Hospitals have been ordered to take action by NHS Improvement after the organisation received 61 reports of bowel care related incidents in hospital over the last four years, sparking a lengthy campaign by the charity Spinal Injuries Association.

Spinal Injuries Association warned that the lives of some patients with spinal injuries may have been put at risk because of delays in providing specialist care to clear their bowels. The charity has received numerous complaints from spinal cord injured people that their bowel care needs were not being met when admitted to hospital or when treated by community nurses. A lack of training, an absence of Trust-wide policies and guidelines and a reluctance to continue the patients’ normal routine all mean that SCI patients have not been not getting the care they need when admitted. A recent Freedom of Information survey conducted by Spinal Injuries Association has shown that 52% of NHS hospital trusts have no policy or guidelines in place whilst 41% of trusts did not run courses to train staff in bowel care techniques. An SIA bowel management survey of SIA members saw half of respondents rating bowel management in their hospital as only 0/10 or 1/10 with 40% saying they had developed other complications as a result of the bowel care – or lack of it – they had received.

The lack of appropriate bowel care can have life-threatening consequences. As well as constipation, bloating, abdominal pain or faecal incontinence more serious issues such as faecal impaction, bowel perforation or autonomic dysreflexia can arise. The Patient Safety Alert requires every NHS Trust to have the policies and procedures in place – as well as appropriately trained staff – to meet the bowel care needs of spinal cord injured (SCI) people.

Dr Rupert Earl, Chair of SIA said:

“Following a sustained campaign by SIA, we welcome the publication today by NHS Improvement of an important Patient Safety Alert regarding intimate digital bowel care interventions for SCI patients. Our members all too frequently report harrowingly bad experiences of digital bowel care both when they are admitted to NHS non-specialist hospital settings and in NHS community nursing provision.

SIA welcomes this Alert as an important first step in providing crucially important care for SCI patients, care that requires trained NHS staff competent and confident in digital bowel care procedures, appropriate policies and guidelines in place and an oversight process to ensure that SCI people are getting the care they need and deserve.

Whilst focusing particularly on those SCI people at risk of Autonomic Dysreflexia, we recognise that inadequate or actual failure to deliver appropriate bowel care is an issue confronting many more people with a spinal cord injury, and SIA will continue to press for best practice to be the norm for all spinal cord injured people with neurogenic bowel dysfunction.”