HoPES (Hope and Prepare Effectively for Surgery): Personalised self-management for managing hip and knee replacement wait lists

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This project addresses the Healthy Ageing Challenge by developing and implementing the **HoPES** (**Ho**pe and **P**repare **E**ffectively for **S**urgery) self-management digital intervention to keep older adults socially connected, in better mental health and physically active as they wait for knee or hip surgery.The project will support the growth of Hope For The Community (H4C, Community Interest Company) expanding its customer-base and advancing new routes to engage with the NHS as a key market.Lengthening waiting lists is particularly an issue in the area of Musculoskeletal medicine (MSK). In England alone, 726,000 people have severe hip osteoarthritis and 1.4 million people have severe knee osteoarthritis. For those whose condition is severe, joint replacement surgery is the only option to alleviate pain, and improve mobility and the ability to self-manage. Nearly 4,000 patients have been waiting for over 2 years for surgery. Under the NHS constitution, 92% of patients should be treated within 18 weeks as part of the referral-to-treatment scheme. While on the waiting list, patients are likely to experience worsening pain, reduced mobility, increased anxiety, and deteriorating health, leading to greater demand for health and care services.We have developed a proof-of-concept digital self-management intervention based on feedback from 17 patients (mean age 71 years) waiting for hip and knee joint replacement and 5 service leads in the NHS South West region.In this project, H4C working with Bath and North East Somerset, Swindon and Wiltshire Partnership (BSW), Gloucestershire ICS and Somerset ICS and Coventry University will develop a new intervention combining evidence-based self-management content and a validated exercise programme. The exercise component is an evidence-based home based exercise programme that participants can personalise to their needs and ability. After the HoPES intervention has been successfully validated, we will scale it to other NHS Trusts for the greatest impact; it will also be possible to develop similar interventions for other patients who are waiting/preparing for other surgeries (e.g. cancer and heart).