THE NATIONAL (ALL-ENGLAND) SPINAL CORD INJURIES ROAD MAP FOR NHS CARE PROVIDERS
Specialised services are those which provide within the NHS for low volume, high impact patient groups. Specialised Spinal Cord Injury Services are provided by the NHS in accordance with Definition 6 (Specialised Spinal Services) which can be accessed via the website of the National Commissioning Group (NCG).
The NCG was established in April 2007, following the recommendations of an independent review chaired by Sir David Carter (The Carter Review). National commissioning is a responsibility of Strategic Health Authorities (SHAs) and NHS London hosts the NCG on behalf of all 10 SHAs. The NCG is a successor organisation to the National Specialist Commissioning Advisory Group (NSCAG), which used to be based in the Department of Health (DH). The Carter Review recommended that the national commissioning function transfer from the Department of Health to the NHS to strengthen its links with NHS commissioning; provide for improved coherence between the different levels of commissioning from local, through regional and supra-regional, up to national level; and to bring about greater accountability and transparency.
The role of the National Commissioning Group (NCG) is to commission specialised services on a national basis for the population of England. In doing so, it aims to ensure that the services commissioned provide a high quality of clinical care and offer equitable access to patients whilst adhering to robust financial processes. Because the pathway contributed through the NCG towards SCI Services is believed to be demonstrably cost-efficient under audit it not expected to be adversely affected by any of the proposals outlined within the Government's new White Paper - Liberating the NHS. Therefore, a specialised national commissioning agreement for SCI Services will continue in place across NHS England until further notice.
For SCI Services the Carter report also highlighted the chronic underfunding, underinvestment and obfuscation occasioned since 1997. An All-Party Parliamentary Working Group (APPWG) was established to provide a more robust and reliable national service framework and care provision for SCI people across their lifetime.
The net result for NHS England through the efforts of the APPWG was the creation of the National SCI Strategy Board (NSCISB) and the evolution of the National SCI Care Pathway which was developed from original work undertaken in 2003-2006 by the South East Coast Specialised Commissioning Group.
In order to rapidly populate the new National Care Pathway the NSCISB has adopted the South of England Standards for Spinal Cord Injury 2010 (see attached) created by the SECSCG in collaboration with the 3 SCI Centres which serve the South of England (Salisbury, Stoke Mandeville and Stanmore). To coordinate and inform the development and adoption of an acute SCI care pathway the NSCISB developed a SCI Trauma Management Statement with an emphasis upon, wherever possible, admitting acute SCI patients to Major Trauma Centres followed by earliest referral to a designated SCI centre, collaborative decision-making regarding spinal surgery and earliest transfer to a specialist SCI Centre. NB: This statement has now been withdrawn by the NSCISB following the publication of the NHS Clinical Advisory Groups Report on Regional Networks for Major Trauma (see document attached to this page above right).
Managing SCI Patients within the new Major Trauma Networks.
In October 2010 the NHS Clinical Advisory Groups Report on Regional Networks for Major Trauma was published. In August 2011 they published a supplement to this report on the Management of People with Spinal Cord Injury. This supplement was written in collaboration with the National SCI Strategy board and incorporated all of the major expectations of the National SCI Care Pathway into the new major trauma pathways. The supplement is available to download from this page (see document attached to this page above right).
You can also now view the draft SCI Care Pathways on the National SCI Strategy Board website (see link above).