All Change Challenge Innovations

Thank you all for your involvement so far. We have now published details of the most impactful ideas. You can filter on the left-hand side for each of the Challenge categories.


Physiotherapy Pain Association

What happened?

  • When did you change? 
Two online open access webinars planned and delivered in May & June 2020. 
Monthly Peer Support and Reflection Group commenced in July 2020.
  • Who was involved? 

The Physiotherapy Pain Association (PPA) Committee and other invited clinicians.

  • How did you change?

In the initial stages of the response to COVID-19, the committee recognised that there were significant barriers to delivery of digital consultations and wished to highlight the experiences of patients and early adopters who had attended online groups and appointments. Interaction with other networks identified that there was some apprehension and low self-efficacy in their abilities to deliver physiotherapy online.  One webinar was on group rehabilitation and another was on individual consultations. Following the webinars, we set up a monthly PPA Peer Support and Supervision Group with trained and trainee facilitators that is free and open to all PPA members. This group has patient representation and supports clinicians to engage in person centred rehabilitation. 

  •  What challenges did you face?
The PPA committee are all volunteers, but were very generous with their time
The PPA have one hour of paid administrator support per week
  • What successes occurred?
Almost 200 people attended the livestream of "Online Pain Management Groups" and the recording has over 1,400 views. 
100 people attended "Digital Consultations" and the recording has 250 views.
The monthly group has been held 3 times and is well attended.

Click here to read the narrative in full.


What happened?

  • When did you change? 
Online offer planned throughout April and commenced in May
  • Who was involved?  
Clinical psychologists and specialist pain physiotherapists in the department; Counterparts at other London Pain Clinics via the Pain Psychologists in London (PPIL) and London Pain Physio Network (LPPN); Trust management and CW+ Charity; Willing patients
  • How did you change?  
90min in-person Pain Education Session converted to 90min Zoom session. Patients then opted into a 50min Zoom assessment with Psych/Phys. Those suitable offered a 12 session virtual Pain Management Programme (vPMP) over 4 weeks
  • What challenges did you face? 
Digital literacy (of patients and staff); Accessibility (e.g. availability of fast enough broadband); Paucity of PMP evidence/literature for online delivery; Development of materials
  • What successes occurred? 
Improved outcomes for patients; stakeholder involvement to reshape vPMP for subsequent cohorts

Click here to read the narrative in full

Collated online resources

Posted by Change Challenge (Admin) 1 week ago

Collated online resources for people living with pain and the clinicians who support them.

What happened?

  • Who was involved?

The Physiotherapy Pain Association (PPA) Committee.

  • How did you change?

Chronic pain is a complex, biopsychosocial long term condition. Physiotherapists often use supplementary materials to aid patients' understanding and facilitate behaviour change. In the initial stages of the response to COVID-19, the committee recognised the need to collate links to helpful online resources.  As some services were closed, we knew some patients would benefit from other types of support.  The services that remained open began supporting people via telehealth or online and we understood that the need for reliable online supplementary material would be greater than ever before. The links were collated by physiotherapists in pain management and a patient representative. These were then uploaded to a designated area on the PPA website.

 What challenges did you face?

  • There are a plethora of online resources and it was a challenge to select some over others. 
  • Previously, this would have been a member benefit, but the PPA were keen to make this freely available to all clinicians and their patients. 

What successes occurred?

  • The landing page received 500 unique page views per month April - June and continues to attract 100-200 unique page views per month. 
  • The 'Keeping Active' link was included in the British Pain Society and Scottish Government guidance on managing Chronic Pain during the COVID 19 pandemic.

Click here or on the attachment below to read the full narrative. 

Back To Life Online

Posted by Change Challenge (Admin) 1 week ago

Back To Life Online – providing a virtual combined physical and psychological treatment programme for low back pain.

What happened? 

  • The COVID-19 pandemic prevented our clinical team at the Royal Orthopaedic Hospital, Birmingham from continuing to provide face to face, group-based combined physical and psychological (CPPP) treatment for low back pain.
  • To establish a virtual online programme we brought together colleagues from
  • Communications
  • Governance
  • Information Technology
  • Administration
  • Patient representation

to ensure the technological and administrative transition to an online programme went smoothly and didn’t impact on the high-quality clinical care provided by our team of physiotherapists, doctors and pain counsellor.

  • Challenges included training clinical teams to use zoom platform, training administration team in new protocols and processes, ensuring the treatment could be provided safely in patients remote locations and developing better resources for providing treatment virtually
  • Having completed several treatment programmes we have demonstrated that clinical outcomes and patient satisfaction scores are comparable to face to face group treatment. Patient dropout rates are also low and comparable to face to face treatment and the transition to a virtual service has been an excellent learning opportunity for the team

Click here or the attachment below to read the full narrative.

Camden MSK Group Lockdown

Posted by Change Challenge (Admin) 2 weeks ago

When did you change?

April 2020 due to halting of pain services and face to face peer group meetings

Who was involved?

MSK Patients, Carers and clinicians.

Camden MSK’s Clinical Director set up the Zoom calls twice weekly and facilitated the meetings until the end of July. The Camden MSK’s Patient Director and Camden MSK Patient Partners assisted facilitation and gave peer support to help others join.

How did you change?

Pre COVID the Patient Director was supporting and attending the patient led pain support group (PPSG) once a month face to face. The community centre was closed due to COVID restrictions, the group therefore had no where to meet physically. The whole country was on ‘lockdown’ during the COVID pandemic, so most patients were also home and feeling quite isolated as many services were limited as well in third sector.

There were discussions online that highlighted the issue of loneliness and knock on effect of people’s mental health in particular those with comorbidities and long-term conditions.

It was decided to create a virtual peer support group for chronic pain patients during the ‘shielding/lockdown’ period.

Initially the group focused on the ‘shielded’ group but it soon became apparent others wanted to attend too. This twice a week Zoom call, which lasted for an hour at the same set time, was open for MSK patients and their carers, but also open to be attended by MSK clinicians.

Goal: To ensure we maintained contact with a group of patients who were no longer able to attend face to face support group sessions, many of whom were already lonely and isolated due to chronic pain and struggling to self- manage.

Click here or on the attachment below to read the full narrative. 

What happened?

  • Covid-19 lead to significant disruption in services we provide as a specialised pain management centre
  • Individual pain management physiotherapy waiting times were already long
  • Now it was unknown when we would be able to resume our normal service
  • We wanted to explore options

Click here or on the attachment below to read the narrative in full. 

When did you change?

  • Developed project in line with the introduction of digital software for electronic records
Who was involved?
  • Physiotherapy Team leads, Software project Lead, Physiotherapy colleagues
How did you change?
  • Explored options on software programme on how and where to embed the screening questions strategy within the digital entries during the assessment process
  • Questions informed by NICE guidance [NG65 & NG100] referral criteria, NICE interactive flowcharts, National Axial Spondyloarthritis Society and ASAS tools and resources to support this screening initiative
What challenges did you face?
  • The screening cannot be mandated within the assessment process and requires clinicians to engage with the pop-up prompt and enter the screening section to complete the screening questions
  • The screening process is not appropriate for all people being assessed and so ‘pop up’ fatigue on the site may mean it is ignored
  • Time factors and pressures to get software into daily clinical practice
  • Screening still requires clinical decision making on when there is sufficient suspicion to make an onward referral
What successes occurred?
  • Collaboration with teams to develop and test the screening strategy

Click here or directly on the attachment below to see the full narrative. 

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