Patient activation describes the knowledge, skills and confidence a person has in managing their own health and health care. Intervening to increase activation can improve a patient's engagement and health outcomes. This is an important factor in helping patients manage their health (Kings Fund 2015). As a part of this study we will quantify patient engagement. Through this we can develop and validate a new tool to comprehensively measure patient outcomes using four domains. These will be Patient reported pain and function (P), shoulder range of movement i.e.