OmYogaMagazineFebruary2019

T

here’s no shortage of information about yoga on the

NHS website as a tool for fitness and wellbeing. But that

doesn’t mean it is widely available to health patients.

There are some cases where your local doctor can

actually prescribe yoga – so it can happen.

The Yoga for Healthy Lower Backs’ programme (YHLB) – created

by yoga instructor Alison Trewhela – is available on a very limited

basis to patients in certain areas.

But it is by no means widespread. In one case, Trewhela says, a

GP surgery paid for some of its patients with more complex needs

to have the opportunity of attending a YHLB course, effectively

shouldering half the costs.

There are many barriers to the further take-up of yoga, including

squeezed NHS budgets and the availability of suitable research.

While NHS cash is a matter for the government, there is plenty going

on in the research field to bolster yoga’s acceptance.

More directly, yoga is becoming more familiar and put to the test

directly with NHS staff. One Clinical Commissioning Group in South

Could yoga one day be available on the NHS?

It already is. But there’s plenty of room for more

Yoga in the NHS

yoga in the NHS

Yorkshire paid for staff who had been off work with stress and back

pain to attend YHLB for free.

In 2015, NHS England chief executive Simon Stevens also

unveiled a £5 million plan for cutting the NHS bill for staff sickness

(reportedly £2.4 billion a year) by serving healthy food and running

yoga and Zumba classes. He said at the time that helping staff stay

well was now a priority.

NHS staff perform some of the most critical but demanding jobs

in the country. Last October, Stevens announced a further mental

health support scheme for all NHS doctors, again reflecting the

immense strain facing the profession.

Perhaps this direct exposure of NHS staff to yoga and its time-

proven benefits, both physical and mental, will drive further acceptance.

This may one day result in yoga finding its way to more patients. Yes,

there are always budgetary constraints, but at a time of changing

demographics – people in the UK and elsewhere in the West are living

longer – and with GPs and hospitals already under crushing pressure, it

could just be the right time to look for alternatives.

YOGA FOR HEALTHY LOWER BACKS

YHLB FOUNDER ALISON TREWHELA SPEAKS TO OM ABOUT THE CHALLENGES

OF YOGA TAKE-UP IN THE NHS

“We know the Yoga for Healthy Lower Backs’ programme, with its rigorous

and robust University of York research findings behind it, really does have

the best chance of any of being offered up to patients via the NHS. This is

especially true now with NHS/Council integrated budgets that recognise

the need to help people to help themselves (self-care, in other words).

When presenting at an NHS Spinal Day, I was able to say that we had lots

of capacity with UK-wide YHLB registered teachers that could help fill

the gaps in the ‘care pathway’ they were describing. The new evidence

about how to best help people with back pain shows how a graded and

structured approach to exercise, along with some psychological support

(yoga philosophy), is the way forwards. However, rather ironically, despite

commissioners knowing they have to find cost-savings, long-term self-

management programmes that help people’s mental health as well as their

musculoskeletal health – such as YHLB – rarely get on the agenda. GPs

do not have many evidence-based options to give patients presenting

with back pain. Those GPs who are educated about YHLB want to be able

to refer to subsidised or free courses. They do not enjoy seeing the same

‘revolving door’ patients coming back in saying: “I still have that back pain,

doctor.” Yet YHLB teachers say it is very rewarding to see so much positive

transformation in people’s lives in such a short space of time.”

Find out more at: yogaforbacks.co.uk

ResultsFeedback from RCGP CPD evening would consider suggesting or referring patients to YHLB & –100% of 21/22 GPs

would support its inclusion as a fully funded NHS service.Patient quotes‘The course got me back to work after 6 ½ month

recovery had plateaued and I was feeling desperate‘I'm firmly convinced that empowering people to tackle things themselves is the best way forward.’ , my .’

Reduction in analgesia and antidepressants was noted Outcomessee the NHS taking a proactive approach to back issues28 pre(-& post-course patient questionnaires) ‘It's great to .’

5 patients reduced / stopped their Opioid medication-

ConclusionThese YHLB Pilots to back pain & function as well as mental health. show impressive outcomes with regards

Funding remains the main obstacle to implementation alongside lack of familiarity amongst GPs.NICE wants it, patients want it, GPs who know it want it:

options such as ‘Yoga for Healthy Lower Backs’. It is time to deself-management with the help of innovative treatment -medicaliseback pain & facilitate

TY‘oheg iam foprl Hemeeantlhtayt Lioonw oerf t Bhaec ekvsi’-deconucers-bea assed

treatAnna meHuetteQuality Improvement Project nt oGP ST3 Leadership scholar South West DpitoYHLB Registered Teachern for patients weanery (NHS Health Education Enith back pa ani (^) gland),
Introduction Back pain is a common and often chronic condition that is costly both for the NHS and our society as a whole. -Cornwall Pilots August 2017
gentle evidenceprogram that enables patients to selfThe Yoga for Healthy Lower Backs programme (YHLB) is a -based [1] and cost-effective [2] 12-week
back pain in the longAims -term. -manage their chronic
▪▪Make YHLB available to NHS patients of PenrynCornish surgeries and evaluate outcomesEducate health care professionals about YHLB+/-other
MethodsSupport for pilots gathered by presenting at clinical meetings ▪Evaluate obstacles to implementation
at Penryn, Referral through GPs, physiotherapists and selfwaiting room posters / fliers.Perranporthand Haylesurgery. -referral using
Funded through patient contribution £56scholarship, subsidized by A. Pilot 1 (n=9/12) & Pilot 2 (n=10) courses were Trewhela& -100, SW Deanery Perranporthsurgery.
taught to Penryn patients. Pilot 3 (n=12) was delivered to patients of Perranporthand St Agnes surgeries.
Preto measure outcomes. Further GP education through presentations at RCGP CPD -and post-course questionnaires were used
Foundation of ‘YHLB Steering group’ and liaison with evening at the Duchy hospital & SWAHSN ‘Sharing best practice’ conference, PPTs to GP ST3s / ST2s & KerrierCMHT.
CCG, Draft created for new local back pain pathway incorporating new NICE guidelines. KernowHealth, RCHT Pain Clinic, local MP.Kernow
Main obstacle Course evaluated at £292 in 2008 [2], currently offered for £224 in the private sector incl. course book, CD & handouts. -Funding
Exclusion of socially deprived patients even with reduced patient contribution towards total course cost.
AcknowledgmentsPossible funding from Cornwall Community Foundation through Age UK.Currently preparing application to another UK charity.
I would like to thank A. Cornish TPDs , the YHLB steering group and the South West DeaneReferences[1] Yoga for Chronic Low Back Pain: A Randomized Trial’ AnnalsTrewhela, E. Campbell, J. Katz, J. Huddy, E. Berry, J. Munro, R. ry for all their efforts, kind support and encouragement. Beckly, L. Fogg, PerranporthSurgery, Penryn surgery, St Agnes surgery, Haylesurgery, the
Randomized Controlled Trial of Yoga for Chronic Low Back Pain: Economic Evaluation’ Spine of Internal Medicine 2011 H. E. Tilbrook, Journal 15th August 2012 Chuang LH, H.Cox, C.HewittSoareset al. [2] ‘A Pragmatic MultiMO, Tilbrook H et al.-centred
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