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WQ.461/2019
WRITTEN QUESTION TO THE MINISTER FOR HEALTH AND SOCIAL SERVICES BY DEPUTY K.G. PAMPLIN OF ST. SAVIOUR
ANSWER TO BE TABLED ON TUESDAY 22nd OCTOBER 2019
Question
Will the Minister provide an update on the work on a formal pathway to improve the care offered in Jersey to spinal cord injury patients, including the timescale for its conclusion?
Answer
Work to develop an end-to-end care pathway, which considers the needs of all individuals with spinal cord injury (SCI) commenced in the second quarter of 2019. This work is part of a wider programme of service improvement across all clinical pathways within the neuroscience service.
To date this work has been led by the Team Lead Physiotherapist – Neuroscience, with support from a Senior Occupational Therapist. The Team Lead Physiotherapist has extensive clinical expertise in Spinal Cord Injury rehabilitation, having worked as a specialist clinician at the London Spinal Cord Injuries Centre (2000-2014). In addition, the Senior Occupational Therapist has extensive local experience of supporting individuals with SCI through her clinical role in the long-term disability and specialist seating teams.
The Team Lead Physiotherapist was involved in a round table meeting, attended by the Minister, in early June 2019. This meeting was convened to consider specific challenges associated with our existing local pathway, which had been brought to the Minister's attention by an islander with SCI. During this meeting, the Minister and the local professionals present acknowledged that further work was required to develop local pathways. However, it was also recognised that this will be a large, complex long-term project, requiring multi-agency, multi-professional collaboration between both local and UK services. No specific date is currently set for completion of this work. It was agreed that this will be undertaken within the remit of existing lead professionals who possess the necessary expertise in this specialist area.
The Team Lead Physiotherapist and the Senior Occupational Therapist have started to develop a database to determine the demographics of our local SCI population. To date, 16 individuals have been identified who would potentially benefit from a formal pathway. The Team has liaised with the South Coast Peer Support Officer from the Spinal Injuries Association charity (SIA) to determine whether its remit could be extended to provide peer support to local islanders with SCI. It has subsequently also begun to consider ways in which our organisations might work together to provide training for local professionals to ensure development of necessary clinical skills to optimise care.
In addition to development of an end-to-end care pathway for these individuals, there has been a more pressing need to ensure that we provide them with safe and holistic care within our inpatient facilities. A particular focus and priority for practice development has been to improve knowledge and skills regarding bowel management for individuals with SCI. Significant progress has been made this year, with the implementation of revised processes of care, which are aligned with best practice recommendations for managing neurogenic bowel dysfunction in these individuals.
Furthermore, the local team has made contact with the specialist SCI team at Salisbury Hospital and has arranged to pilot teleconferencing follow-up clinics for local individuals with SCI as an alternative to them needing to travel back to Salisbury. The first of these is arranged for November 2019.