The Duke of Cornwall Spinal Treatment Centre at SDH

“The greatest cause of a traumatic spinal cord injury is having a fall,” said Anne Seaman, the spinal centre’s clinical educator and patient support lead.

"It can be anything from falling down the stairs at home or falling out of a hammock, off a ladder or falling badly during extreme sports like skydiving.

“If there is injury to the spinal cord within the neck region, it results in tetraplegia, causing some degree of paralysis and a loss of sensation from the neck down including the trunk, arms, hands and legs.

"Most of these patients will need care when they leave the centre. If the injury is below the neck in the spinal cord, it results in paraplegia, where they have full use of their arms and hands. Most of these patients will be completely independent wheelchair users."

The spinal centre at Salisbury admits trauma patients once they have been treated at major trauma centres such as hospitals in Southampton, Plymouth and Bournemouth.

An outreach team from the centre, first visits patients in the hospital to talk about their injury and what they can expect at the spinal centre.

They also give advice to the team caring for them, including doctors, nurses and therapists. Many patients have spinal surgery prior to their transfer to the centre.

Anne, who has worked on the spinal unit for 27 years, said: “The rehabilitation these days is about looking after each patient as an individual.

"While some have no mobility or sensation, many patients do have some and go from being able to do absolutely nothing to being almost independent, including walking. We take people from the age of 16 and above, we do not have an age limit – it’s whether they can benefit from the treatment here.”

The multidisciplinary team approach provides for 42 inpatients on two wards – Avon and Tamar. There are also dedicated therapy and outpatients departments.

It can also cater for three patients needing a ventilator – these patients are unable to breathe without support because their spinal cord injury means they no longer have the muscle power required to breathe.

“The main thing we do here is rehab, the process is about looking at the best options for each individual," Anne said.

"Patients all have an individual education programme, with monthly meetings involving friends and family who are all part of the team.

"Essentially we want them to reach the highest level of independence possible which means they can then go home or to a temporary interim placement, before they go home.

“Therapists look at what’s going to be most practical for the patient and how well they cope with it. It involves the patient learning new skills such as how to do catheterisation, how to look after their skin and get dressed.

“Patients stay here for about four or five months, depending on what their individual needs are – some may leave sooner if their paralysis is limited or they get some return of movement or sensation."

The spinal treatment centre covers the South West to West Sussex and up to Gloucester, which means many patients are not from the local area. 

It holds a family and friends information day every year where people can learn about different aspects of care.

“Patients do have anxieties initially living with spinal injury but we are able to support them psychologically, which is a major aspect, and over time they become more confident with their skills.

Even if they can’t be independent physically, they can tell their carers or family what they need and how they want to do it,” says Anne Seaman.

“In the weeks leading up to discharge, patients go home at weekends if appropriate, and we also have a flat here where patients can stay with their family and friends.

"The nurses pretend they are the district nurse coming in. We try to mimic their home life to see what it will be like – it’s important for families to have that time together away from the hospital environment. 

“When patients leave the outpatient team continue to support patients who are offered appointments for review clinics and lifetime support. We have a community liaison team who visit patients in their own homes."

"I came here from the Midlands to work in the spinal centre,” Anne Seaman, pictured above, says. 
“What makes me stay here is that we meet people who initially think that life is over and they can’t do anything ever again, that it’s all finished.

“We teach them to see what their abilities are rather than only seeing their disability.

“All the time they are here, they learn what they can do and they are different and more confident people when they leave.

“It’s seeing them grow in the time they’re here – there are a lot of people like me that just want to see the best for them not just when they're here but when they go home and it’s brilliant hearing what they do once they leave – they go off around the world, learn to drive, have children.”

Horatio’s Garden is also part of the centre, providing sanctuaries for patients. Patients can take part in gentle rehabilitation activities in the garden organised by the charity.