Asked by: Gill Furniss (Labour - Sheffield Brightside and Hillsborough)
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.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
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:
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.
Asked by: Helen Morgan (Liberal Democrat - North Shropshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to provide (a) comprehensive healthcare guidance on and (b) access to specialised gynaecological support for (i) the management of menstruation, (ii) contraception options, (iii) safe pregnancy care and (iv) other related matters for people with spinal cord injuries.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Government will prioritise women’s health, placing women’s equality at the heart of our agenda, and ensuring that women’s health is never neglected again. NHS England Specialised Commissioning has a Clinical Reference Group (CRG) for specialised women’s services that provides clinical advice and leadership for complex obstetrics and maternity, and complex gynaecology and fertility preservation services. Specialist gynaecological services are commissioned in line with the service specification published by the CRG.
Furthermore, there is a CRG for rehabilitation, and complex disability and spinal cord injury services. Specialist services for spinal cord injuries are commissioned in line with the service specification published by the CRG. The National Institute for Health and Care Excellence also has guidance on the assessment and early management of spinal cord injuries, which is available at the following link:
https://www.nice.org.uk/guidance/ng41
Menstrual problems and symptoms, such as heavy or painful periods, are common and can have a significant impact on women and girls’ wellbeing, and their participation in education and the workplace. We also recognise that having a spinal cord injury can create additional challenges for women and girls when it comes to managing their period. A range of treatments are available and can help manage menstrual symptoms and gynaecological conditions. Women and girls should contact their general practice (GP) if menstrual problems are affecting their daily life.
In November 2023, NHS England published a decision support tool for managing heavy periods. This tool supports women’s understanding of their symptoms and appropriate treatment options, to support discussion with clinicians.
The Royal College of General Practitioners (RCGP) has published a Women’s Health Library which brings together educational resources and guidelines on women’s health from the RCGP, the Royal College of Obstetricians and Gynaecologists, and the Faculty of Sexual and Reproductive Healthcare. This resource is continually updated to ensure GPs and other primary healthcare professionals have the most up-to-date advice, to provide the best care for their patients.
We are committed to ensuring that the public receives equitable access to the best possible contraceptive services. Different methods of contraception are available from a range of different settings, including direct from pharmacies, both prescribed and over the counter, from GPs, and from local authority commissioned sexual and reproductive health services.
The NHS Pharmacy Contraception Service was launched in April 2023, enabling pharmacists to issue ongoing supplies of contraception initiated in GP surgeries and sexual health services. The service relaunched in December 2023 to enable community pharmacies to also initiate oral contraception. This service offers greater choice in how people can access contraception services. It will also create additional capacity in GP and sexual health clinics to support meeting the demand for more complex assessments.
The Government will continue to work with the NHS as it delivers its three-year maternity and neonatal plan to grow our maternity workforce, develop a culture of safety, and ensure women and babies receive safe, compassionate care.
Asked by: Helen Morgan (Liberal Democrat - North Shropshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to ensure that women with spinal cord injuries receive adequate postnatal support including (a) breast feeding assistance and (b) tailored rehabilitation services.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
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. According to NHS England’s guidance, all women who have given birth should be offered a check-up with their general practice six to eight weeks after giving birth. The check-up will cover a range of topics such as mental health, physical recovery, breastfeeding, and support with family planning. NHS England is also rolling out perinatal pelvic health services to reduce rates of perineal tears, and maternal mental health services to provide additional mental health support and improve outcomes for women.
We know that breastfeeding has significant benefits for both mother and baby. The Government is committed to achieving the healthiest generation of children ever, and central to this is our commitment to give every baby the best start in life. This includes helping families to achieve their breastfeeding goals. It is important that all families are supported to make the right choice for them and have prompt and easy access to high-quality advice and services to help them achieve their infant feeding goals.
The Department is working closely with 75 local authorities across England to improve their infant feeding services, including breastfeeding support, through the Family Hubs and Start for Life programme. These services are helping families to access face-to-face and virtual infant feeding support whenever they need it, and in a location that suits them. This could be at home, in their family hub, or in a hospital setting.
We want to build on the actions that local areas are already taking through the Family Hubs and Start for Life programme to improve their infant feeding services. At a national level, families across the United Kingdom can access round-the-clock support and advice on breastfeeding through the National Breastfeeding Helpline.
The Department recognises the profound impact that spinal injuries can have on an individual and their loved ones, and the importance of early access to high-quality neurorehabilitation. The National Institute for Health and Care Excellence has produced guidance on rehabilitation after traumatic injury, which includes specific recommendations regarding rehabilitation for those with spinal injuries. Further information is available at the following link:
https://www.nice.org.uk/guidance/ng211
Asked by: Andrew Selous (Conservative - South West Bedfordshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many complaints NHS England have received relating to the adequacy of bowel care provided to people with neurogenic bowel disorders in the last 12 months; and what steps her Department is taking to help ensure that patients receive (a) timely and (b) appropriate care.
Answered by Andrew Stephenson
NHS England has not received any direct complaints relating to the adequacy of bowel care provided to people with neurogenic bowel disorders resulting from a spinal cord injury in the last 12 months. Complaints about clinical care should be directed to the hospital providing the care, which would be able to conduct the necessarily investigations.
To help ensure that patients with neurogenic bowel receive timely and appropriate care, NHS England has developed a range of guidance, including its Excellence in Continence Care guidance. NHS England has also published a service specification for spinal cord injury services, which makes specific reference to bowel care. It outlines that patients with spinal injury should be provided with advice and care by specialist nursing staff in specialist fields, including in the field of bladder and bowel management. In addition, National Institute for Health and Care Excellence guidelines on faecal incontinence set out the care that patients with neurogenic bowel should receive, including a neurological bowel management programme.
Asked by: Andrew Selous (Conservative - South West Bedfordshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what estimate she has made of the (a) cost to the NHS of lack of specialist bowel care for patients with neurogenic bowel disorders and (b) additional costs incurred by (i) diagnosis and treatment of pressure sores resulting from inadequate care and (ii) other secondary complications.
Answered by Andrew Stephenson
The Department has no plans at present to establish a national policy on neurogenic bowel disorder. To help ensure that patients with neurogenic bowel receive timely and appropriate care, NHS England has developed a range of guidance, including its Excellence in Continence Care guidance. NHS England has also published a service specification for spinal cord injury services, which makes specific reference to bowel care. It outlines that patients with spinal injury should be provided with advice and care by specialist nursing staff in specialist fields, including in the field of bladder and bowel management. In addition, National Institute for Health and Care Excellence guidelines on faecal incontinence set out the care that patients with neurogenic bowel should receive, including a neurological bowel management programme.
No estimate has been made of the cost to the National Health Service of a lack of specialist bowel care for patients with neurogenic bowel disorders. Nor has an estimate been made of the costs incurred by the diagnosis and treatment of pressure sores, resulting from inadequate care and other secondary complications.
Asked by: Andrew Selous (Conservative - South West Bedfordshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what her policy is on establishing a national policy for neurogenic bowel cancer; and what steps her Department is taking to ensure adequate care is available for people who need it.
Answered by Andrew Stephenson
The Department has no plans at present to establish a national policy on neurogenic bowel disorder. To help ensure that patients with neurogenic bowel receive timely and appropriate care, NHS England has developed a range of guidance, including its Excellence in Continence Care guidance. NHS England has also published a service specification for spinal cord injury services, which makes specific reference to bowel care. It outlines that patients with spinal injury should be provided with advice and care by specialist nursing staff in specialist fields, including in the field of bladder and bowel management. In addition, National Institute for Health and Care Excellence guidelines on faecal incontinence set out the care that patients with neurogenic bowel should receive, including a neurological bowel management programme.
No estimate has been made of the cost to the National Health Service of a lack of specialist bowel care for patients with neurogenic bowel disorders. Nor has an estimate been made of the costs incurred by the diagnosis and treatment of pressure sores, resulting from inadequate care and other secondary complications.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of whether the absence of special provisions in the NHS to provide routine diagnostic tests such as mammograms and cervical smears to women who are paralysed following a spinal cord injury and are wheelchair bound complies with the Equality Act 2010.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
Under the Equality Act 2010 and the Health and Social Care Act 2012, National Health Service screening providers have a legal duty to make sure screening services are accessible to everyone, including people with one or more protected characteristics.
NHS England is committed to improving the accessibility of the screening programmes it commissions under the Public Health Services (S7a) agreement, particularly for under-served groups in society such as those with disabilities. Contractually, providers of NHS screening services are required to make reasonable adjustments to ensure that their services are accessible for people with disabilities.
Services make reasonable adjustments within the constraints of equipment, to ensure that disabled people are offered the opportunity to have screening, however there may be situations where this is not possible. Providers will deal with these on a case-by-case basis and offer an alternative approach as necessary.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what action they are taking to ensure that routine diagnostic tests, such as mammograms and cervical smears, are made available on the NHS to women who are paralysed following spinal cord injury and are wheelchair bound.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
Under the Equality Act 2010 and the Health and Social Care Act 2012, National Health Service screening providers have a legal duty to make sure screening services are accessible to everyone, including people with one or more protected characteristics.
NHS England is committed to improving the accessibility of the screening programmes it commissions under the Public Health Services (S7a) agreement, particularly for under-served groups in society such as those with disabilities. Contractually, providers of NHS screening services are required to make reasonable adjustments to ensure that their services are accessible for people with disabilities.
Services make reasonable adjustments within the constraints of equipment, to ensure that disabled people are offered the opportunity to have screening, however there may be situations where this is not possible. Providers will deal with these on a case-by-case basis and offer an alternative approach as necessary.
Asked by: Rupa Huq (Labour - Ealing Central and Acton)
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 improve bowel care for people with spinal cord injuries.
Answered by Helen Whately - Shadow Secretary of State for Work and Pensions
To support improved bowel care for people with spinal cord injury (SCI) NHS England has published a service specification setting out what providers must have in place to deliver SCI services. This includes specialist multidisciplinary teams providing advice and care in bowel management, including promoting and manging continence.
Asked by: Andy McDonald (Labour - Middlesbrough and Thornaby East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what estimate he has made of the number of people living with a spinal cord injury in England.
Answered by Helen Whately - Shadow Secretary of State for Work and Pensions
The information requested is not held centrally.