Health Bill [HL]

My Lords, Amendment 70, tabled by the noble Baronesses, Lady Masham and Lady Wilkins, and by the noble Lord, Lord Carlile, seeks to establish in statute a new national bed bureau to oversee the commissioning of services for spinal injuries. I am, again, grateful to those noble Lords for raising this important issue of spinal injury services, and for the helpful background information provided through the Spinal Injuries Association. In particular, I wish to commend the energy and unstinting perseverance of the noble Baroness, Lady Masham, on behalf of spinal cord injury sufferers. As has been pointed out, the noble Baroness, Lady Masham, met the Director of National Specialised Commissioning on 21 April to discuss a range of concerns that were raised during a debate in Grand Committee. I know that the national director of specialised services was much persuaded by the accounts of patient experiences and pledged co-ordinated action by specialised commissioners; that was set down earlier this week in a letter to the noble Baroness. I hope she will forgive me if I restate some of the key points that have been agreed. Under the auspices of the National Specialised Commissioning Group, it is proposed that a national strategy group for spinal cord injury services be established, composed of the 10 specialised commissioning groups in England, the eight specialist spinal injuries centres, and the appropriate stakeholders representing patients and the public. That strategy group will offer a co-ordinated overview of commissioning arrangements across England, and promote much closer collaborations across traditional boundaries to ensure that patients have improved access to specialised beds. Existing work on quality standards and best practice, initiated in the south of England spinal injuries consortium, will be further developed, promoted and disseminated through that group. I hope that this forum for commissioners and providers offers new ways for all stakeholders to work positively and openly together, to effect the improvements to services that we all wish to see. It has also been proposed that a rapid feasibility assessment be undertaken to establish whether a bed bureau function for spinal cord injuries could be established using the infrastructure of the existing emergency bed bureau service that is managed by the London ambulance service. Initial discussions have already taken place, and we will keep stakeholders up to date with those developments. The debate in Grand Committee and briefings from the Spinal Injuries Association clearly identified some significant gaps in capturing accurate and reliable data. While the SIA surveys have given helpful indications, we do not yet have the full picture necessary to inform the long-term strategic directions of service planning. While specialised commissioners and their south of England consortium have taken a useful step forward, we recognise that a more systematic approach is needed across England so that our decisions are soundly based. We will, therefore, look to develop a set of data requirements with the specialist centres that could inform future strategy. This will also build on the existing programme of England-wide work supporting payment-by-results development sites. I would also like to take this opportunity to welcome Professor Keith Willett as the Government’s new national director for trauma. Professor Willett has extensive experience in trauma care and medical management; his appointment sends a clear message of intent from the Government on these issues. I understand that the noble Baroness, Lady Masham, briefly met Professor Willett at a recent Lords’ debate. Although the full scope of the work in which the national clinical director will be involved has yet to be finalised, an overall review of post-trauma rehabilitation— something that we hope to investigate as part of work on major trauma networks—should include spinal cord injury. In addition, the Department of Health has recently commissioned the development of good practice clinical guidelines for adult acute and critical care services. This is led by clinicians in the field and involves a range of stakeholders. The guidance will focus on outcomes and aims to set out good clinical pathways. The scope of the guidelines will include patients with spinal cord injuries. It will include arrangements for the transfer of critically ill patients—including those with spinal injuries—between hospitals for specialist care or diagnostic services. We have also heard from the noble Baroness that my honourable friend the Parliamentary Under-Secretary for Health has written to Ruth Carnall, the chair of the National Specialised Commissioning Group, asking for her ongoing support for the measures that we have outlined today, and for her continued commitment as part of future priorities. I am grateful to the noble Baroness for bringing this important issue to our attention, and I hope that the proposed programmes of work will provide her with reassurance. I therefore ask her, if she feels able, to withdraw the amendment.