Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps he has taken to consult specialist healthcare professionals and people with lived experience of spinal cord injury in determining changes to commissioning structures for specialist spinal cord injury services to address geographic variations in (a) access and (b) quality of rehabilitation services for people with spinal cord injury.

Ahead of its planned abolition, NHS England has been considering whether any specialised services currently retained for national commissioning by NHS England should transfer to integrated care boards (ICBs) or become the commissioning responsibility of the Department. This process, which has included engagement with NHS England’s regional commissioning teams and relevant national clinical leads, has identified 11 services, including spinal cord injury services, which would benefit from a more integrated approach to commissioning achieved through the transfer of commissioning responsibility to ICBs. A final decision on which specialised services will transfer and become the commissioning responsibility of ICBs will need approval by Parliament for the necessary changes in primary legislation and, where required, secondary legislation.

Changes to the commissioning architecture will not themselves result in any service change. Where commissioning plans would result in service change, commissioners have a statutory duty to involve and consult the public, which would provide an opportunity to hear from people with lived experience. We recognise that where responsibility for commissioning specialised services is transferred to ICBs, it will be important to maintain expert commissioning knowledge and capability. That is why we are taking steps to establish an office for Pan-ICB Commissioning within each of the seven National Health Service regions to support all ICBs across a region in commissioning specialised services, including the planning and commissioning of services ‘at scale’ where this is appropriate.

The Government fully recognises the importance of maintaining a national framework of standards and clinical commissioning policies to ensure equitable access to specialised services for all patients. This will apply to all specialised services regardless of whether they become the commissioning responsibility of ICBs or the Department in the future.

We are committing to addressing geographic variation in the access to and the quality of rehabilitation services for people with spinal cord injury. In October 2025, the National Institute for Health and Care Excellence (NICE) published new guidance on rehabilitation for chronic neurological disorders, which includes rehabilitation for spinal cord injury. NICE guidelines are evidence-based, informed by clinical expertise, and represent best practice. The Government expects commissioners and service providers to take NICE guidance fully into account when designing services that meet the needs of their local population and work towards implementation over time.