Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what provision exists within the NHS for diagnostic investigations, including upright and dynamic MRI, for suspected craniocervical instability; and whether he plans to expand access to that provision.

In England, the organisation and delivery of multidisciplinary care for patients with hypermobile Ehlers-Danlos syndromes (hEDS) and associated co-morbidities is a matter for local National Health Service systems. Integrated care boards are responsible for commissioning services to meet the needs of their populations, including access to relevant specialties such as rheumatology, neurology, pain management, and, where appropriate, neurosurgical services, with decisions about referrals and coordination of care made by clinicians, based on individual patient need and the available evidence. Multidisciplinary team working is an established part of NHS practice for patients with complex needs.

The Department has made no specific national assessment of the adequacy of care pathways for people with hEDS and associated co‑morbidities. There is currently no single nationally defined care pathway or service specification specific to hEDS or related co- morbidities. Clinical management is guided by existing evidence, relevant National Institute for Health and Care Excellence guidance where available, and the clinical judgement of specialist teams. The Government continues to support improvements in care for people with complex conditions through wider initiatives, such as the 10-Year Health Plan and Getting it Right First Time programme.

Diagnostic investigations for suspected craniocervical instability, including magnetic resonance imaging (MRI) and computed tomography, are available through existing NHS pathways. Access to more specialised imaging, such as upright or dynamic MRI, is determined locally and used in limited circumstances based on clinical need. There are no current plans to expand national provision.

Responsibility for education and training sits with healthcare professionals themselves and with NHS England, which leads workforce planning and supports continuing professional development. Clinicians are expected to keep their knowledge up to date, drawing on national guidance, research evidence, and professional resources relevant to their role.