To ask the Minister of Health for an update on the delivery of a facial palsy service in Northern Ireland.

Mr Butler (The Minister of Health)

I thank the Member for his question. A facial palsy regional planning group was established in September 2023. That group developed an action plan, which included the establishment of a local and regional pathway to assist with assessment and treatment. In addition, a new nidirect web page was developed in order to assist patients who experience facial palsy and its symptoms. That web page signposts patients to helpful information whilst waiting for assessment. Through the development of a local pathway, it was determined that specialist facial therapy input provides an essential part of conservative management during recovery. To that end, a small amount of funding was identified through waiting list initiatives funding to address the recurrent list of patients who were waiting to be seen by a facial therapist and to develop a future pathway to a regional facial therapy service, which is part of the multidisciplinary team model. My Department has now allocated funding to enable specialist facial therapy input to be delivered in the Belfast and South Eastern Health and Social Care Trust areas. By expanding the current service provision, we are now able to deliver a range of benefits, including standardisation of care through the introduction of clear referral and treatment pathways, as well as improved patient outcomes through early intervention and access to specialist therapy. I hope that further recurrent investment can be secured in order to put in place an enhanced regional service for those who require highly specialised services. However, that is not possible at present, given wider service pressures and priorities.

Mr Butler

I will do my best to answer those three questions, if I can remember what the three of them were. I pay tribute to Janet Robb, who is a phenomenal advocate who is passionate about those services. She has contributed marvellously, as can be seen and heard on the nidirect web video. It is important to understand the context in which we are operating. On average, between three and five patients a year are assessed to be suitable for facial palsy surgery in Northern Ireland. Those referrals are managed by the South Eastern Health and Social Care Trust as part of the network arrangement with a specialist provider in Great Britain. That arrangement was informal, but the strategic planning and performance group (SPPG) has recently secured funding to enable a formal arrangement to be put in place. Discussions have now commenced with clinicians in the South Eastern Health and Social Care Trust and its UK counterparts to determine the best provider for that formal commissioning arrangement. Most facial palsy assessment and treatment is provided locally through local hospital specialities. The SPPG sends most of those patients who require specialist surgery and/or Botox treatment to GB via an extra-contractual referral (ECR) arrangement. My office has already been in contact with Ms Robb to arrange a meeting. Thank you for raising the matter today.

Mrs Dodds

Minister, I have constituents who come to me with this very perplexing problem. Many of them have to pay for their own injections to relieve their facial palsy symptoms. That is extremely taxing on those individuals. You spoke about funding that had been allocated by the South Eastern Trust for the treatment of facial palsy through the waiting list initiative. Many, however, question whether that is being directed specifically at facial palsy or has been subsumed into the wider specialities in plastic surgery —

Mr Speaker

Get to the point, please.

Mrs Dodds

— in the trust.

Mr Butler

I thank the Member for her question. It is a fair question to ask. When we look at the Budget allocations and the pressures that we are under, it is absolutely right that every penny needs to be accounted for. One could say that much more needs to be done. The work that the SPPG has done with the limited funding that it has been able to allocate from the elective waiting list is useful, but it is not the end picture. For those who await services and have been struggling, we need to do much more. I urge my Executive colleagues to get around the table and agree a Budget to ensure the future development of such services and to ensure that funding for the services that need to be provided is recurrent so that we have that full picture.

Mr McGuigan

Minister, previous estimates suggest that between 576 and 750 people here develop facial palsy each year. As was suggested in the two previous questions, I suggest that sufferers have been left behind here. In the absence of a commissioned service, where are patients currently being referred to for specialist physiotherapy, psychological support, ophthalmology and reconstructive treatment; and how long are the waiting lists?

Mr Butler

I thank the Member for that detailed question. This is a developing service, and the SPPG has entered into wider arrangements with the Belfast Trust and South Eastern Trust to develop those services in a better way. Unfortunately, across the trusts, the people interface service is not done in the same way. It is a priority for me to ensure equitable access across the provision. I will get back to the Member on his question with a detailed, trust-wide picture, because equity is important in the provision of those services.

Mr O'Toole

Minister, you are very welcome to the role. This is the first time that I have asked you a question in your new role, so the best of luck to you. Specifically on paediatric palsy, I am aware of a case involving a family who have had real issues around pathways for paediatric facial palsy. I have written to you about the subject and the specific issues that arise. Are you willing to meet to discuss those issues? They are connected to adult palsy but slightly specific to paediatric palsy and distinct from the broader adult facial palsy issues. There are specific issues here. If you are willing to meet so that we can clarify some of those points, it would be helpful.

Mr Butler

I thank the Member for welcoming me warmly into the role. Absolutely, you can reach out with those issues. I remember the question that you posed and the pressures that are faced in that paediatric setting. You are quite right: facial palsy has myriad conditions that underpin it right through the age brackets. I absolutely make a commitment to you: if you pick that up with my private office, we will sort something out.