Asked by: Rosena Allin-Khan (Labour - Tooting)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the effect of delays in discharges from NHS Spinal Cord Injury Centres on patients awaiting treatment; and what steps his Department has taken to reduce those delays.
Answered by Seema Kennedy
NHS England is aware of the benefits of timely admission to a Spinal Cord Injury Centre (SCIC). A key aim of the Spinal Cord Injury Review is to produce a service that is able to offer each newly injured patient prompt admission to a SCIC.
We are currently working with the existing eight centres to develop a network model that will allow the sharing of best practice and improve standardisation of high quality care. This would include learning from the experiences of centres that currently have the lowest waiting times for admission. The network would also enable the co-ordination of the actions of referring hospitals and their awareness of the referral processes to SCI centres and ensure they are supported with information and specialist advice about how best to look after cord injured patients prior to admission.
There is also work underway looking at options to increase SCI care provision to meet unmet demand across the eight centres, with the possibility of a new unit to serve the population that currently has limited access to a SCI centre. Any new SCI unit would need to be co-located with a major trauma centre.
Asked by: Baroness Masham of Ilton (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government whether NHS England intend to increase the capacity of the National Spinal Cord Injury Service by 54 beds, as recommended in their recent Service Review.
Answered by Lord O'Shaughnessy
NHS England continues to work with stakeholders to deliver the key components of the ongoing Spinal Cord Injury Service Review.
The two principal actions that need to be taken forward as a result of the review are identifying the best way of meeting the need for additional inpatient capacity, recommended as 54 beds; and the establishment of a national spinal cord injury network.
Over the coming months there will be an evaluation of capital bids required for the building of a new unit. Network proposals are also being finalised. The increase in capacity of the Spinal Cord Injury Service cannot be confirmed until the evaluation and review are completed.
Asked by: Ian C. Lucas (Labour - Wrexham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what the timetable is for NHS England to respond to its service review on specialist spinal cord injury services; and what the timetable is for further steps to be taken in relation to that review.
Answered by Steve Brine
In September 2017 the Specialised Commissioning Oversight Group at NHS England approved the recommended Case for Change for Spinal Cord Injury (SCI) services. Recommendations include improvements in efficiency and standardisation within the current eight SCI centres, and an increase in SCI service provision. No timeline has yet been determined by NHS England for implementation.
Asked by: Ian C. Lucas (Labour - Wrexham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what information his Department holds on the timetable for the beds being used by non-spinal cord injured patients in the (a) National Spinal Injuries Centre at Stoke Mandeville and (b) Yorkshire Regional Spinal Injuries Centre, Pinderfields to be returned to use by spinal cord injured patients.
Answered by Steve Brine
NHS England commissions specialised spinal care from eight centres in England for patients who have suffered a spinal cord injury, totalling 374 beds. The service is managed locally and delivered by spinal cord injury specialists, both within the spinal cord injury centres and as outreach to acute hospitals and following discharge for transition and reintegration into the community.
NHS England’s national team has advised that it is not aware of any intelligence to suggest that a spinal cord injury patient has been denied a specialist bed during the winter period due to its use by a non-spinal cord injury patient.
Information concerning the number and proportion of spinal cord injured patients who are treated in a specialist spinal cord injury centre for their initial rehabilitation relative to those who receive that rehabilitation in a different clinical or other setting is not held centrally.
Asked by: Ian C. Lucas (Labour - Wrexham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what information his Department holds on the number and proportion of spinal cord injured patients who are treated in a specialist spinal cord injury centre for their initial rehabilitation relative to those who receive that rehabilitation in a different clinical or other setting (a) nationally, (b) by country and (c) by region.
Answered by Steve Brine
NHS England commissions specialised spinal care from eight centres in England for patients who have suffered a spinal cord injury, totalling 374 beds. The service is managed locally and delivered by spinal cord injury specialists, both within the spinal cord injury centres and as outreach to acute hospitals and following discharge for transition and reintegration into the community.
NHS England’s national team has advised that it is not aware of any intelligence to suggest that a spinal cord injury patient has been denied a specialist bed during the winter period due to its use by a non-spinal cord injury patient.
Information concerning the number and proportion of spinal cord injured patients who are treated in a specialist spinal cord injury centre for their initial rehabilitation relative to those who receive that rehabilitation in a different clinical or other setting is not held centrally.
Asked by: Ian C. Lucas (Labour - Wrexham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what plans he has to ensure that beds in spinal cord injury centres are prioritised for the use of people with spinal cord injuries who require specialist care in future winters.
Answered by Steve Brine
NHS England commissions specialised spinal care from eight centres in England for patients who have suffered a spinal cord injury, totalling 374 beds. The service is managed locally and delivered by spinal cord injury specialists, both within the spinal cord injury centres and as outreach to acute hospitals and following discharge for transition and reintegration into the community.
NHS England’s national team has advised that it is not aware of any intelligence to suggest that a spinal cord injury patient has been denied a specialist bed during the winter period due to its use by a non-spinal cord injury patient.
Asked by: Ben Bradshaw (Labour - Exeter)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what progress his Department has made in implementing the recommendations of the Third Report of the Health Select Committee, Session 2000-01, Head Injury: Rehabilitation.
Answered by Steve Brine
This is a matter for NHS England as the body responsible for commissioning providers of neuro rehabilitation across England.
NHS England’s current specification for neuro rehabilitation takes account of research based evidence which shows that:
- Rehabilitation in specialist settings for people with traumatic brain or spinal cord injury and stroke is effective and provides value for money in terms of reducing length of stay in hospital and reducing the costs of long-term care;
- Early transfer to specialist centres and more intense rehabilitation programmes are cost effective, the latter particularly in the small group of people who have high care costs due to very severe brain injury;
- Clinical and cost-benefits are similar for people with severe behavioural problems following brain injury; and
- Continued co-ordinated multidisciplinary rehabilitation in the community improves long-term outcomes and can help to reduce hospital re-admissions.
This specification is used within contracts held between NHS England and providers of neuro rehabilitation across England. Each region is responsible for monitoring the performance and quality outcomes of the service provided, as described within the specification.
Asked by: Ian C. Lucas (Labour - Wrexham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what steps he is taking to ensure that people with spinal cord injuries are treated in specialist units.
Answered by David Mowat
NHS England commissions specialised spinal care services nationally. All patients needing specialist spinal care following either injury or disease progression should be referred to a specialist centre after initial treatment or assessment at a local hospital.
These services encompass acute care following the injury, rehabilitation and life-long follow-up of people living with spinal cord injury.
Asked by: Jim Shannon (Democratic Unionist Party - Strangford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, whether the NHS has made an assessment of the potential effect of spinal tap on increasing the mobility of wheelchair-bound patients.
Answered by David Mowat
Lumbar puncture or ‘spinal tap’ is used to test for conditions affecting the brain, spinal cord or other parts of the nervous system. The hon. Member may be referring to a pioneering treatment, the Injured Spinal Cord Pressure Evaluation Procedure, used to reduce inflammation by reducing pressure build up within the spinal column caused by swelling and so preserving nerve function. This treatment is at an early stage of development and no assessment has yet been made of its potential effect on increasing the mobility of wheelchair users.
NHS England will only consider commissioning procedures and interventions that are evidenced and where the evidence is published or where the National Institute for Health and Care Excellence has produced guidance. This procedure remains in trial phase for acute spinal injury.
Asked by: Andrew Gwynne (Labour - Denton and Reddish)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, if his Department will make an assessment of the effect on patient access to medical technologies of NHS England's development of specialised commissioning policies in each of the last three years; and if he will make a statement.
Answered by George Freeman
NHS England holds direct commissioning responsibility for prescribed specialised services. This includes the development of clinical commissioning policies which establish fair and equitable access for patients in England to drugs, medical devices and treatments for specialised services.
The current portfolio of innovative medical devices that are routinely commissioned by NHS England for specialised services is broad and includes Deep Brain Stimulation for a number of clinical indications; Spinal Rods for Scoliosis that may be adjusted in children non-invasively; and a Phrenic Nerve Stimulator to assist the breathing of patients with spinal cord injury.
Where a device based treatment is not yet routinely commissioned on the basis of the current evidence of clinical and cost effectiveness, but is nonetheless believed to show significant promise as a future National Health Service treatment, NHS England has established a Commissioning through Evaluation (CtE) programme to gather valuable additional data to inform future decisions on eligibility for NHS funded care. Selective Internal Radiation Therapy - where radioactive beads are used to deliver focussed treatment of tumours within the liver, and Mitraclip - enabling non-surgical repair of the mitral valve of the heart - are two examples included in NHS England's current CtE programme.