Abstract
The Healthy Living Centre Alliance has created the Better Days Pain Support project, an integrated model utilising a community development approach, co-designed to be a bottom-up, localised response to chronic pain, creating a comfortable and welcoming setting in the Healthy Living Centre with trained staff who are mindful of chronic social isolation associated with LTCs. Our approach is person-centred, developing a relationship based on trust to nurture a long-term relationship with the beneficiary.
Better Days is a collaborative multi-disciplinary project aimed at improving social and mental health outcomes for people who live in NI and with chronic pain. Beginning in 2017 it has evolved into a region-wide series of programmes facilitating guided peer-support for and with people living with pain using a community development approach. We view this approach as central to its success.
Better Days is an evolving, flexible and responsive programme lasting up to 12-weeks involving pharmacists, physiotherapists, complementary therapists, and community development workers working as Pain Support Facilitators. The facilitators encourage a peer-led approach which aims to:
- increase participants knowledge of pain, challenge their reliance on medication, encourage personal ownership of plans to overcome pain,
- improve participants mental health through social inclusion and self-efficacy, facilitate an appropriate gentle exercise regime
- involve participants in determining elements of the course and nature of the programme.
The programme is monitored locally by HLCs using appropriate tools agreed by the Steering Group. An independent evaluation was carried out on the 22-23 Better Days. Continued engagement with participants following completion of the structured programmes was highlighted:
- providing a wraparound approach to beneficiaries with other complementary programmes made available and encouraged
- pain support facilitators carry out a further monitoring exercise with participants three months after the initial programme ends.
- HLCA and the Mental Health Foundation are currently exploring avenues of opportunity to create a structured peer support programme for all participants, enhancing initial outcomes by overcoming barriers to employment and volunteering, structuring user-involvement in motivating newcomers, access to natural heritage, arts and culture.
Pain Support Facilitators work in neighbourhood-based Healthy Living Centres in cities, towns and countryside. HLC Alliance provides regional co-ordination and training while quality assurance is provided by a multi-disciplinary steering group, comprised of representatives from the Alliance, Public Health Agency, Department of Health, Queens University, pain specialists, doctors, and pharmacists and programme facilitators.
Results have been very positive, the majority of participants consistently recording improvements to wellbeing and self-efficacy. In 2020 the Alliance won two of the most prestigious ‘PrescQIPP’ NHS Health Awards arising from the huge success we've had with the programme, the collaboration securing the ‘Delivering Across Integrated Care Award’ and also won the overall Silver Award.
Learning outcomes:
Commitment from all Steering Group members
Including participants on Steering Group
Workforce appropriately trained, flexible and enthusiastic
Listening to facilitators and participants alike – the challenge is to make it easy and enjoyable for all
Flexible programme works
Independent evaluation
Multi-year funding (now achieved
Adequate financial resources
Knowledge Exchange with Irish Republic