Acquired Brain Injury Action Plan

Caroline Johnson Excerpts

Thursday 4th December 2025 Westminster Hall

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

It is a pleasure to serve under your chairmanship, Dame Siobhain. I congratulate my right hon. Friend the Member for South Holland and The Deepings (Sir John Hayes) on securing a debate on a subject that I know is important to him, to many of our constituents and to the whole House. The brain is so important. It is responsible for moving and thinking, homeostasis, consciousness, our senses and how we interpret the world—essentially, it makes us the people that we are. Acquired brain injuries are therefore an important issue.

As other hon. Members have said, acquired brain injuries are the leading cause of death and disability in those aged between one and 40. Every 90 seconds, someone somewhere in this country—over 330,000 people per year—is admitted to hospital with acquired brain injury. They can have difficulties with walking, with talking, with moving, with thinking skills, with tiredness and fatigue, and with changes in personality. People can have one large brain injury with devastating effects, but they can also have multiple, small, almost unnoticed brain injuries, the cumulative effect of which can be quite severe, and the long-term effects of which can lead to dementia.

The previous Government began work on an acquired brain injury plan and made a public call for evidence in 2022. Unfortunately, that work was interrupted somewhat by the general election. It has been picked up by the current Government, who say they will publish such a plan; it is nearly the end of the year, and I hope they are not going to break that promise, and add to the list of the many other plans that they have delayed. Will the Minister tell us when the plan is going to be published? When it is published, will it include the evidence given in response to the 2022 public call for evidence by so many stakeholders, charities and other relevant organisations?

What should that plan contain? I will look at it from the perspective of this Government, who are looking for the three shifts in healthcare. First, they want to move toward prevention. It seems sensible to prevent brain injury in the first place, if we can, and we know some things that we can do. When I was a teenager, horse-riding and skiing were usually done without helmets; that would be very unusual now. We have not been so successful with cycling: people know that wearing a helmet is wise, to prevent brain injury, but if we looked outside into Parliament Square, we would see lots of cyclists, many of whom are not wearing a helmet that could protect them from brain injury. What are the Government doing to make people more aware of ways that they can protect themselves from brain injury? Concussion management guidance for those taking part in elite, amateur and school sport is important, as others have said today.

Stroke is a form of acquired brain injury and I spoke to representatives of the Stroke Association earlier this term. They talked about two things that can help to prevent or limit brain injury from stroke: first, blood pressure checks and identifying previously undiagnosed hypertension, and secondly, mechanical thrombectomy, which limits the injury that occurs.

The previous Government rolled out blood pressure checks to thousands of pharmacies across the country. Will the Minister update us on what further steps have been taken to identify undiagnosed hypertension since she came into office? The previous Government also began to roll out mechanical thrombectomy. I understand that this Government intend to ensure that a universal service for that technique is available by Easter next year. Essentially, mechanical thrombectomy is when an interventional neuroradiologist takes a wire into the vessels, floats it up into the brain and mechanically removes a clot. It is particularly helpful for people who have had a large stroke where the damage is not yet complete in the brain. Damage can be limited significantly by the use of that very clever procedure.

Earlier this week, I was kindly invited to visit the mechanical thrombectomy service in Romford and see the work done there. I was told about the delay that can occur due to inter-hospital transfer. The Minister, in response to written parliamentary questions, has talked about what constitutes a universal service: it is being able to access a service within four hours. One limit to that ability, as I understand it, is that when someone who has had a stroke attends a hospital that does not offer a mechanical thrombectomy service, the time it takes to transfer them to a hospital that does, after acceptance for the process, affects people’s ability to have that lifesaving in some cases, and certainly disability-saving, treatment.

When I was a junior doctor, I was lucky enough to care for people taking part in the total body hypothermia for neonatal encephalopathy trial—the TOBY trial. Essentially, we took babies who had suffered a brain injury around the time of birth and cooled their whole body to reduce the brain injury that they suffered. That was very effective, and became standard practice. What is the Minister doing to help people who want to do research into other ways of reducing brain injury? How is she helping with research, and what is she doing to sponsor it?

What work is the Minister doing with the social care teams at the Department for Education? One of the sad things that I have seen during my time as a consultant paediatrician is children with inflicted injury—particularly babies. In many cases their injuries should have been preventable because those families were known to social care before the injury occurred. What is being done to protect those extremely vulnerable children? There are other causes of acquired brain injury too. Could the Minister talk about what she thinks the most important causes are and what she and the Government are doing to reduce their incidence?

The other shift that the Government want is from hospital into the community. I was lucky to meet Headway Lincolnshire this week, which told me that there were only 12 in-patient beds available for acute brain injury rehab across Lincolnshire. That is not sufficient. When the charity provides counselling services, it has to do so online from outside the county because there is no one available in the county to provide them. What is the Minister doing to ensure that there is good neuro-rehab across the country, including in rural areas? Also, what is the Minister doing to make sure that rehab is long term? Neuro-recovery takes a long time. It is not just a case of a couple of appointments on leaving hospital; it needs to be over a more sustained period.

For people suffering complex injury, there are many professionals involved. Some people will have a physio, an occupational therapist, a speech and language therapist, nurses, doctors, carers and many others. NICE’s new neuro-rehab guidelines, published in October, talk about how it is difficult for patients to negotiate that, and they recommend a single point of contact. Does the Minister plan to ensure that that NICE recommendation is delivered? If so, how and when?

I would like to pay particular tribute to a young lady I met recently who is one of my constituents. She experienced a traumatic brain injury as a child, but with her determination, great family and community support and rehab, she has made a good recovery and is training as a nurse so that she can help others who suffer as she has. She is an incredibly impressive young woman. She highlighted to me the need for better rehab and school support. I urge the Minister to ensure that they are delivered.

The final shift that the Minister has talked about is from analogue to digital. Digital offers us huge capacity in rehabilitation from acquired brain injury. I talked to a gentleman who had had a stroke and was admitted to a rehab unit where he got involved in Wii Fit—a Nintendo game from some time ago. He was using it along with another person who was recovering from a stroke at the same time, and they became very competitive at these balance and movement games. That really helped them to recover. What is being done to make rehab more fun or competitive? Some of the exercises that people are asked to do can be quite difficult. How can we make them more enjoyable? There are apps available to improve communication, memory and fine motor skills, and virtual reality can help with cognitive rehab. How is the Minister ensuring that those are available to all who would benefit from them?

In summary, we need a detailed plan looking at prevention, acute treatment and rehabilitation. I hope it will not be delayed in the same way as all the other Government plans seem to be. I also hope that it will contain a delivery chapter that sets out not just what the Government want to do, but how they want to do it and when they want to do it by. Will the Minister confirm whether the relevant workforce will be included in the plan, or whether we will have to wait for the long-delayed workforce plan? Neuro-rehabilitation is really difficult, but many people show huge courage and determination in their work to rehabilitate. We need to support them in every way that we can.