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

该项目通过开发和实施**希望**(**何**PE和**P**有效地**S**外科手术)自我管理数字干预来应对健康老龄化挑战，以保持老年人的社会联系，使他们在等待膝盖或髋部手术时保持更好的心理健康和身体活动。该项目将支持社区希望(H4C，社区利益公司)的增长，扩大其客户基础，并提出新的途径，作为关键市场与NHS接触。延长等待名单是肌肉骨骼药物(MSK)领域的一个特别问题。仅在英格兰，就有72.6万人患有严重的髋关节骨性关节炎，140万人患有严重的膝骨性关节炎。对于病情严重的患者，关节置换手术是缓解疼痛、改善活动能力和自我管理能力的唯一选择。近4000名患者已经等了两年多的手术。根据NHS宪法，作为转诊到治疗计划的一部分，92%的患者应在18周内接受治疗。在等待名单上，患者可能会经历疼痛加剧、行动不便、焦虑增加和健康恶化，导致对健康和护理服务的更大需求。我们开发了一种概念验证数字自我管理干预，基于17名等待髋关节和膝关节置换的患者(平均年龄71岁)和NHS西南地区5名服务线索的反馈。在这个项目中，H4C与巴斯和东北部萨默塞特、斯温登和威尔特郡合作(BSW)、格洛斯特郡ICS和萨默塞特ICS和考文垂大学将开发一种新的干预措施，将基于证据的自我管理内容与有效的锻炼计划相结合。锻炼部分是一种基于证据的家庭锻炼计划，参与者可以根据自己的需求和能力进行个性化锻炼。在HOPE干预措施被成功验证后，我们将把它推广到其他NHS信托基金，以获得最大的影响；也将有可能为等待/准备接受其他手术(例如癌症和心脏)的其他患者开发类似的干预措施。

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).