Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps he is taking to increase access to (a) preventative care, (b) diagnosis and (c) long term management strategies for women with spinal cord injury who are at increased risk of (i) uterine prolapse and (ii) osteoporosis.

The Government will prioritise women’s health, placing women’s equality at the heart of our agenda and ensuring women’s health is never again neglected. Symptoms of uterine prolapse can usually be improved with pelvic floor exercises and lifestyle changes, but sometimes medical treatment is needed. The National Institute for Health and Care Excellence (NICE) has produced guidance on the management of pelvic organ prolapse in women, which is available at the following link:

https://www.nice.org.uk/guidance/ng123

For patients who need surgery for uterine prolapse, NHS England’s Specialised Commissioning Clinical Reference Group (CRG) for specialised women’s services has produced a service specification for specialised complex surgery for urinary incontinence and vaginal and uterine prolapse, which is available at the following link:

https://www.england.nhs.uk/publication/service-specification-specialised-complex-surgery-for-urinary-incontinence-and-vaginal-and-uterine-prolapse-16-years-and-above/

MSK conditions, such as osteoporosis, disproportionately impact women. One in three women will experience an osteoporotic fracture in their lifetime, compared to one in five men. Women are more at risk of developing osteoporosis due to hormone changes that happen at menopause, and which directly affect bone density.

For all people, including those with spinal injuries, regular exercise and healthy eating are important factors in preventing osteoporosis. Weight-bearing exercise and resistance exercise can improve bone density and help to prevent osteoporosis. Eating foods rich in calcium and vitamin D, or taking vitamin D supplements, is also an important way people can maintain their bone health and reduce their risk of osteoporosis.

The drug Raloxifene is also recommended by the NICE for the primary prevention of osteoporotic fragility fractures in postmenopausal women. In addition, the Government is committed to expanding access to Fracture Liaison Services, a globally recognised secondary fracture prevention model for those with osteoporosis, which can reduce the risk of refracture by up to 40%. With NHS England, we are considering a range of options to identify the most effective ways of improving the quality of, and access to, the Fracture Liaison Service model and the interventions it provides.

To support early diagnosis of osteoporosis, including in those with spinal cord injuries, the Government is investing £1.5 billion of capital funding in 2025/26 for new surgical hubs and diagnostic scanners to build capacity for over 30,000 additional procedures and over 1.25 million diagnostic tests as they come online.

Specialist services for spinal cord injuries are commissioned in line with the service specification published by NHS England’s Specialised Commissioning CRG. Spinal cord injury centres provide life-long services and support, providing ongoing advice and management for those under their care. Through the spinal cord injury centres and voluntary sector, women have access to female discussion forums.