NHS / Council Commissioning
Yoga for Healthy Lower Backs (YHLB) Programme – Long-Term Self-Management
More Social Prescribing and Universal Personalised Care community projects should offer / signpost strongly to this evidence-based specialised ONCE-OFF 12-week yoga course, as it is effective, safe and ready-to-go. It makes most sense to offer this specific programme with its proven cost-effectiveness (‘Spine Journal’) and return on investment (PHE MSK ROI tool 2017).
In our original research, the Yoga for Healthy Lower Backs courses were offered up as if within the NHS ‘alongside GP care’ … this is where it sits well, i.e. within the community/Primary Care.
Social prescribing of this evidence-based (EBM) YHLB yoga is happening already and can help social prescribing and Universal Personalised Care projects meet their positive outcomes and return on investment targets.
GPs and Pain Management Consultants Support YHLB
GPs and other health professionals are already signposting strongly to YHLB throughout the UK. Patients are asking for YHLB.
100% of GPs attending an RCGP Tamar Faculty CPD Presentation on YHLB said they would refer to YHLB (and felt patient contribution to costs, e.g. Resources Pack, would motivate commitment and attendance). (more info available)
It should be offered as a patient choice – either as strong signposting or subsidized
People who have experienced YHLB want more people to benefit
Patients on NHS Pilots had good outcomes and would be ‘Extremely Likely’ to recommend YHLB to Friends and Family
YHLB Teachers available throughout the UK
YHLB empowers people to help themselves to improved long-term health and well-being.
Talk to us about part-funding and taster class ideas.
YHLB Fits with:
NHS England’s 5 Year Forward View, Right Care, STP plans for long-term self-management and primary and secondary prevention, Integrated Care Systems, Public Health MSK (YHLB is listed in PHE MSK ROI report and tool), latest evidence for back pain treatments (exercise with mind-body approach).
Video (1-minute) speaks about Prevention, Long-Term Conditions, Early Intervention https://www.youtube.com/channel/UCQEpEd5xLjxUgditA6Vnbjg/featured
Take advantage of Prior background investment –
- 11+ yrs design, evaluation, post-research development
- effort, work and passion of 1000s people (researchers, charity, publisher, GPs, national bodies, teachers);
- £438,500++ investment (includes £285,000 charity funding).
YHLB Approx. Course Costs (based on 10 attendees):
- Private sector = £154 pp teaching fees (includes hall hire) plus £60 pp Resources Pack = bargain rates to get the programme to more people (more in some areas/London and with smaller numbers).
- Course valued at £292 pp (Spine Journal 2012)
- ?Patient Contribution of £60-£154 = 12 x ‘mind/body programme prescription’ charges / ‘commitment contract’? Studies show payment contribution = acceptable to patients/ GPs.
Comparative Potential Costs and Benefits:
– One private back pain manipulation and advice consultation could cost £40+ with some patients having weekly, fortnightly or monthly sessions for months or years = £1000s
– A cappucino @ £2.50 per day for 16 weeks = £280
– Council gym membership for 12 weeks = £100
– NHS annual costs of back pain = over £1 billion
– Cost of similar rehabilitation programmes (COPD; cardiac BHF) = £307-£477 pp
– Cost of a referral to Outpatient consultant or attendance at A&E (gov.uk) = £114-£132
– Private consultant first appointment = £150-£250
– Cost of 1700 patients with complex LTCs in one CCG = £36 million p.a. (Right Care) – YHLB
could help reduce, e.g. chronic back pain, fibromyalgia, depression/anxiety with MSK
Back Pain Patients are twice as costly to the NHS as non-back pain patients.
Annual NHS Cost for ‘back pain patients’ = £1076 compared to ‘non-back-pain patients’ = £516 pa (London School of Economics & Political Sciences studied 100,000+ NHS patients 2013)…….
…Turning patients into non-back-pain patients through programmes such as YHLB could save current and ongoing costs = good investment and happy patients.
Also see PHE MSK ROI Toolkit Oct 2017.
Case Study and Health Professional Testimonials
“This course is unique…this is absolutely what I would do, if I had back pain…and it helped my frozen shoulder” Back Pain Specialist Physiotherapist, Pain Clinic
“Life-changing, after years of frustration.”
“No more A&E visits and meds for me – I have learnt how to prevent my muscle spasms.”
“Very pleased to have avoided surgery and enjoying being happily back at work.”
“This extraordinary yoga programme should be offered up to more people.” (GP helped via the YHLB course, after spinal surgery)
Yoga for Healthy Lower Backs (YHLB) offered by self-employed registered teachers supported by national YHLB social enterprise.
Registered YHLB Teachers.
Before training in this more specialised yoga via our ‘Yoga for Healthy Lower Backs Teacher Training Course’, our self-employed teachers have already qualified in, and had considerable experience of, general yoga teaching. Therefore, all YHLB yoga teachers trained, registered, supported by the YHLB training school and listed on our website are already qualified yoga teachers from various yoga schools and methods with considerable prior teaching experience. Whilst undertaking the 300-hour YHLB teacher training over an approx. 6-12 month period, teachers are mentored and supported throughout the time that they teach their first YHLB course. The YHLB training has been approved as a British Wheel of Yoga (yoga governing body for Sport England and Sports & Recreation Alliance) ‘Recognised Centre of excellence in training and standards’ and a British Council for Yoga Therapy member organisation. Some YHLB teachers are also registered with CNHC.
Published on 16 August 2012 ‘Arthritis Research UK’
Yoga Cost-Effective for Back Pain?
Specialised group yoga classes could provide a cost-effective way of treating patients with chronic or recurrent low back pain, according to the UK’s largest ever study of the benefits of yoga.
Funded by Arthritis Research UK and led by the University of York, the study provides an evaluation of a specially-developed 12-week group yoga intervention programme compared to conventional general practitioner (GP) care alone.
The results published in Spine, show that the yoga intervention programme – ‘Yoga for Healthy Lower Backs’ – is likely to be cost effective for both the UK National Health Service (NHS) and wider society.
The cost assumed for yoga intervention is important in determining whether this is an efficient use of NHS resources. As yoga classes are not currently available through the NHS, the researchers examined a range of possible costs. They conclude that if the NHS was to offer specialist yoga and managed to maintain the cost below £300 per patient (for a cycle of 12 classes), there is a high probability (around 70 per cent) of the yoga intervention being cost effective. Researchers also found that those taking part in the yoga programme had far fewer days off work than those in the control group.
On average, a control group participant reported 12 days off due to back pain, whereas those in the yoga group had four days off. The cost associated with taking time off was £1,202 for a control group member, compared with £374 for a yoga group member. The study was carried out by researchers from the University of York’s Department of Health Sciences and the Centre for Health Economics, and the Hull York Medical School.
Chief Investigator Professor David Torgerson, Director of York Trials Unit, in the University of York’s Department of Health Sciences, said: “Back pain represents a significant burden to the NHS in the UK and to society as a whole. As well as the associated health care costs, it is also a major cause of work absenteeism which leads to a productivity loss to society. “While yoga has been shown as an effective intervention for treating chronic and low back pain, until now there has been little evidence on its cost effectiveness. In our study we evaluated a specially-designed yoga class package by using individual-level data from a multi-centred randomized controlled trial. On the basis of the 12-month trial, we conclude that 12 weekly group classes of specialised yoga are likely to provide a cost-effective intervention for the treatment of patients with chronic or recurrent low back pain.”
Back pain is estimated to cost the NHS £1.37 billion and the health care sector £2.10 billion a year. It is also one of the most common conditions treated in primary care in the UK with about 2.6 million people seeking advice from their GP about back pain each year.
Professor Alan Silman, medical director of Arthritis Research UK, said: “We welcome the fact that not only has yoga been found to help people manage their back pain, but that it is also cost effective, and results in fewer sick days. It is another option for people who are struggling to manage their condition, and one that encourages the move to self-management. Yoga is an intervention that has been proven to make their everyday lives easier and their pain more manageable. “We’d hope that on the back of this, more people with back pain are encouraged to take up the yoga programme.” The trial involved two groups of people who were identified as having chronic or recurrent back pain. A group of 156 people were offered group yoga classes specially designed to improve back function, while a second control group of 157 people received GP care alone. Both groups received usual GP care, which could have involved, for example, referral to pain clinics and physiotherapists or prescription of painkillers.
The 12-week yoga programme was delivered by 12 experienced yoga teachers. It was designed by Alison Trewhela, an Iyengar Yoga teacher and senior practitioner in yoga on the British Register of Complementary Practitioners, in collaboration with yoga teacher Anna Semlyen, a back care advisor to the British Wheel of Yoga.
Alison Trewhela said: “GPs and commissioners are showing great interest in this yoga programme. Many consider it could be the primary treatment option because it offers long-term positive outcomes, as well as a multi-disciplinary combination of taught skills that suits the bio-psycho-social nature of the condition of chronic low back pain. “Within its confidence-boosting, gradually-progressing environment, the gentle ‘Yoga for Healthy Lower Backs’ course addresses joint mobility, muscle-strengthening, emphasis on the breath, mental attitude to pain and perspective on life lessons, postural awareness and low back education, relaxation techniques, and advice about other potentially health-giving techniques and benefits.”
More information on the York Trials Unit’s randomized controlled trial is available at www.yogatrial.co.uk. Lower back pain sufferers, yoga teachers and health professionals can also learn more about the ‘Yoga for Healthy Lower Backs’ programme at www.yogaforbacks.co.uk, a website created by the yoga teachers involved.
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