County border red tape leaves boy without physio

Reuben had Selective Dorsal Rhizotomy surgery, typically performed on children with conditions such as cerebral palsy to improve their mobility

The family of an eight-year-old boy who has cerebral palsy said he has been "disadvantaged" by county boundary "bureaucracy".

Reuben, who lives in Royston, which is in Hertfordshire but close to the Cambridgeshire border, had surgery to improve his mobility, but neither of those county's NHS services would provide his aftercare in school.

His GP fell under Cambridgeshire, but his school was in Hertfordshire, which caused delays in arranging the physiotherapy and risk assessments needed for him to safely return to school.

"He's not getting the same type of care that other children would be getting when they're in one county, one authority," said Reuben's mother Jenny, 41.

Joe and Jenny hoped their experience would lead to change so other families would not have to "fight" for aftercare like they did

Reuben had Selective Dorsal Rhizotomy (SDR) surgery, which helped relieve some of the spasticity in his legs so he could "do a lot more of the things that other eight-year-olds would routinely do," Jenny said.

Following the surgery he needed physiotherapy, which was hoped to be partly carried out at his Hertfordshire school.

There was confusion, however, about which county's NHS body would be responsible for it, which led to delays in Reuben receiving the care he needed.

With no clear agreement between the two NHS bodies, Reuben's parents paid £4,000 for private physiotherapy, supported by their family, so he would not miss school.

"We couldn't keep waiting for the bureaucracy to catch up, he had to have his physiotherapy needs met now and he couldn't be missing school for half a day three times a week."

"Reuben is disadvantaged because he's on a county boundary," Jenny said.

"You can't split children in half... it's ludicrous.

"It's a shame we had to put energy into servicing the bureaucracy when actually, it should have been the other way around, it should have been what the bureaucracy needed to do to help the child."

Reuben's father, Joe, 40, added the parents were "very grateful" for the financial support from their family as they would not have been able to afford the physiotherapy without it.

He said the surgery had been very positive for the family "but for the support afterwards not to be there, and for us to fight for it, doesn't feel right".

"The future's bright for Reuben, he's playing football at a club now...it's improved things no end," says Joe

Hertfordshire and West Essex Integrated Care Board (ICB) said that although Royston is in Hertfordshire, NHS services for residents were commissioned by Cambridgeshire and Peterborough ICB.

Cambridgeshire and Peterborough ICB said it could not comment on individual cases but explained that children's physiotherapy was delivered in various settings depending on clinical need.

Ash James, the director of practice and development at the Chartered Society of Physiotherapy, said: "After major surgery, physiotherapy is essential for recovery. No child should miss out on the care they need because of administrative boundaries or unclear responsibilities."

Reuben's father, Joe, says since the surgery he was able to take Reuben to his first football match in Bournemouth