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ESCAPE-pain is a rehabilitation programme for people with chronic joint pain, that integrates educational self-management and coping strategies with an exercise regimen individualised for each participant. It helps people understand their condition, teaches them simple things they can help themselves with, and takes them through a progressive exercise programme so they learn how to cope with pain better. 

Osteoarthritis affects approximately 8 million people in the UK, and is becoming more common as we live longer. In collaboration with ESCAPE-pain we are running a series of physiotherapist-led sessions, taking place at the Sue Bramley Centre, Barking. This 12-session programme, twice a week for 6-weeks, for people over the age of 45 aims to:

  • Enable them to manage their joint pain, helping them to carry out normal activities without fearing pain
  • Help them to appreciate the benefits of simple exercise, encouraging them to become active and independent
  • Provide them with the skills and suggest ways that they may manage their symptoms more effectively
  • Work with them to plan their activities and set goals they can achieve through exercise
  • Provide a fun, group-based activity to allow people suffering from joint pain to discuss and overcome their issues together!



Your personal data will be treated as strictly confidential. The processing of personal data is governed by the Data Protection Act 2018 (DPA) and the General Data Protection Regulations 2018 (GDPR).

What data we need:

To run the Escape Pain course, Care City will collect personal data on all attendees. This will include your name, date of birth, address, emergency contact details and details of your GP practice as well as any relevant medical history.

Why we need it:

We need to know your personal data and medical history in order for the clinician running the course to monitor you safely during the programme and for the team to be able to keep in touch with you during the programme. We also want to understand the impact of the Escape Pain course on our attendees and to know if it makes a difference to your pain, movement and function.

What we do with it:

The participant forms will be stored securely in the Care City office, and only accessed by the Escape Pain programme team. We will not share your data with anyone else, unless requested by yourself. However, if you become unwell or a medical emergency arises during the course, your medical history may be shared with other health professionals.

Any data used to evaluate the impact of the course will be anonymised. As a programme hosted by North East London Foundation Trust, Care City has a robust Data Protection regime in place to oversee the effective and secure processing of your personal data. More details on this can be provided if requested.

How long we keep it:

We will store your data for 24 months from the end of the Escape Pain course. 

What we would also like to do with your data:

We would like to use your name, telephone number and email address to inform you of any relevant future programmes and opportunities (for example similar exercise programmes, social groups etc.) which may be of interest to you. This information will not be shared with third parties.

If at any point you would like to withdraw your personal details, please inform the course organisers and these be securely destroyed.

Your rights and personal data

You have the following rights with respect to your personal data:

  • The right to access information we hold on you
  • The right to correct and update the information we hold on you
  • The right to have your information erased
  • The right to object to processing of your data
  • The right to data portability
  • The right to withdraw your consent at any time for any processing of data to which consent was sought.
  • The right to object to the processing of personal data
  • The right to lodge a complaint with the Information Commissioner’s Office

Contact Details:

Please contact us if you have any questions about this General Privacy Notice, the information we hold about you or if you would like to exercise relevant rights or have a query or complaint.

You have the right to ask to see any information we hold about you by sending an email to Hannah Harniess, Head of Projects at Care City This email address is being protected from spambots. You need JavaScript enabled to view it.

You can contact the Information Commissioner’s Office on 0303 123 1113, via their website or by post; Information Commissioner’s Office, Wycliffe House, Water Lane, Wilmslow, Cheshire, SK9 5AF


John Craig, Chief Executive of Care City, blogs about their experience of innovation and improvement through their work as an NHS England Test Bed.

Saturn V launched the first space station, but legend has it that the plans for the rocket were lost. In recent years, NASA scientists looking to re-energise lunar exploration have not been working from documents – they have taken a 40-year-old Saturn V into their workshop, and tried to fire it up.

Is it a farce that NASA’s engineers have to start again? Not at all. The story that the plans for Saturn V were lost is false. Plans just aren’t as valuable as we think. NASA’s plans didn’t get close to capturing what it really took to make the rocket’s 1 million components, let alone how to make them work together.

Abstracted from the people who use them – and the culture in which they work – brilliant tools and plans make much less sense than we might expect. The problem for health care is that this kind of abstraction happens a lot.

Many improvement teams are clinically dominated, and spend most of their time working inside single health care organisations. Abstracted from the development of new tools and approaches, they can struggle to challenge prevailing orthodoxy.

At the same time, too much innovation is outside-in, driven by technologists and entrepreneurs rather than clinicians and patients. Abstracted from the people who use their products, they can focus too narrowly on specific transactions, and miss the bigger picture.

At Care City – through our work as an NHS England Test Bed – we have seen first-hand the effect of overcoming these divides, and better connecting technologists, entrepreneurs, clinicians and patients.

Even the best and most radical innovations require the same painstaking improvement cycles to really work and achieve excellence. No matter the quality of training, support and information, clinicians – like those NASA engineers armed with reams of blueprints – have a huge amount to do to make sense of an innovation and to make it work. Implementation is a creative act.

Equally, clinicians who only want to improve outcomes for their patients can drive dramatic innovation. Care City worked with Alivecor’s Kardia Mobile – a mobile ECG – looking at its potential for the atrial fibrillation pathway. We tested the technology with a huge range of stakeholders to generate ideas. We tested screening services, both within GP practices and community pharmacies. Building on what we learned, we tested a new pathway, enabling community pharmacies to refer directly to a one-stop clinic at Barts Health. The evidence suggests that this pathway is quicker, more cost-effective and has the potential to prevent 1,600 strokes nationwide.

But who was the innovator in this example? In the language of the Test Bed programme, it is Alivecor, but their product is unchanged by the process.  Leaders and clinicians on the other hand – like Dr Sotiris Antoniou from Barts Health – have led the development of a new pathway.

As Care City reflects on its first Test Bed programme, it is absolutely clear to us that the Health Foundation is right that improvement across health and care will not be achieved without the infrastructure, skills and relationships to support it.

We also reflect on some of the distinctions we take for granted in health care. First, health care still distinguishes strongly between improvement and innovation. Both are useful terms, and the way innovations introduce a ‘new dimension of performance’ is distinct. However, do these activities need to be pursued separately, by different people, in different organisations in different ways? This distinction may reinforce both the insularity of improvement work and the disconnection of innovation from the needs of health systems.

Relatedly, health care thinks of improvement as a science and innovation as an art. Is there much more to this than the personalities and habits of those engaged in the work? Improvers must retain ambition for dramatic progress, and be open to uncertainty and to the toughest challenges we face. Innovators must remember that – however beautiful the app or the tool – the only real benchmark is better outcomes for people using the innovation.

Lastly, we believe we should be more sensitive to the number of conversations that are about innovations or workforce, but not both. As shortages not just of money but also of people intensify, we need to be clearer that the purpose of all innovation is productivity. Developing our people and the tools they use should happen together, and that will be at the heart of Care City’s work for the future.

Care City and HealthUnlocked’s collaboration bears fruit as the HealthUnlocked EMIS plug-in for social prescribing goes live across Barking & Dagenham.

Barking and Dagenham GP’s will be able to quickly and easily deliver a digital social prescription to their patients as part of their standard consultation or appointment as the HealthUnlocked EMIS plug-in for social prescribing will go live across the Boroughs over the coming weeks.

The tool that directs and signposts patients to local services, charities and voluntary sector support, and relevant HealthUnlocked online support communities was developed and tested by HealthUnlocked in collaboration with Care City as part of the NHS England & Office of Life Sciences Innovation Test Bed Programme and has proved popular with both GPs and patients. London Borough of Barking & Dagenham and Barking & Dagenham CCG have agreed to work with Care City to grow its use and transform health and care services in the area for the better.

Since February, the HealthUnlocked solution has enabled over 600 social prescriptions to be issued in eleven practices across Barking & Dagenham. Of these prescriptions, most related to helping patients to get active, eat healthily and lose weight loss and to dealing with anxiety and depression.

The solution will be sustained and extended as part of Care City’s partnership with LB Barking & Dagenham, funded under the Better Care Fund. Most practices will use the tool to send social prescriptions directly to patients – in some cases, this will be mediated by a Link Worker, to whom the patient is referred, for more intensive face-to-face support.

John Craig, Chief Executive, Care City commented “As well as promoting healthy lifestyles, public services are very conscious that loneliness and isolation can undermining health and well-being, costing services money. Social prescribing tackles these issues head on. This digital approach to social prescribing enables GPs to connect people to the resources that exist all around them – places where they can make friends, get expert help, or both. These digital tools do not replace face-to-face help; on the contrary, they are designed to help people to build the relationships that can make a real difference to their lives”.

Dr Matt Jameson Evans, Chief Medical Officer of HealthUnlocked said: “By using digital social prescriptions and opening up support and services to patients, we can give people the tools to a better quality of life, reduce reliance on medications and reduce demand on Emergency Departments and GPs in the NHS. I’m delighted that our collaboration with Care City has extended beyond the initial pilot and is now going to be changing lives across Barking & Dagenham.”

This news follows the announcement last week that Care City alongside the BHR Provider Alliance has committed to rolling out its Atrial Fibrillation (AF) Pathway across Barking, Havering & Redbridge, working with local community pharmacies and hospitals to find and treat AF and prevent strokes.