Acquired Brain Injury

Seema Kennedy Excerpts

Tuesday 2nd July 2019 Westminster Hall

[The Parliamentary Under-Secretary of State for Health and Social Care (Seema Kennedy)]

It is a pleasure to serve under your chairmanship, Mr Rosindell. I thank the hon. Member for Rhondda (Chris Bryant) for introducing the debate, and for challenging the Government on this important issue. He is an indefatigable champion for those living with acquired brain injury, about which he has taught me a lot in the few months for which I have been in my position.

I also thank all right hon. and hon. Members who have spoken, and those who have been present but have not spoken. People have shared personal experiences—things that are painful to them, and that they have lived with for a long time. I particularly welcome the hon. Member for Newport West (Ruth Jones) to her place. I think that this is the first time that I have responded to a debate in which she has spoken.

As with many long-term conditions, ABI affects not only a person’s health but aspects of their family life, work and relationships. I responded to the debate on 9 May. I am still chasing ministerial colleagues in other Departments for their comments, but because time is quite short I will focus today on the many points that have been raised about the health aspects. However, I will go back to ministerial colleagues, chase them and impress on them that this important issue affects many Government Departments.

I met representatives of Headway after the debate on 9 May, and I thank those who work with Headway and organisations such as the UK Brain Injury Forum. Such organisations are really valuable to people living with ABI. They raise awareness and provide help to support those with the condition, as well as families and carers. The hon. Member for Darlington (Jenny Chapman) mentioned how important that is. I take on board the report of the all-party group, to which the Government responded, and I pay tribute to the hon. Member for Rhondda and my right hon. Friend the Member for South Holland and The Deepings (Sir John Hayes).

In 2014, two years after the introduction of major trauma centres, there was an independent audit of the regional trauma networks, commissioned by NHS England. That audit showed that patients had a 30% improved chance of surviving severe injuries, and that the networks had saved 600 lives. That does not mean that they are perfect, but some progress has been made since their inception. Although the majority of rehabilitation care is locally provided, NHS England commissions specialised services for those patients with the most complex levels of need. For people who have ABI, timely and appropriate neuro-rehabilitation is an important part of their care.

I thank the APPG for all the work it has done on rehabilitation prescriptions, which reflect the assessment of the physical, functional, vocational, educational, cognitive, psychological and social rehabilitation needs of a patient, and are an important element of rehab care. Of course, the APPG report stated that all patients with ABI should benefit from an RP.

I will touch on lots of the points that Members have mentioned. In particular, I thank the hon. Member for Rhondda for drawing the House’s attention to the third and final report of the audit, which was published in April 2019, only a few days before we last discussed this matter. It is encouraging that 94% of patients accessing specialist rehab have evidence of functional improvement, but the report suggests that there is more work to be done to ensure that all patients who could benefit from specialist rehabilitation can access it.

[John Woodcock (Barrow and Furness) (Ind)]

Does the Minister share my concern that there is no universal information for when people present at A&E or the doctor’s with a head injury? After I fell off a ladder in 2012, I was surprised that I was not given so much as a leaflet to say that there might be long-lasting effects. Some people are clearly good at picking it up, but it should be absolutely obvious that everyone who strikes their head should be given extra attention by the NHS in case they develop symptoms.

[Seema Kennedy]

I thank the hon. Gentleman for raising that point. I was talking to another colleague who had a brain injury just last year, and she said exactly the same thing. That was not in A&E; it was at a GP practice. There are of course training modules for GPs to access, but debates such as this one and my conversations with NHS England can only help in raising awareness. I thank the hon. Gentleman for bringing that point to my attention.

To return to the audit, its authors estimate that current provision caters for 40% of those who need the services, so there is a lot more to do. On capacity, the audit made some recommendations, including that trauma centres should review their processes and ensure that standards for rehabilitation provision and availability are met, and that commissioners should consider opportunities for development of specialist rehab capacity, both for in-patient and community-based services—a point that hon. Members have raised. These are important points. Although we only had this debate two months ago, I am glad that the hon. Member for Rhondda has raised the subject again. I will discuss with NHS England what it is thinking, what it is doing on the audit and what the next steps are. We need to impress on it the importance of bed provision.

The majority of rehab care is commissioned and managed locally and there are guidelines produced by NHS England, such as the principles and expectations for good adult rehabilitation, which describe what good rehabilitation care looks like. There is additional guidance that covers both adults and children.

Many hon. Members mentioned neuro-rehabilitation for children, and I know that NHS England is aware that there is variability in the provision for children. Best practice guidance was published in 2016, but there is always more to be done. I will take the points away and speak to NHS England. We are looking at how we can educate people on foetal alcohol syndrome, and I am happy to report back to the House on that.

The hon. Member for Newport West raised a specific issue about speech and language therapists and physiotherapists. I very much agree that we need a joined-up approach to care and I am concerned to hear that there is a gap. Members can make representations to NHS England on that. I know the situation is different in Wales, but I would be very happy if the hon. Lady would keep me informed.

The hon. Member for Rhondda raised the injury cost recovery scheme. Again, that is a matter for the DWP and I will be pressing ministerial colleagues to respond on that point. That scheme allows for the recovery of costs for providing treatment to an injured person where that person has made a successful personal injury claim against a third party. It recovers funds from insurance companies and pays into the NHS or hospital ambulance services. The current cap is around £53,000, renewed annually in line with inflation. I will follow up with more detail—the hon. Gentleman looks slightly sceptical.

[Chris Bryant]

I do.

[Seema Kennedy]

I have found it is always good to be sceptical in this place.

The NHS long-term plan was announced in January this year. There are some key actions designed to improve the care, treatment and support of people with long-term conditions, such as ABI. Community services, which play a crucial role in helping people with long-term conditions such as brain injury, remain as independent and well supported as possible and are to receive significant investment. The long-term plan set out £4.5 billion of new investment in primary and community care, including for expanded community multidisciplinary teams, providing rapid targeted support to those identified as having the greatest risks, including those with long-term health conditions.

There is also the comprehensive model of personalised care, which includes self-care, care planning, personal health budgets and social prescribing, and which we hope will reach 2.5 million people by 2023-24.

[Jenny Chapman]

I am worried about the long-term plan. Yes, brain injury is included, but so is just about everything else. My concern is that brain injury is getting lost and is not getting the priority it needs; although I appreciate the Minister taking the trouble to raise points and ask questions, that will not be sufficiently effective. We need something with more teeth. We need to be very clear what a patient can expect, what their rights are and what their family can do about it if those things are not provided. Trusts and whatever the structures are in the different parts of the country must be compelled to provide a certain level of service.

--- Later in debate ---

[Seema Kennedy]

I take the challenge set by the hon. Lady. On the question of the response to the audit, I will ask NHS England to show me how it is implementing that. Guidelines are great, and trusts should be doing certain things, but I accept that there is variability.

The hon. Member for Rhondda and my right hon. Friend the Member for South Holland and The Deepings used some great quotations in their speeches, so I will conclude my remarks with a quotation attributed to Sir Francis Drake, who said:

“There must be a beginning of any great matter, but the continuing until the end until it be thoroughly finished yields the true glory.”

Ministerial office is not something that I take for granted, but I hope that today’s debate has demonstrated how seriously this Government and this Minister take ABI and the devastating effects it can have on our constituents.