Asked by: Baroness Tonge (Non-affiliated - Life peer)
Question to the Department for International Development:
To ask Her Majesty’s Government, following the destruction of the Al-Wafa hospital in Gaza, what assessment they have made of where those with neurological injuries from Operation Protective Edge are receiving treatment; and what level of rehabilitation and specialist breathing equipment is currently available to amputees and those with spinal cord injuries.
Answered by Baroness Verma
DFID has supported UK – Med teams to deliver training and workshops to partners’ teams on spinal cord injury rehabilitation, neurological assessment, plastics and burns, and brain injuries rehabilitation as identified by trainers and trainees in the UK-MED / UK International Emergency Trauma Response (UKIETR) project. The training benefitted a number of outreach team members of Handicap International partners, while 42 beneficiaries benefitted from assessment and follow up technical support during UK-Med teams on the job trainings. UK-MED teams indicated that over the course of the project, major improvements have been noted in clinical assessment and in the treatment of complex trauma cases. Post-tests following workshops have consistently revealed significant changes in team confidence in managing trauma.
Asked by: Baroness Tonge (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what plans they have to support Professor Raisman’s research into spinal cord injury following the success of his first clinical trial in Poland.
Answered by Earl Howe - Deputy Leader of the House of Lords
Professor Raisman, currently at the University College London Institute of Neurology, has been developing this technique for around 40 years, 30 of which were spent at the Medical Research Council’s National Institute for Medical Research (NIMR). All of the basic research and animal proof of concept for this work was undertaken during Professor Raisman’s time at the NIMR and a summary of this work can be found at:
www.nimr.mrc.ac.uk/news/clinical-success-for-research-programme-which-started-at-nimr/
Since Professor Raisman left the NIMR the Medical Research Council (MRC) has been involved in guiding the clinical translation of this work, however the MRC is not currently supporting his research.
The MRC always welcomes high quality applications for support into any aspect of human health. These are judged in open competition with other demands on funding and awards are made according to their scientific quality and importance to human health. When appropriate, high quality research in particular areas of strategic importance may be given priority in competition for funds, but research excellence and importance to health continue to be the primary considerations in funding decisions.
The National Institute for Health Research (NIHR) funds eleven biomedical research centres that conduct translational research to transform scientific breakthroughs into benefits for patients. These centres are formed through partnerships between England’s leading National Health Service organisations and universities. The NIHR is investing £110 million over five years (2012-17) in the NIHR biomedical research centre at University College London Hospitals NHS Foundation Trust and University College London. The centre is supporting research on the use of cells from the lining of the nose to repair damaged nerves in the spinal cord.
Asked by: Lord Verjee (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what is the total bed capacity of the United Kingdom's spinal injury units; and how that figure compares to the current level of acute and long-term readmissions.
Answered by Earl Howe - Deputy Leader of the House of Lords
In England, the current capacity recommendation for spinal cord injury (SCI) patients as set out in NHS England’s specialised SCI service specification is a minimum of 20 beds at each of the eight specialised SCI centres. NHS England is responsible for commissioning SCI services and for reviewing capacity of SCI services in England.
NHS England has advised that over the next year the SCI Clinical Reference Group is due to undertake a demand and capacity review of SCI services in England. There are no routinely available figures about acute and long-term readmissions to these units.
Asked by: Baroness Wilkins (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government, further to the Written Answer by the Parliamentary Under-Secretary of State for Health, Jane Ellison MP on 21 July (HC Deb, col 1009W), what assessment they have made of NHS England’s Spinal Cord Injury Service Specification of a minimum of 20 beds per unit against the criterion of providing a "safe and effective service".
Answered by Earl Howe - Deputy Leader of the House of Lords
The fluctuations of waiting times and the ability to discharge a patient to the next phase of their care are key factors in enabling the admission of new patients to a centre. NHS England, the eight specialist centres in England and the Spinal Injuries Association are working together to recommend changes to the continuing care process that would enable spinal cord injured patients to move to the next stage of their care as soon as clinically appropriate.
The overall bed complement for England is being reviewed through a demand and capacity project, led by the Spinal Cord Injury (SCI) Clinical Reference Group (CRG). The CRG aims to produce a report in 2015-16.
NHS England’s SCI service specification clearly sets out what providers must have in place to offer evidence-based, safe and effective services. It sets a core requirement that each specialised SCI Centre can demonstrate they have a minimum of 20 beds dedicated exclusively for the treatment and rehabilitation of SCI patients.
This requirement was developed by the SCI CRG and endorsed and was adopted by NHS England as the responsible commissioner.
Asked by: Baroness Wilkins (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what action they are taking to reduce the waiting lists for admission to the eight specialist spinal injury units in England of newly injured spinal cord patients prior to the review of demand and capacity by the Spinal Cord Injury Clinical Reference Group.
Answered by Earl Howe - Deputy Leader of the House of Lords
The fluctuations of waiting times and the ability to discharge a patient to the next phase of their care are key factors in enabling the admission of new patients to a centre. NHS England, the eight specialist centres in England and the Spinal Injuries Association are working together to recommend changes to the continuing care process that would enable spinal cord injured patients to move to the next stage of their care as soon as clinically appropriate.
The overall bed complement for England is being reviewed through a demand and capacity project, led by the Spinal Cord Injury (SCI) Clinical Reference Group (CRG). The CRG aims to produce a report in 2015-16.
NHS England’s SCI service specification clearly sets out what providers must have in place to offer evidence-based, safe and effective services. It sets a core requirement that each specialised SCI Centre can demonstrate they have a minimum of 20 beds dedicated exclusively for the treatment and rehabilitation of SCI patients.
This requirement was developed by the SCI CRG and endorsed and was adopted by NHS England as the responsible commissioner.
Asked by: Ian C. Lucas (Labour - Wrexham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, how many beds in each UK spinal cord injury centre have been ring fenced for the treatment of spinal cord injured readmissions or outpatients in each of the last five years.
Answered by Jane Ellison
NHS England’s Spinal Cord Injuries (SCI) service specification clearly sets out what providers must have in place to offer evidence-based, safe and effective services. It sets a core requirement that each specialised SCI Centre (SCIC) can demonstrate they have a minimum of 20 beds dedicated exclusively for the treatment and rehabilitation of SCI patients. Specialised SCI Services encompass all activity for SCI patients provided by the host trust of the SCIC, including any readmission or attendance for SCI-related care, wherever the treatment is located in the trust. A copy of the specification can be found at the following link:
www.england.nhs.uk/wp-content/uploads/2014/04/d13-spinal-cord-0414.pdf
NHS England is aware that a number of beds in one ward at Stoke Mandeville spinal injuries unit are being used as escalation beds by medical specialties to assist with patient flow. It is planned for these beds to re-open as specialist spinal beds from September 2014.
Asked by: Ian C. Lucas (Labour - Wrexham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, how many beds in each UK spinal cord injury centre are ring fenced for the exclusive treatment of spinal cord injured readmissions or outpatients.
Answered by Jane Ellison
NHS England’s Spinal Cord Injuries (SCI) service specification clearly sets out what providers must have in place to offer evidence-based, safe and effective services. It sets a core requirement that each specialised SCI Centre (SCIC) can demonstrate they have a minimum of 20 beds dedicated exclusively for the treatment and rehabilitation of SCI patients. Specialised SCI Services encompass all activity for SCI patients provided by the host trust of the SCIC, including any readmission or attendance for SCI-related care, wherever the treatment is located in the trust. A copy of the specification can be found at the following link:
www.england.nhs.uk/wp-content/uploads/2014/04/d13-spinal-cord-0414.pdf
NHS England is aware that a number of beds in one ward at Stoke Mandeville spinal injuries unit are being used as escalation beds by medical specialties to assist with patient flow. It is planned for these beds to re-open as specialist spinal beds from September 2014.
Asked by: Ian C. Lucas (Labour - Wrexham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, if he will investigate the alleged misallocation of the specialist spinal injury beds at Stoke Mandeville Hospital and the use by non-spinal cord injury patients.
Answered by Jane Ellison
NHS England’s Spinal Cord Injuries (SCI) service specification clearly sets out what providers must have in place to offer evidence-based, safe and effective services. It sets a core requirement that each specialised SCI Centre (SCIC) can demonstrate they have a minimum of 20 beds dedicated exclusively for the treatment and rehabilitation of SCI patients. Specialised SCI Services encompass all activity for SCI patients provided by the host trust of the SCIC, including any readmission or attendance for SCI-related care, wherever the treatment is located in the trust. A copy of the specification can be found at the following link:
www.england.nhs.uk/wp-content/uploads/2014/04/d13-spinal-cord-0414.pdf
NHS England is aware that a number of beds in one ward at Stoke Mandeville spinal injuries unit are being used as escalation beds by medical specialties to assist with patient flow. It is planned for these beds to re-open as specialist spinal beds from September 2014.
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 the average cost per night is of a bed in (a) an intensive therapy unit or high dependency unit, (b) a district general hospital, (c) a spinal cord injury centre and (d) a spinal cord injury centre for a ventilated spinal cord injured patient.
Answered by Jane Ellison
Information is not available in the format requested.
Such information as is available is from reference costs, which are the average unit costs to National Health Service trusts and foundation trusts of providing defined services in a given financial year to NHS patients. Unit costs for inpatient care, including spinal cord injury, requiring the use of a hospital bed for at least one night are submitted per finished consultant episode rather than per night. Only unit costs for inpatient stays beyond the expected length of stay for each treatment are submitted per bed day. Unit costs for critical care, including in an intensive therapy unit or high dependency unit, are submitted per critical care bed day. This information is shown in the following table.
National average unit costs of adult critical care, elective and non-elective care, and spinal cord injury care in England, 2012-13
| Unit cost per finished consultant episode4 | Unit cost per excess bed day5 | Unit cost per critical care bed day6 |
Adult critical care1 | - | - | 1,173 |
Inpatient care2 | 1,758 | 273 | - |
Spinal cord injury care3 | 7,649 | 354 | - |
Notes:
1National average adult critical care costs submitted in reference costs by all NHS trusts and NHS foundation trusts that provided patient care in critical care units during 2012-13 give the nearest equivalent to the average cost per night of a bed in an intensive therapy unit or high dependency unit. They relate to parts of the patient’s hospital stay that require organ system support in a designated critical care bed. These are conventionally grouped into critical care areas, such as an intensive therapy unit or high dependency unit, but may include temporary, non-standard locations.
2National average elective and non-elective inpatient costs submitted in reference costs by all NHS trusts and NHS foundation trusts that admitted patients during 2012-13 give the nearest equivalent to the average cost per night of a bed in a district general hospital. No attempt has been made to distinguish between district general hospitals and other types of trust, such as specialist or teaching trusts.
3National average elective and non-elective inpatient costs submitted in reference costs against treatment function code 323, spinal injuries, by the following eight trusts providing spinal cord injury centres in England give the nearest equivalent to the average cost per night of a bed in a spinal cord injury centre:
(a) Buckinghamshire Healthcare NHS Trust
(b) Mid Yorkshire Hospitals NHS Trust
(c) Salisbury NHS Foundation Trust
(d) Sheffield Teaching Hospitals NHS Foundation Trust
(e) South Tees Hospitals NHS Foundation Trust
(f) Southport and Ormskirk Hospital NHS Trust
(g) St George's Healthcare NHS Trust
(h) The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust
4Reference costs for elective and non-elective inpatient episodes of care distinguish between the inlier unit cost below a statistically derived expected length of stay (known as a trim point) for a given treatment, and an excess bed day cost for each bed day over the trim point. Inlier unit costs cover the costs of active treatment and are submitted per finished consultant episode rather than per bed day.
5Excess bed day costs are used to estimate the cost of an overnight stay in a hospital bed and generally include routine ward costs such as nursing, dressings, and blood tests, although they may also include the costs of active treatment where this continues beyond the trim point, especially for specialised services.
6Adult critical care costs are submitted per critical care bed day.
Source: Reference costs, Department of Health
Asked by: Baroness Masham of Ilton (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government how long the waiting lists for beds for patients with spinal injuries are at the spinal units at (1) the National Spinal Injuries Centre, Stoke Mandeville Hospital, (2) the Duke of Cornwall Spinal Treatment Centre, Salisbury, and (3) the Royal National OrthopaedicHospital, Stanmore.
Answered by Earl Howe - Deputy Leader of the House of Lords
NHS England has advised that all three centres have periodically experienced problems admitting patients promptly, especially for those patients requiring ventilation, and consequently waiting lists for admission have developed. To ensure patients awaiting admission receive appropriate assessment and support, the centres have been providing outreach care to patients at the hospitals to which they are admitted, which will usually be a major trauma centre.
The fluctuations of waiting times and the ability to discharge a patient to the next phase of their care are key factors in enabling the admission of new patients to a centre. NHS England, the eight specialist centres in England and the Spinal Injuries Association are working together to recommend changes to the continuing care process that would enable spinal cord injured patients to move to the next stage of their care as soon as clinically appropriate.
The overall bed complement for England is being reviewed through a demand and capacity project, led by the Spinal Cord Injury Clinical Reference Group (CRG). The CRG aims to produce a report in 2015-16.