Why the UK needs a national spinal cord injury strategy

The United Kingdom was once a global leader in spinal cord injury (SCI) care, largely due to the pioneering efforts of Professor Sir Ludwig Guttmann at Stoke Mandeville Hospital. 

However, the recent report by the All-Party Parliamentary Group (APPG) on Spinal Cord Injury, From Fragmented to Coordinated, highlights a system that is now fragmented, inequitable, and failing thousands of individuals each year. 

The inquiry’s findings are unequivocal: a National SCI Strategy isn't merely desirable, but essential.

The scale of the challenge

Every two hours, someone in the UK sustains a spinal cord injury. Annually, there are approximately 4,700 new cases, and over 105,000 people are currently living with SCI. 

Whether these injuries are traumatic, from accidents, or non-traumatic, from illness, they have profound and lasting effects on mobility, independence, mental health, and the ability to work and participate in society.

Despite the complexity and severity of SCI, access to care remains inconsistent. Only 20% of patients receive inpatient rehabilitation at a specialist centre. 

Many experience delays in referral, inadequate rehabilitation, and poorly co-ordinated transitions back into the community. These deficiencies result in poorer health outcomes and increased costs for the NHS and social care systems. The report estimates the lifetime economic impact of SCI at £1.12 million per case.

Why a national spinal cord injury strategy?

The inquiry heard consistent evidence of systemic failings:

• Fragmentation and Inequality: Access to specialist centres and services depends on geography, leaving many without timely care.
• Data Blind Spots: The UK lacks a modern SCI registry, making planning and accountability impossible.
• Training Gaps: NHS staff in general hospitals often lack the skills to manage SCI safely, leading to preventable complications.
• Housing and Reintegration Failures: Only 11% of patients are discharged into permanent, adapted housing; 20% of patients, many young people, are placed in care homes for older people due to the lack of appropriate housing.
• Psychological Neglect: Mental health support is patchy, despite high rates of depression and anxiety among SCI patients.
• Research Underinvestment: Government spending on SCI research is just £3 million annually which equates to £1 for every £875 spent on care.

These shortcomings aren't inevitable, but rather the result of decades of missed opportunities and insufficient national leadership.

The blueprint for change

The report calls for a co-ordinated approach involving government, healthcare providers, and charities to stabilise the system, strengthen infrastructure, and implement a National SCI Strategy that delivers meaningful reform.

Immediate post-injury priorities include early admission to specialist SCI centres, which significantly improves outcomes and reduces complications. The report emphasises that inadequate knowledge among healthcare professionals increases the risk of secondary complications, such as infections and pressure sores, and can lead to life-threatening conditions.

Regional disparities persist, creating a ‘postcode lottery’ in which some patients face long waits or lack access to specialist care altogether. The report recommends standardising funding across the UK to ensure equitable access and consistent quality of care, alongside increased investment in research and workforce development.

A strong emphasis is placed on psychological, vocational, and peer support, with patient voices central to decision-making. The APPG specifically recommends that children have guaranteed access to specialist centres, adapted housing, and accessible education.

The human cost and the path forward

Behind the statistics are real people. As the report notes, over the long term, SCI imposes pervasive and compounding burdens across physical, mental, social, economic and familial domains. 

Drawing on my experience in supporting clients living with SCI, I've witnessed the fragmented and disjointed nature of the current system and the impact this has not only on the person living with SCI but also on their wider support network. In my experience it's family members who often take on long-term unpaid care, with significant impacts on their own health, finances and quality of life.

The APPG’s report presents a compelling case for comprehensive reform and a National Spinal Cord Injury Strategy would provide a coherent vision, align resources with evidence, and deliver dignity, equity, and hope to thousands of people living with SCI.

Supporting clients affected by spinal cord injury

At Irwin Mitchell rehabilitation is a focus, and in March, we'll be hosting a conference on life after spinal cord injury. The conference will look at the challenges which arise following discharge from a rehab unit, navigating relationships with friends and family, and learning to live as independently as possible. 

There are a number of ways we support our clients living with SCI, most notably in accessing early specialist support. 

Our Support and Rehabilitation co-ordinators work to assess our clients’ immediate needs. They help them to access rehabilitation, care, welfare and other benefits advice and to manage issues such as equipment and housing while a legal claim is ongoing. 

When I'm in a position to secure compensation for my clients, this provides access to privately funded care and case management, therapies, aids, equipment and accommodation. It's often astonishing how much progress my clients can make when their rehabilitation is optimised.  

Find out more about Irwin Mitchell's expertise in supporting families affected by SCI at our dedicated Spinal Cord Injury section.