Spasticity management extends to patients across Somerset

Patients who are affected by severe tight and overactive muscles due to a neurological condition are now benefiting from an extended spasticity management service.

Spasticity is a condition in which muscles become over active and tighten, preventing normal fluid movement. It occurs after a person has had a head injury, stroke or has an ongoing condition such as multiple sclerosis. It also affects children with cerebral palsy.

It can be painful and interferes with everyday activities, including difficulty with movements, walking, and may cause falls or skin problems. In the majority of people, their spasticity can be managed with exercises or oral medication, however some need more specialist interventions such as botulinum toxin (botox) injections.

Helen Wilkinson, our clinical integration advisor, who also has a role as a consultant therapist, said:

“Our Somerset-wide spasticity management team is based at Musgrove Park Hospital and works closely with our community therapists and stroke rehabilitation units.

“We felt that we hadn’t quite got the care pathway right for our patients, so we involved colleagues in a service review to identify the problems and improve the provision.

“We also drew on a wealth of national evidence and the experiences of patients in Somerset to think about what the pathway should look like.

“Thanks to the merger of our two NHS trusts in Somerset breaking down boundaries, we were able to train up key therapists and nurses in the community so they now have a higher skill level in managing spasticity and are the specialists for that area. And those colleagues have also been using this learning to support others within their teams.”

Another significant change is that these key clinicians can refer into the service, whereas before only GPs or consultants could refer in.

“A therapist in the community can now speak to one of our trained specialists to ask for advice on a patient’s management, they will also screen the information and can initiate any required onward referral without needing to go through the GP referral process,” said Helen.

“It saves such a lot of time for patients too, as sometimes it used to take weeks for a referral to come through. The referral is also likely to be more detailed as the specialists have a more in-depth knowledge of the patient’s specific condition.

“But to be sure that everyone has access to the same information we have put a structure in place where the community referrals gets sent to the patient’s GP at the same time as us, giving them the opportunity to add further information.”

The service has also adapted to the changing landscape caused by the COVID-19 pandemic.

“Having all the key individuals involved in spasticity management in place in the community during the pandemic has helped us to monitor our patients,” Helen said.

“We’ve really embraced technology and our colleagues send us videos of the patient they’ve seen so we can analyse their movement problems and give appropriate advice.

“The review has also enabled us to carry out a limited number of visits to care homes in exceptional circumstances. During the pandemic we’ve been able to work with the care home staff and our community therapists virtually to treat our most vulnerable patients.

“Previously the service was always centred around the Taunton area as we only had clinic facilities at Musgrove Park and Dene Barton hospitals, but because of the merger of our trusts we now have open access to sites in the community and can extend our provision to other areas in the county.

“We have already set up a clinic at South Petherton Hospital and this has had a real positive impact on patients in the east of Somerset.

“It has reduced their need to travel and this is absolutely vital to many of our patients who have varying degrees of disabilities and struggle to get to Taunton.”

Steve is a patient in the east of the county who used to travel to Musgrove Park for his botulinum toxin injections, but is now being seen at South Petherton Hospital.

“I have found it so much easier and convenient to have my injections at South Petherton Hospital,” he said.

“It’s quieter and the atmosphere is a little less hectic so I feel a lot more comfortable when having my treatment.”