Lower back pain is both debilitating and widespread. It is estimated that 2.5million people seek help from their GP every year and to cost the NHS £5bn a year.
The Health Innovation Network (HIN) has set out a 12-month programme to improve people’s lower back outcomes. Sam Hudson and Fay Sibley explain why they asked Partners in Creation to run an Action Based Co-creation (ABC) workshop to ground their programme in the lived experience and needs of people with lower back pain.
“What I was attracted to was the fact that ABC is a little bit different,” says Sam Hudson, expert lead for patient experience. “There are a lot of participation methods out there, but the strength of this workshop was that it was such a mix of everything.
“The different activities on the day meant that everyone could get something from it. Some people really liked the painting and drawing, some the roleplay, some would have got a lot from the visualisation, while others found benefit in talking about their stories.
“In terms of the delivery, the facilitation brought out the key issues well. People had plenty of time to share their stories, which were very helpful, and I think we got a good sense of the problem of lower back pain from the perspective of people who suffer from it.”
ABC workshops take people out of their comfort zone to try things they wouldn’t expect. “You get a room full of adults and there’s always some reluctance about creative activities,” explains Fay Sibley, Darzi Fellow (musculoskeletal) and senior project manager. “But through the skill of the facilitators, once participants had engaged in the activity, I was actually blown away by how creative people really are. Using different mediums to explore ideas gave them a freedom, a licence.”
Genuine patient involvement
Introduced right at the start of the HIN’s lower back pain programme, the insights gained from the ABC are set to drive the development of the project.
For Fay the nature and timing of the workshop made it radically different to previous forms of engagement. “This is genuinely innovative. We pay a lot of lip-service in healthcare to patient involvement, it’s something that is seen as ‘a good thing to do’ but it’s almost always a tick box [exercise] that happens after you’ve started an activity.
“We are very much at the scoping stage, without a preconceived idea of what we’re going to do. With the ABC we’ve been able to really hear what patients feel and want. We can use it as the springboard for what we do, as a driver.”
The 40-strong workshop was made up of back pain sufferers, clinicians and managers from the HIN. But with the professionals in the minority, the professionals did not dominate proceedings.
“It was a different power dynamic to what we’re used to seeing,” says Fay. “In healthcare the clinician is the expert. They’re the top of the tree [and] they have all the power in the relationship, so it was an interesting shift in the workshop.”
People generated solutions
The ‘perfect world’ solutions people came up with may not always work in practice, but they do provide valuable insight and a starting point for development.
“The vision that the patients developed gives us a great understanding of the barriers people currently face, when managing their lower back pain and the ways they help themselves," explains Sam. We’ve got a really good sense of the problem, in quite a lot of detail. We’ve got a shared vision for how things could look. That’s where we need to start work now.”
The ABC workshop took place over one day on Saturday 26 November.
For more information about co-creation or the ABC workshops, or to get in touch with Sam or Fay, click here.
The HIN is one of 15 Academic Health Science Networks around the country. Made up of scientists, NHS commissioners and providers, local authorities, patients and industry, the HIN sets out to encourage innovations and best practice using evidence-based research.