Visiting the National Spinal Injuries Centre at @buckshealthcare

Had a really inspiring day yesterday visiting the National Spinal Injuries Centre at Stoke Mandeville in Aylesbury — part of @buckshealthcare.

It’s a specialist service, and a very special place which does what it says on the tin — treating adults and children with short and long-term spinal cord injuries and associated problems with paralysis. The Centre carries out surgery and helps patients rehabilitate, understand and live with their injury.

Buckinghamshire Healthcare NHS Trust is fairly unique in that it is an Integrated Acute and Community Trust and hosts the Spinal Injury Centre at Stoke Mandeville — and my role as Digital Director covers all of these very diverse services with very diverse needs.

There’s about a hundred adult patients and less than 10 children. I toured the Unit and this is what I saw.

In the main Occupational Therapy room there was a hive of activity — first of a raft of specialist wheelchairs — which involves a significant level of mechanical activity.

And a sewing machine to stitch together custom supports to hold/grip things like pens — tailored to individual hands.

And a machine that bent/moulded plastic sheets to do similar. It’s obvious when you see it but fascinating to see the level of fabrication going on.

There was an innocuous looking garden — until it was explained to me that the paths were designed to show the level of rise and fall needed for easy wheelchair use, and different materials such as gravel to navigate.

The garden led to a bungalow — I’d walked past this building many times but didn’t realise what it is for — and what it’s for is to help patients adjust to living in a home as part of their rehab. Before Covid I believe it could also be used for family members to visit in a ‘home setting’. Great facility but with two major ‘but’s’ — the first is it has no Wifi and the second is it doesn’t reflect what I suspect will be many homes use of Smart tech to help manage home facilities e.g. voice or app based (more below!)

I then went on a walkabout on the wards — upstairs the wards are high dependency — often on ventilation, and downstairs less dependent (but obviously still high care needs). Saw a range of issues here from the clinical needs of a spinal patient (pic below showing some of it!), to power points for clinical tech — but also patient devices like iPads.

And downstairs on one of the walls a reminder that it’s not just about spinal injury, it’s about skin care and the risk of pressure ulcers, and the lack of information your brain may receive re touch, pain, pressure and temperature. It’s about bladder management as after a spinal cord injury the brain cannot receive messages from the bladder when it is full (hope you’re ok with words like ‘poo’ and different aspects of it — working in health and previously on the NHS Digital Service Manual we need to be not afraid of words like pee and poo!)

I also think I saw Henry in one of the wards who I met at Kettering in ICU, awaiting a bed in Bucks. Glad to see he landed and looked to be doing well. The NHS, one big family.

Then we went outside and visited Horatio’s Garden. What a place of beauty and of such value to the patients. You can read about the charity behind Horatio’s Garden but what a tremendous legacy that grew from such a tragedy for Horatio and his family. This pic doesn’t do the garden justice but it’s one of the facilities there to host events etc

We then wandered into the Upper Limb facility — super smart tech but dodgy wifi….

I then spent some time with Alison from Aspire (https://www.aspire.org.uk/) — a charity providing practical help to people who have been paralysed by spinal cord Injury. Alison is embedded in the unit and works directly with patients on understanding their needs and exploring options — often tech — that could help meet them.

We covered lots — including a reminder of the value of Dragon dictation software, some fantastic eye tracking technology from Tobii Dynavox (pic above) and an hour’s session with one of the patients helping him use his own iPad and the inbuilt voice control to navigate the web and download audio books.

As ever it wasn’t just about the tech, it was also talking to the patient and hearing his story — from being active at the start of the year, to having a bacterium that now means he has very limited mobility, and how his whole life will now change. And simple things that so much matter for patient dignity like having a shave or a haircut (and yes the Spinal Injuries Centre does have a hairdresser’s within the building…)

So, what next — a reminder of the things I’ve promised to do

• Take my mate Ashley to review ‘the bungalow’ to make it Smart home enabled. Anyone with a spinal injury with reduced ability is most likely to be using Smart tech in the home (Alexa, Nest etc) — let’s make sure we have the same tech in ‘our’ bungalow so patients can familiarise themselves with the art of the possible
• Utterly reminded me of our Able-ness focus. Reminded me of what I knew at the OU back in the early 2000’s and more recently with Molly Watts at NHS Digital. MUST REMIND MYSELF not to accept ‘supplier says’, ‘implement this solution’ etc. and of course FOCUS ON USER NEEDS which include accessibility (painful watching a patient scroll down the horrible ‘free Public Wifi T&Cs)
• Impressed by Dragon software and eye tracking software. Disappointed by Apple iOS voice recognition. Will explore wider use of Dragon in the Acute and Community to help with letter dictation and obviously support patient usage in Spinal
• Must fix Wifi on wards (and everywhere). Connectivity is an essential utility alongside power, energy and water. The same is just as true in hospital (and the community) — particularly for spinal patients who are often long stay and family can be some hours drive away (and the mental adjustment can be as significant as the physical rehab)
• Embarrassed to type this — it appears the Occupational Therapy techs don’t have laptops — will be seeking more laptops and/or desktop PCs in the OT room.
• Sort a timetabling solution! For such long stay patients there’s a massive diary to coordinate of various therapies — and so far we’ve failed and I think we can help.

Been a bit of a week…