, two-thirds of people with osteoarthritis report depression when their pain is at its worst. However, 62% of ESCAPE-pain participants in the Eastern region reported an improvement in their quality of life following the programme.

Health Innovation East have supported awareness of the resource in primary care including ensuring it is added to the referral pathway in system one and conducted media initiatives to drive patients to register for the course. we are also looking at self-management exercise programmes for osteoarthritis in the Prison Service.

ESCAPE-pain has been recognised with awards from both the Royal Society for Public Health and the British Society for Rheumatology. It has been recommended as a preferred intervention for musculoskeletal conditions by Public Health England as it showed a positive return of investment of £5.20 for every £1 spent.

Get in contact with us if you are interested in rolling out ESCAPE-pain in your area.

Dr Jag Alhuwalia Health Innovation East Chief Clinical Officer

“ESCAPE-pain has made a great start in the Eastern region. According to the first reports from participants, the programme has demonstrated a clear clinical impact, bringing a reduction in pain and improvement in participants’ quality of life.”

Jag Ahluwalia, Chief Clinical Officer from Health Innovation East
Joint pain icon self care
MSK Care Initiative of the Year

ESCAPE-pain was announced as MSK Care Initiative of the Year at the HSJ Value Awards 2020.

Read more.

ESCAPE-pain participant and physiotherapist
ESCAPE-pain: A new exercise and support group

The ESCAPE-pain programme offers those affected by osteoarthritis the opportunity to learn to manage their symptoms and exercise safely.

Read more in this news piece.

Why this impact story is relevant to you


We provide the know-how to take ideas forward in complex health systems.

We spread great ideas across the eastern region and beyond.Get involved