Building a Better Health Service

Back on Track


In 2012 the HSE Primary Care Physiotherapy Services ran a pilot programme with between six and eight participants to gauge the impact of a combined exercise and education programme for those in chronic, non-specific pain. This was because on analysing the patients returning to physiotherapy services, they highlighted that between 15%-20% presented with the same problem for over 6 months with poor adherence to exercises regimes.

The pilot was successful and so it garnered support from the Ballymun Primary Care Team and in collaboration with Dublin City Council, they established the interagency group. The programme is funded by the HSE Primary Care Physiotherapy Services and Dublin County Council without extra staffing and in the DCC Sports and Leisure Centre. The aim of the initiative, run by senior physiotherapist Vanda Cummins is to improve activity levels in order to manage the chronic pain suffered by those in lower socio-economic areas with low levels of health literacy. In 2013 the programme welcomed its first group of participants to their first of six sessions with an initial 1:1 consultation with a physiotherapist.

As part of the educational element of the programme Vanda Cummins secured training in the biopsychosocial elements of pain management. A combination of gym and pool exercises with a physiotherapist and instructor support are provided during each of the sessions. A GP holds two sessions on ‘explaining pain’ as well as dieticians and mental health nurses providing assistance to the participants. In this way, the programme provides multidisciplinary care to those in chronic pain, empowering individuals to manage their health in a more proactive way. Throughout the six sessions occupational therapists and public health nurses visit the group to check in and provide assistance to those who need it.

There are a range of local and national level programmes that work alongside the Back on Track initiative, like for example, STOP stress, DCC Leisure Passport, MARC, headspace and Chronic Pain Ireland. Discounted leisure centre memberships to all those who participate in the programme is an incentive to continue with the pain management habits created, especially for those with limited access to affordable services like members of the Travelling community. As a result of the interagency collaboration, this initiative is easily transferrable to another setting and promotes goals set out in the Healthy Ireland report of 2013.