We grant funded two Waiting Well pathfinder projects to pilot and demonstrate how partnership work between the voluntary, community and social enterprise sector (VCSE) and primary care networks can support patients experiencing pain whilst waiting for elective hospital treatment for musculoskeletal (MSK) conditions.
The programmes differed in delivery models and target populations but both featured co-design and emphasis on facilitated peer support and non-medical activities as effective approaches to improving wellbeing and reducing pain.
The HALE and Affinity Care pathfinder project aimed to support patients waiting for care on MSK pathways during the pandemic with wellbeing services such as peer support and hobby type interests such as crafts, knitting and art projects. The service was co-designed with patients, clinicians and VCSE provider HALE with a service that was designed to manage pain differently than through traditional clinical methods. The service and its evaluation was designed to test out a range of activities and assess their impact.
Patients were consulted pre programme about their activity preferences which enabled a programme of activities to be scheduled with equipment, facilitation and IT support for remote delivery. The programme engaged 45 patients of an original cohort of 88 in a remotely delivered programme with a total of 30 sessions delivered with additional share and support groups delivered via email and WhatsApp. Patients kept pain diaries to support evaluation with successful case studies and MSK questionnaires used to evidence effectiveness.
The MSK Partnership co-designed, tested and delivered a pilot health and care pathway for people with long term or evolving musculoskeletal conditions. The pathway was an addition to current provision and a route to alternative/complementary provision delivered by VCSEs in communities. The pathway offered person-centered support, focused on healthier lifestyle choices around physical activity, diet and enabling individuals to better manage their condition – including their mental health. The pathway proactively engaged people with long term or evolving MSK conditions, including those on long waiting lists for surgery due to COVID. Clinicians working in the MSK service identified patients with chronic pain who were no longer seeking a cure.
MSK Connect used co-design principals and targeted people living in deprived communities who were on long waiting lists with a specific focus on Black and minority ethnic communities and those with severe mental illness. Patients expressed a wish to focus on food, diet and nutrition, resilience, mental health support, exercise, mobility and moving more.
The pilot received very positive feedback from GP who welcomed demedicalising pain management in line with the National Institute for Health and Care Excellence (NICE) guidelines and valued the opportunity to work with voluntary services which already exist and are embedded in the community.