Brain & Spinal Injuries Handbook 2015 Edition by Bold Media Limited

2015 EDITION

BRAIN AND SPINAL

INJURY HANDBOOK

DISABILITY REVIEW MAGAZINE

CONTENTS PERSONAL INJURY LAWYERS

P1-2 P6-7 P9 P 11 P13 P15

Choosing The Right Lawyer For You Questions To Ask Your Solicitor Impact of Medical Negligence Confessions of An Injury Lawyer Personal Injury Leg Amputation Understanding Serious Injury BUSINESS SERVICES

P22 Approach To Legal Costs P23 Proffessional Profiles CASE MANAGEMENT

P47 What Is Case Management P47 Choosing The Right Case Mananger RECOVERY AND REHABILITATION

P24-25 Rehabilitation After Brain Injury P26-28 Clever Therapy For The Upper Limbs P 32-33 Improving Life After Brain Injury P34-35 Striving for Independence Helping Hands P37 P41 Overcoming Swallowing Problems P44-45 Ottobock, Jims Traumatic Accident FINANCIAL PLANNING

P49 Legal Help For Serious Injuries P50-51 Protect Disability Benefits P52 The Care Act- In Brief

P53 P54 P55 P56-57

EMG Provides Support Mike Talbot, Organic Brain Injury Lifetime Cashflow Modelling Revitalise Steps up to Step-Down

Choosing the right personal injury lawyer for you Starting a compensation claim can be a daunting process, so it is important to make sure you have the best possible injury solicitor working on your case to maximise your chances of success. Unfortunately, there are a lot of rogue, inexperienced and incompetent injury lawyers in the UK, so the main thing to look for are the accreditations mentioned in the section below. All of claims.co.uk’s injury lawyers have been awarded these accreditations, so you can be sure to get the expert help you need to make a claim. o o o o o o

Making a Claim All About the Compensation Claims Process Compensation Calculator How to Win Personal Injury Compensation Submit Your Claim The Complete Guide to No Win No Fee Compensation

We also recommend avoiding companies who make cold calls, or send unsolicited text messages. These companies use unscrupulous methods for contacting potential accident victims, and set out purely to make a profit – they provide an impersonal service, and don’t really care about getting the best deal for their clients. Professional organisations and bodies for injury solicitors The biggest organisation overseeing the work of personal injury lawyers in the UK is The Law Society. This association represents professionals in England and Wales (there are separate organisations for lawyers in Scotland and Northern Ireland), and provides accreditation to personal injury lawyers who uphold a high standard of legal representation and work hard for their clients. It is always recommended to go with an injury solicitor who is a member of The Law The two main accreditations awarded by The Law Society cover solicitors who specialise in clinical/ medical negligence and personal injury. The presence of either of these two symbols demonstrate that the injury lawyers in question have been accredited by The Law Society and provide an excellent service in their chosen field.

PERSONAL INJURY

The Solicitors Regulation Authority is a board of The Law Society created by the Legal Services Act 2007. Prior to this, regulatory functions were carried out by The Law Society, but a report into legal services in England and Wales by Sir David Clementi recommended that all regulatory bodies be made separate from professional and representative organisations. This is the main body that regulates solicitors in England and Wales, though there are other, smaller regulators. All solicitors must be regulated by an approved body. Voluntary bodies Another not-for-profit organisation that represents British injury solicitors is the Association of Personal Injury Lawyers (APIL). A smaller organisation than The Law Society, APIL represents only solicitors who practice personal injury law. Members of APIL are required to adhere to a strict code of conduct, so lawyers who are members should provide an excellent service.

APILâ&#x20AC;&#x2122;s accreditation scheme rewards injury solicitors who demonstrate their expertise in personal injury law after five years membership.

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With expert legal help to unlock financial support and access quality rehabilitation, families and friends can start to re-build their lives. Birchall Blackburn Law specialises in serious and catastrophic injury law. It has more than 60 years experience supporting adults and children with brain and spinal injuries. Speak to our Head of Serious and Catastrophic Injury, Dianne Yates.

Freephone 0800 9 8 Email dmyates@b

8 1548

irchallblackburn.c

Birchall Blackburn Law is a trading name of BB Legal Limited, which is authorised and regulated by the Solicitors Regulation Authority.

o.uk

PERSONAL INJURY

The right expe rt support is vital in the aftermath of a b r a i n or spinal injury What matters after suffering a serious brain or spinal injury is finding the right support to help the sufferer on the road to rehabilitation. Birchall Blackburn Law takes its lead from Dave Bowes, a member of GB Ice Climbing and GB Para-climbing Teams, who had to rebuild his life after a catastrophic road accident.

Dave says, “The seemingly impossible can be achieved with the right support and determination.” Despite his brain injury seriously affecting his balance, memory, sleep and emotions, Dave refuses to let his life changing injuries stop him from climbing. Since getting the right medical, emotional and financial support, Dave has become British Para-climbing Champion in his category and has been on the podium at every round of the World Cup. He is currently ranked fourth in the World after a very close competition at the World Championships in September 2014 and at the end of last year he made the able bodied GB Ice Climbing team. In the immediate aftermath of a brain or spinal injury, medical support takes priority. At a later stage emotional and practical help is essential, but it is financial assistance that can

open access to the best treatments, care and support for a family trying to rebuild a life. It is critical to investigate whether Government benefits and legal compensation are available to assist. Financial support can speed up access to quality rehabilitation and it is absolutely necessary if a family loses income from a bread winner. The money could be needed for specialist rehabilitation services, changes to the home and car, purchasing aids and equipment, care and assistance, covering loss of earnings and paying for private medical treatment. Birchall Blackburn Law’s serious and catastrophic injury team help serious injury victims access the best rehabilitation services possible, as quickly as possible, through expert legal advice and assistance to securing benefits, concessions and compensation. It is vital to work with a solicitor experienced in brain and spinal injury cases. A specialist solicitor will deal with all elements of a compensation claim - such as an interim payment to speed up the rehabilitation process - and let the family focus on rebuilding their lives. Compassionate, professional and understanding, we know first-hand that financial compensation is the key to rehabilitation and re-building life with a brain or spinal injury.

For confidential and initial free advice in the aftermath of a brain or spinal injury contact Birchall Blackburn Law on freephone 0800 988 1548 or email Dianne Yates at dmyates@birchallblackburn.co.uk. PAGE 5

Questions to ask your solicitor No solicitor who is prepared to act for you or your family should object to answering questions fully and honestly. The following questions are blunt, but you should not be afraid to ask them. Take a written list of questions when you see a solicitor for an initial interview, and make a note of the answers given. You may want to ask the person accompanying you to ask the questions. If a solicitor objects to the questions or to your note making, you should ask yourself why. Q How long have you undertaken brain injury work and how many cases are you handling at the moment? A. The answer will give you a good idea of the individual's experience, and their familiarity with brain injury work, i.e. whether or not they deal with such cases on a regular basis. Q What proportion of your present workload is brain injury? What does the balance of your workload comprise of? A. The answer to this question will tell you whether or not the solicitor you are i nstructing is a specialist in brain injury and is capable of handling a serious injury claim. Q Will you be dealing with my case personally? A. You may choose a specialist solicitor who is experienced in dealing with brain injury work. If, however, that solicitor is not going to handle your case personally, it is possible that your case will be passed on to a more junior solicitor who may not necessarily be a specialist. You must, therefore, establish from the outset that the solicitor you are instructing will deal with your case personally and will be available for

for you when needed. It is not unusual for solicitors to delegate or teamwork, but the solicitor instructed by you must have the time to properly assess your case and be involved in all the important steps. Q Do you belong to the Association of Personal Injury Lawyers (APIL)? Do you belong to the Law Societyâ&#x20AC;&#x2122;s Personal Injury Panel? A. Membership of Professional Bodies is an indication of special interest, and also that there are reputable organisations to contact in the rare case of a complaint being necessary. Q When will you be able to apply for an interim payment? A. Compensation claims, especially potentially large or complex claims, may take some time to conclude. In the meantime you will need to pay for rehabilitation, aids or adaptations or

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PERSONAL INJURY Q Can we phone you if we have any problems? A. Yes! You should also have a contact to whom you can speak in your solicitor's absence even solicitors fall ill and have holidays but you should feel confident that in these circumstances, there is someone in the legal team who can take on your enquiries and address your concerns. Q Will you keep in regular contact with us, and how will this be done? A. Your solicitor should be prepared to keep in contact on a regular basis. Most of the misunderstandings between clients and their solicitors arise from poor communication. Q Do you have links with your local Headway groups? A. A solicitor with links to Headway will not only be an ideal source of information about local support, but will also have opportunities to hear news from the wider world of brain injury research, support and development. adaptations or additional family expenses. Your solicitor should be aware of these likely needs and know the system for getting a result. Your solicitor should be able to advise you whether yours is a case in which an early interim payment was likely and if not why not. Q What are the options for funding the case? (e.g. “no win, no fee”; legal expenses insurance; legal aid) A. You must feel confident you understand the fee structures and the potential risks involved. This will help you make a decision on the right choice of legal representative for you. Q Are you prepared to visit us at home if necessary? A. There may be difficulties travelling to the solicitor’s office. Also, visiting a solicitor can be an intimidating experience at the best of times. The individual with brain injury may feel more at ease in their own surroundings.

Q Do you have experience working with brain injury professionals? A. The term "brain injury professionals" covers a a wide range of different expertise from benefits experience to neuro-psychology. You should be able to have confidence in your solicitor's knowledge of the kinds of professionals who might be consulted about the support necessary for you or your family members. Q On average, what settlements do you achieve for your clients and what investment advice do you give? A. Once your compensation award has been finalised you may need advice on how to financially manage large sums of money. If your solicitor regularly deals with large claims, the better knowledge and access to appropriate financial advice he or she will have. Gaining some knowledge about the solicitors and their different ways of working is an important step to making a choice of legal representative that suits you.

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Expertise with empathy Our Personal Injury and Clinical Negligence teams have 20 years experience of acting for families affected by spinal cord injury. Our expert lawyers and medically qualified staff are very aware of the catastrophic impact that an unexpected injury can have, not just upon the injured person but also upon the wider family.

For a free consultation or to start a Spinal Cord injury claim (UK or overseas) please call our Solicitors on:

0844 620 6600

We will provide you with expert advice throughout the whole claims process through to obtaining care and rehabilitation services, property services, wills and tax advice, and Court of Protection.

www.blclaims.co.uk or call 0844 620 6600 5093BM_BLClaims_190x130_1v.indd 1

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PERSONAL INJURY

Tackling The Impact of Medical Negligence During recent months we have all seen lots in the media about financial and staffing problems in the National Health Service. These problems sometimes undermine the NHS’s ability to deliver the services expected. Inevitably, rising demand for medical services stretches resources, but that is no justification for inadequate or negligent treatment. When serious failings in medical care cause mental or physical disability, patients and their families face emotional, practical and financial issues. Where disability is long-term or even permanent, the financial implications can be enormous, as many readers of Disability Review Magazine are only too well aware. Some people may feel uneasy about pursuing a case against an NHS Trust or other healthcare provider. Attwaters Jameson Hill’s specialist medical negligence lawyers understand those concerns and offer the view that such action may not only help the client through severe difficulties but also improve things for other patients in the future. Experienced and sympathetic The firm’s experienced and sympathetic team handles medical negligence cases of all kinds. Keeping up to date with the law and recent developments in medical treatment as well as putting clients’ best interests first, it has earned a national reputation for successful claims against hospitals, GPs and other healthcare professionals. Serious instances of negligence can arise in virtually any healthcare setting. Surgical errors can have a devastating impact. Attwaters Jameson Hill recently achieved a £0.5m settlement for a man with a below-the-knee amputation arising from a mistake. Misdiagnosis, delayed diagnosis and nursing errors may also have serious consequences. “We also share the wide concern about apparent low priority for mental health issues,” comments the firm’s Head of Medical Negligence, Madeline Seibert. “Poor responses to psychiatric patients’ needs can bring fatal outcomes, or leave patients with serious self-harm injuries. We have handled various distressing cases involving dire mental health services.” Lifelong effects of birth injury Another distressing issue is birth injury due to negligent or inadequate care during pregnancy, labour or delivery. Lifelong disability, such as from cerebral palsy, can be the outcome. Attwaters Jameson Hill achieved a £7.3m award for a bright, intelligent boy trapped in a severely disabled body due to negligent obstetric care. That exceptional award reflected the cost of complex lifetime care, but whatever the nature of suffering and disability due to medical negligence, Attwaters Jameson Hill will strive for the best result in every case it takes on.

If you have suffered an injury, either through an accident or medical negligence, we can help you We will make the process of your claim as straightforward as possible ensuring it is resolved sympathetically, speedily and efficiently. We have four office locations serving Essex, Hertfordshire, outer London and beyond.

ASSOCIATION OF PERSONAL INJURY LAWYERS

Accredited Personal Injury Practice

01279 638803 info@attwaters.co.uk www.attwatersjamesonhill.co.uk

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The confessions of

PERSONAL INJURY

an injury lawyer

Fresh from law school I was lucky enough to secure a great job as a trainee solicitor in a Preston law firm where my first boss was handling claims on behalf of most of the 44 people catastrophically injured in a methane explosion in a water treatment plant during a civic visit. I was mere photocopy fodder at the time but seeing how a meticulous and brilliant lawyer bravely fought for justice sowed the seed that has grown throughout my career. From that moment I was hooked. I admit to an absolute obsession to fight for the right of all innocent accident victims to be properly compensated for the injuries they did not deserve to suffer. The pinnacle of this devotion is to take a case involving injuries of maximum gravity all the way to securing a client’s financial and practical future. As a keen motorcyclist I have been able to combine my passion for everything two wheeled with dealing with the almost inevitable consequence of motorcycling on overcrowded roads. The reputation I, and my firm, have gained in the motorcycle and scooter community is a badge of honour I wear with pride.

I confess however to despair at the present state of the legal sector of personal injury. There is not a day goes by when I have to bear the inane ramblings of lazy journalists calling me a lousy ambulance chaser or compensation culture vulture. Perhaps I can see that the constant flow of cash for crash stories vomited out of insurance companies over funded PR departments has built a public interest momentum but balance must be restored. Imagine what Mrs W would say about how my firm has looked after her since the accident four years ago when an inattentive Micra driver caused her to lose a leg and suffer other serious injuries? We have worked hand in glove with rehabilitation experts to provide practical solutions throughout her recovery to the extent of having her sloping garden terraced with raised planters so she could continue her horticultural hobby. It is that forensic attention to detail that is so important and so right in a catastrophic case. Rehabilitation, such as this, has been a major leap forward since I started my career. Some, but not all, insurers have recognised that to work with us to provide day to day solutions to client’s disability needs and where appropriate re-training, leads to a more successful case outcome for all concerned rather than waiting to be forced through court proceedings to write a big cheque. The stated aim of my firm is to engage fully in looking at every aspect of our client’s present and future needs and how they can be met. So, I confess, I am proud to be a lawyer, proud to be a personal injury lawyer of over twenty five years’ experience and will continue to fight fearlessly for clients and their families to have their future secured when the worst happens.

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Tees are listed in the Legal 500 as one of the leading claimant medical negligence firms. We are members of the Association of Personal Injury Lawyers, Headway and approved by the Child Brain Injury Trust as a provider of legal services.

White coat syndrome? Complaining about medical treatment can be daunting and distressing. Our approachable, sympathetic team is ready to work alongside you. We will keep you informed and guide you every step of the way. We will listen to your account, identify your concerns and objectives and give clear realistic advice on how to proceed. Talk to Janine Collier or Paul Taylor to arrange your free initial consultation.

0800 0131165

advice@teeslaw.co.uk Tees Law is a trading name of Stanley Tee LLP regulated by the Solicitors Regulation Authority. Registered in England and Wales number OC327874.

Open for business since 1857, Tayntons heritage dates back over 150 years. During this time we have not only developed and crafted our full range of legal services, but we have also cemented our position as an approachable and flexible Gloucester-based law firm. At Tayntons we deal with all your legal needs, from private and family law to the intricate details of business law. Our own business is shaped around your legal requirements, with the aim to make the whole legal process easy and accessible for you. We are a local firm with local knowledge and are deeply rooted in the Gloucestershire region. Our offices are located in the heart of Gloucester allowing us to fully engage in our community whilst also offering our services nationwide. Tayntons highly-qualified team are on hand to guide you through the legal process. Providing flexible ways of working and forward thinking solutions, our team are not afraid of new ideas or of challenging convention. It is all of these elements combined that enable us to offer you something truly unique.

0800 158 4147 info@tayntons.co.uk 8-12 Clarence Street, Gloucester, GL1 1DZ.

PERSONAL INJURY

Personal Injury Leg Amputation Leicester - Client Interview In October 2009, Leicester resident Mr Mistry was standing on the pavement outside of Leicester Train Station when a car mounted the curb, crushing his legs against a barrier. The accident left Mr Mistry with two broken legs, one of which had to be amputated. Speaking about how he felt at the time of the accident, Mr Mistry says: “I waited about 10 minutes for an ambulance and needed several litres of blood when it arrived. People seemed more shocked than I was when it happened. I remember thinking ‘Oh for God’s sake!’ because it seemed more of an inconvenience than anything. The next thing I remember is waking up in hospital. I knew what needed to happen to my leg and wasn’t in shock – I just told my parents and the doctor that I wanted to be walking again as soon as possible.” Finding the right solicitor Mr Mistry quickly sought legal advice for his injuries, with the help of his sister who researched a lot of local solicitors before contacting Bray & Bray because of their track record involving serious injuries. Describing his first impression of serious injury specialist Ian Johnson, Mr Mistry says: “I first met Ian whilst I was in hospital. It was quite daunting to start with, but Ian is the friendliest person and was professional from start to finish.” On the road to recovery Once Mr Mistry was out of hospital, he was led by Ian Johnson’s expertise to find an agent to help with rehabilitation equipment to use in order to start walking again. Ian then looked into a rehabilitation centre that Mr Mistry wanted to try, before researching and recommending the best type of prosthetic leg for Mr Mistry to use. The next stage of Mr Mistry’s recovery was to try to get back into employment. Ian also guided him through this and helped to secure Mr Mistry a job in a local call centre. Commenting on this stage, Mr Mistry says: “I found that integrating back into a working environment was extremely beneficial to my recovery.” Compensation awarded When it came to compensation for Mr Mistry’s injuries, Ian Johnson explained what Mr Mistry would need for the rest of his life, as a result of the accident; then fought to win the appropriate amount for him in court. “Ian explained the minimum and maximum figures I could anticipate receiving in compensation for a case involving amputation,” explains Mr Mistry. “He gave me a realistic figure with the lowest amount being £1.2million and the highest £1.9million.” The final figure that Mr Mistry was able to take home was £1.7million in compensation. Long term support and guidance Since the case has settled, Mr Mistry describes how things have changed for him: “I feel normal now – I don’t feel alienated or out of place anymore,” he says. “I spoke with Ian recently and am looking to upgrade my prosthesis to a Genium limb soon, so that I can have one that supports more activities like running and climbing. It’s great that Ian is still there for guidance, I know that I can still go to him for advice anytime. I’m looking to buy a house, so Ian has referred me to someone from Bray & Bray for that and he has links with Welford Place Wealth Management Independent Financial Advisers, who are looking after me to ensure that I have good financial advice for the rest of my life too.” Commenting on the service received from Ian and Bray & Bray as a firm, Mr Mistry says: “It was the first time I’ve ever had to use a solicitor and it was a good experience, which included help from several people from the Personal Injury, Conveyancing, and Wills and Trusts departments. Not knowing what to expect, I was given step by step guidance, free space when I wanted it and it felt like Ian always answered my queries as soon as he possibly could. “The best thing about Ian was that he was realistic all the way through my case and I really appreciated him not sugar coating any of his answers. I’ve chosen to stay in touch with him and would like to show him how well I’ve developed since I last saw him, because it’s down to him and the other specialists he put me in touch with, that I’ve gotten this far already.” Summarising, Mr Mistry says: “Overall, the service I received from Bray & Bray was fantastic – I couldn’t ask for a better solicitor or firm.”

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PERSONAL INJURY

Understanding Serious Injury Carpenters Solicitors have a well-established and respected team of serious injury lawyers dedicated to conducting litigation for high value complex cases, and our experience and expertise includes technical cases involving brain injury, spinal injury, amputation, pain syndromes, multiple fracture and fatality cases. We understand that serious injuries are almost certainly life changing events for the victims and also the people closest to them, often resulting in a permanent change to their quality of life. Serious injuries by nature are very traumatic and need to be handled with due care and expertise and we understand that money alone won’t solve all the problems that our clients face and we work to ensure every aspect of their, rehabilitation, adjustment to their new circumstances or on-going care is facilitated. Our serious injury team have recently reached settlement on a case involving a 19 year old, ‘EG’, who suffered an acute head injury with severe brain injuries, which included a skull fracture, an intracerebral haemorrhage, as well as a fractured left femur and splenic rupture, caused by a road traffic accident in 2012. The Third Party, a bus, had failed to comply with a red traffic light, colliding with the vehicle in which the client was a rear seat passenger. In 2014 a settlement was reached of £2,000,000 and agreed as a lump sum, with periodical payments of £230,000 per year for life for the care and case management to be uplifted by the 80th Centile of ASHE 6115, which is the annual published index of national inflation of carer’s wages. This will ensure that the sum will always meet EG’s care bill. The settlement on a lump sum conventional basis equates to approximately £10,000,000. Contrary to the Defendants wish to place the Claimant in a nursing home, upon reaching the settlement, we were able to secure permanent residence for EG at the family home with 24 hour paid nursing care, in line with the families wishes. Our serious injury team worked tirelessly to achieve the best possible outcome in this case not just for EG, but for EG’s family too and this commitment went far beyond financial compensation. It is important that treatment and care are of primary concern when representing a client in the wake of a serious injury. Members of the Serious Team have panel membership with specialist brain injury charities Headway and UKABIF, and deal with claims of the highest value.

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Unsure which way to turn? Old Square Chambers’ barristers have a wealth of experience acting for the victims of catastrophic injury, including brain and spinal injuries and clinical negligence cases. Our clients choose Old Square Chambers to represent them because of our stand-out reputation in this field. Our expertise also includes the most catastrophic of childbirth, amputation, chronic pain conditions and psychiatric disorders.

Don’t just take our word for it... This set is a ‘hothouse of talent that is home to some key individuals’. It has both clerks and barristers who are seen as accessible and accommodating. Solicitors described their services as ‘beyond expectations’. Chambers & Partners 2015

“

Old Square Chambers has ‘over the years, demonstrated a very high standard in personal injury work’ and is ‘the go-to set for reliable, client-friendly and no-nonsense counsel’. Legal 500 2014

London Office 10-11 Bedford Row London WC1R 4BU LONDON: 020 7269 0300 BRISTOL: 0117 930 5100

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@OldSqChambers

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PERSONAL INJURY

Seeking anonymity for compensation claimants The purpose of compensation in a personal injury or clinical negligence claim is to help the injured person return to the position that they would have been in if the negligence had not occurred. In cases involving severe brain injuries, this could include compensation for on going professional care, adapted accommodation and potential loss of earnings over the course of the injured person’s lifetime. Compensation in these cases can be substantial and may attract the attention of the media. This publicity can often be unwelcome, so far as the injured person and their family is concerned. It is possible for the court to restrict what information can be published about the injured person, through what is called an ‘anonymity order’. This will usually involve the court prohibiting the media from publishing the names and addresses of the injured person and their immediate family, as well as restricting access to documents in the court’s records. Anonymity orders can protect the interests of those who may suffer added distress as a result of being exposed to unwanted publicity and who, in the worst case scenario, could be exploited by people seeking access to their compensation. If the injured person is a child or an adult who lacks the mental capacity to pursue the claim on their own behalf (known as ‘protected parties’), the court will be more inclined to grant anonymity due to their increased vulnerability. It is the responsibility of those who are pursuing claims on behalf of children and protected parties (who will often be members of their families) to decide whether they want to seek anonymity as this is not imposed automatically. However, if they decide that they wish to apply then, at least in the case of children and protected parties, anonymity will typically be granted by the courts. For more information on anonymity and personal injury or clinical negligence compensation claims, please contact Lucy Wilton or visit our website www.russell-cooke.co.uk.

Our personal injury and clinical negligence team have a national reputation for excellence. We can offer you high-quality specialist advice on most legal matters, personal or professional.

+44 (0)20 8546 6111 www.russell-cooke.co.uk PAGE 17

Anderson Strathern Anderson Strathern’s specialist lawyers understand brain injuries and the needs of the injured and their families. As a full service law firm, we have every specialist legal skill needed to take our clients on the journey from a legal case in court for compensation for the injury itself all the way through to creating a new life with the money received. Winning damages is not the end of the journey, for many it is the start of the journey. We are able to travel on the journey with our clients from seeking compensation to assisting with all the post-compensation issues such as investments, personal Injury Trusts, land purchase, house-building and all the legal matters around welfare and capacity including wills and power of Attorney. Accredited specialists Our Law Society of Scotland Accredited Specialists in Personal Injury and Medical Negligence, Robert Carr and Judy Williamson, are part of the top ranked Healthcare Team at Anderson Strathern. They each have over 25 years injury litigation experience in the Scottish court and, together with the full Healthcare Team, have been responsible for securing many multi-million pound damages awards over the years. Compassion and tenacity Our driving factor is to help our clients. We go further. For us, our brain injured clients are people first and foremost. We offer reassurance, compassion, tenacity and specialist legal skills. We believe this is what those whose lives have been irrevocably changed by catastrophic injury as a result of an accident or medical negligence need from their solicitors. Individuality The most important thing that we remember is that not all cases are the same - every one is an individual and has suffered an injury and event that is particular to them. Understanding the client and their injury is key to pursuing a successful claim. A brain injury can occur at birth, for instance through oxygen starvation during labour. The outcome of that can be a level of brain injury which allows for more limited quality of life than usual or, at the other end of the spectrum, it can be a completely life-limiting event. The injury can be the result of a serious road traffic accident. It can be an accident at work. It can be a failure to correctly diagnose or giving the wrong treatment.

We take you further Anderson Strathern has a proven record in cases of catastrophic injury, securing around £21 million in claims in the last three years. However, as a caring, full-service legal firm, Anderson Strathern goes further to ease the entire journey – from PersonaI Injury Trusts and custom-built homes, to Wills and Power of Attorney – providing specialist support and advice at every stage. Our experienced team can provide bespoke packages, tailored to each client’s needs. We won’t settle for less. For further information, please contact judy.williamson@andersonstrathern.co.uk

www.andersonstrathern.co.uk www.andersonstrathern.co.uk

“The firm is first class. I could not have asked for anyone better to deal with our case.”

PERSONAL INJURY

All the help you need Making a claim for negligence can be a stressful and challenging time - as one of the most experienced Clinical Negligence/Medical Negligence teams in the East Midlands, we have over 40 years of experience in helping people through it. Our experience is recognised by the Legal 500 (a who’s who of the legal profession) with head of team, Louise Tyler, being a member of the Law Society’s Clinical Negligence Panel and the AvMa (Action against Medical Accidents) Panel. We understand that if you have suffered catastrophic injuries, you are looking for answers. More often than not, it’s as simple as getting to the truth; the truth about what happened and why. Put simply, we recognise that compensation may not be the only thing on your mind. Another of the many benefits we can offer is access to a sizeable team; not only can we help ensure that claims are progressed as swiftly and efficiently as possible, we can draw upon a vast bank of knowledge and experience. One aspect of our job is to look at the bigger picture; to not only recover compensation which will enable you to improve your life in terms of care, rehabilitation and housing but also to consider other needs such as Wills, Trusts and Court of Protection where necessary. The nature of our work means that clients tend to remain with the firm for some time, and during that time we build up trusting relationships. This means that as well as assisting in respect to your litigation claim, we can also be here to provide friendly advice across a range of issues. We pride ourselves on our friendly, down to-earth-approach, so we can understand you and you can understand us. Funding a claim can be expensive, often adding to your worries which are why we have a range of funding options. Legal aid is available for children who have suffered a brain injury as a result of birth; legal expense cover if the claimants have legal insurance; and, no win no fee agreements. We handle all sizes of claims, from £1,000 up to £multi-million and whilst being particularly strong in Northamptonshire and Leicestershire, we cover the entire country in relation to claims against all health care providers such as hospitals, doctors, general practitioners, osteopaths and physiotherapists, whether the treatment received was NHS or privately funded. At Wilson Browne we are always on your side; we’re all the help you need. For further information contact Wilson Browne Solicitors on 0800 088 6004, by email at enquiries@wilsonbrowne.co.uk or by visiting wilsonbrowne.co.uk

Sometimes it’s not about compensation For many of our clients, pursuing a Clinical Negligence case isn’t about seeking or gaining financial compensation. It’s more about discovering what really happened. Why it happened. How it was allowed to happen. And who was responsible. Our dedicated specialists, with many years’ practical experience, will guide you through the often difficult process that will help you get to the truth, provide the answers, and bring about resolution. An initial phone consultation is both free and, of course, completely confidential. All you need to do is talk to us.

0800 088 6004 enquiries@wilsonbrowne.co.uk wilsonbrowne.co.uk WB Clinical Neg Ad 110x156mm_0515.indd 1

12/05/2015 14:23

A level playing field? Access to football grounds for disabled fans Manchester City Etihad Stadium

48,000 Total capacity

190

Spaces for home wheelchair users.

Liverpool Anfield

45,522 Total capacity

20,532 Total capacity

St James’ Park

52,339 Total capacity

170

Spaces for wheelchair users at designated points.

Arsenal

100

Wheelchair spaces, all are located in the home end, 8 reserved for away fans.

Swansea Liberty Stadium

Newcastle United

Emirates Stadium

60,432 Total capacity

240

Wheelchair spaces

Chelsea

226

Wheelchair spaces exceeding the recommended requirement of 150

Stamford Bridge

41,837 Total capacity

103

Wheelchair spaces for home supporters

All statistics retrieved from http://www.levelplayingfield.org.uk/

The fact that many rich football grounds fall (in some cases, woefully) short of providing even the minimum number of wheelchair spaces recommended by the Home Office speaks volumes. It sends a clear message that disabled fans are not as welcome as able-bodied ones. It is striking that football stadiums lag so far behind other entertainment venues. Given that sport is all about physical ability and prowess,

I can’t help wondering whether there is some kind of body-machismo at play here. What is clear is that, with notable exceptions such as Swansea City, I believe Premier League clubs are letting disabled supporters down badly. And proper access isn’t just about being able to get into the ground, it’s about the quality of the experience once there. Disabled fans report many ways in which

their enjoyment of the game is compromised by the conditions of their access. These include having to sit with supporters of the other team (with all the exposure to hostility that can come with that), not being able to see because of fans in front of them standing up, not being able to sit with other family members due to

number restrictions in designated wheelchair areas, and having to sit behind the goal in the direct line of fire. We believe it is time to stop and look at the current state of play, and highlight how far clubs still have to go if they are to score the all-important goal of meaningful equaility for disabled fans

by Emma Satyamurti, Employment & Discrimination Partner, Leigh Day T: 020 7650 1164 E: esatyamurti@leighday.co.uk @esatyamurti

Rebuilding lives after a brain injury When a loved one has a brain injury it is life-changing for the whole family. We have over 25 years’ experience of helping clients with brain injuries to achieve the financial security needed to help rebuild their lives. We understand the challenges you face and we will help you in every way that we can. Our expert service includes: • Specialist solicitors who will visit you at home or in hospital • No Win No Fee arrangements • Lawyers who will work to secure early rehabilitation • Lawyers who understand the importance of early interim payments • Expertise in recovering compensation for equipment such as wheelchairs/vehicle/assistive technology • A track record in obtaining damages for specially adapted homes for our clients

For a no obligation discussion, please contact Sally Moore on 0800 689 9046 or seriousinjury@leighday.co.uk

PERSONAL INJURY/BUSINESS SERVICES

Leading lawyers for brain injury claims Thomson Snell & Passmore has in-depth experience in dealing with complex claims arising from brain injury and other life changing accidents. Our specialist Court of Protection and Personal Injury teams work closely together to safeguard our clients’ affairs.

Tunbridge Wells T 01892 510000 Thames Gateway T 01322 623700 www.ts-p.co.uk Here for you since 1570 Brain Injury-half ad.indd 1

PUTTING PROFIT BACK INTO LEGAL COSTS

17/05/2015 17:06

BRAIN & SPINAL INjURy, COURT OF PROTECTION, CLINICAL NEGLIGENCE

For 20 years PIC have been Costs Lawyers and Costs Consultants specialising in Civil Litigation claims including Brain & Spinal Injury, Clinical Negligence and Court of Protection matters. Why Choose Us: • Our commitment to maximising costs recovery for Claimant Solicitors and adding value to their bottom line • Our dedication to releasing lock up in the shortest possible time • Excellent customer service

For further information: T: 03458 72 76 78 | E: info@pic.legal www.pic.legal PAGE 21

A totally professional & personal approach to Legal Costs

P L C PARAMOUNT LEGAL PARAMOUNT LEGAL COSTS LIMITED COSTS

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Rural Enterprise Centre Redhills, Penr ith Cumbria C A11 0DT DX: 63314 Penr ith T: 01768 213072 F: 01768 213073 E: info@paramountlegalcosts.co.uk

W: www.paramountlegalcosts.co.uk

A complete Costing & Negotiation Service that can be tailored to your needs

P C L P L C

PARAMOUNT LEGAL COSTS LIMITED

Rural Enterprise Centre Redhills, Penr ith Cumbria C A11 0DT

DX: 63314 Penrith T: 01768 213072 F: 01768 213073 E: info@paramountlegalcosts.co.uk W: www.paramountlegalcosts.co.uk

We specialise in catastrophic injury, brain injury, spinal injury & clinical negligence.

Please contact us on one of the following Quoting TB2015 to discuss your requirements and our competitive terms of business.

P L C PARAMOUNT LEGAL PARAMOUNT LEGAL COSTS LIMITED COSTS

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Rural Enterprise Centre Redhills, Penr ith Cumbria C A11 0DT DX: 63314 Penr ith T: 01768 213072 F: 01768 213073 E: info@paramountlegalcosts.co.uk W: www.paramountlegalcosts.co.uk

P L C

PARAMOUNT LEGAL COSTS LIMITED

Rural Enterprise Centre Redhills, Penr ith Cumbria C A11 0DT

DX: 63314 Penrith T: 01768 213072 F: 01768 213073 E: info@paramountlegalcosts.co.uk W: www.paramountlegalcosts.co.uk

P L C

PARAMOUNT LEGAL COSTS LIMITED

Rural Enterprise Centre Redhills, Penr ith Cumbria C A11 0DT

DX: 63314 Penrith T: 01768 213072 F: 01768 213073 E: info@paramountlegalcosts.co.uk W: www.paramountlegalcosts.co.uk

T 01228 819131 F 01228 501810 E info@paramountlegalcosts.co.uk DX 63314 PENRITH

L A G E L T N U O M D A E R T A I P M I L S T S CO e r t n e C e s i er pr PARAMOUNT LEGAL COSTS LIMITED www.paramountlegalcosts.co.uk

P L C

PARAMOUNT LEGAL PARAMOUNT LEGAL COSTS LIMITED COSTS

LIMITED

Rural Enterprise Centre Redhills, Penr ith Cumbria C A11 0DT

DX: 63314 Penr ith T: 01768 213072 F: 01768 213073 E: info@paramountlegalcosts.co.uk W: www.paramountlegalcosts.co.uk

BUSINESS SERVICES

PROFFESSIONAL PROFILES TOM BROCKLEBANK

Senior Costs Draftsman at Paramount Legal Costs Ltd

Partner at Thompson Snell & Passmore

EDDIE FARDELL

info@paramountlegalcosts.co.uk

www.ts-p.co.uk

Areas of Practice: specialise in legal costs recovery in claims for: Catastrophic Injury Brain Injury & Spinal Injury Clinical Negligence

Area of practice: Court of Protection

01228 815394

01892 701251 eddie.fardell@ts-p.co.uk

tom.brocklebank@paramountlegalcosts.co.uk

BELINDA MEMMOTT

FIONA FLYNN

Clinical Lead at Proclaim Care Limited helpis@proclaim-care.co.uk

jonathan.clement@ts-p.co.uk

Areas of Practice: Severe / Catastrophic Injuries

Area of practice: Brain injury

(01698) 207755 belindamemmott@proclaim-care.co.uk

01892 701264 jonathan.clement@ts-p.co.uk

Case Manager at Anglia Case Management Ltd Fiona.flynn@angliacasemanagement.co.uk

CAROLINE WILKINSON

Area of practice: Adults with Brain Injury, Spinal Injury, or other complex disabilities

Telephone 01359 271900 www.angliacasemanagement.co.uk

Partner at Tayntons

Case Manager at Anglia Case Management Ltd

Caroline.wilkinson@angliacasemanagement.co.uk

Area of practice: Children with Brain Injury, cerebral palsy, or other complex disabilities

JOANNE THOMPSON

Partner at Thompson Snell & Passmore

JONATHAN CLEMENT

Telephone 01359 271900 www.angliacasemanagement.co.uk

CLAIRE ROANTREE

Partner at Colemans-ctts

joanne.thompson@tayntons.co.uk

enquiries@colemans-ctts

Areas of Practice Personal Injury Clinical Neglegence

Areas of Practice: Brain Injury, Catastrophic Injury, Military PTSD

Telephone 0800 158 4147 info@tayntons.co.uk

Telephone 0208 296 9966 claire.roantree@colemans-ctts.co.uk

PAGE 23

Rehabilitation after brain injury Unlike most other cells in the body, brain cells do not regenerate when they are destroyed. However, this does not mean that no recovery can occur. The brain is somewhat flexible and is able to reorganize itself, to an extent, in order to regain lost function. This is known as brain 'plasticity'. During recovery, other areas of the brain take over the activities of the damaged areas and new nerve pathways can be established using undamaged brain cells. Engaging in activity helps these alternative pathways to develop. Rehabilitation aims to help the brain learn alternative ways of working in order to minimise the long-term impact of the brain injury. Rehabilitation also helps the survivor and the family to cope successfully with any remaining disabilities.

Timescales for recovery and rehabilitation after brain injury In the first month or two after a severe brain injury it is only possible to guess at the length of time that recovery will take and the likely outcome. All that is certain is that recovery is a slow process and will take months or years rather than weeks. Six months after the injury the picture will be clearer, but it is wise to wait until about a year after the accident before making any important decisions regarding the future. After a year or so one can be reasonably certain about the eventual degree of physical recovery. However, psychological recovery can take considerably longer and it is usually these more subtle psychological problems that cause longer-term difficulties, particularly for family members. People do sometimes talk about there being a limited 'window' for recovery after brain injury, for example, that recovery ceases to take place beyond two years. However, this is now known not to be the case and people may actually continue to improve for a number of years after brain injury. Indeed,

many people say that they never stop re-gaining the skills that they lost following the injury. Nevertheless, the greatest visible progress does occur in the first six months or so post-injury and after this improvement is often less obvious.

Accessing brain injury rehabilitation services There are many rehabilitation services across the UK, run by the NHS or private firms. Choosing which rehabilitation unit to refer someone with a brain injury to should involve the clinical team, the patient and their family. Once a referral has been made, the rehabilitation unit will usually carry out an assessment to make sure their service is suitable. Availability and funding for places varies. However, most units, including private ones, accept NHS referrals and will be funded by the NHS. Other possible sources of funding include the local authority, medical insurance, compensation claims and self-funding. It is important to ensure that whoever is likely to have to fund the rehabilitation is aware that a referral has been made. The rehabilitation service will not be able to accept an admission until funding has been authorised. Many services accept referrals from outside their own area, but there are often limited places available and long waiting lists. Specific details about the referral process, availability of places and funding options will be available from the unit. Taking up a rehabilitation placement is an important commitment, and it is wise to explore all the options, visit different rehabilitation settings, and ask as many questions as possible before a placement is confirmed.

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RECOVERY & REHABILITATION

Rehabilitation settings

Brain injury rehabilitation occurs in the following settings:

"Family members are very often a crucial asset to the patient, providing both long-term support and a major contribution to the rehabilitation process. It is also important for the team to recognise that family members often have a special rapport with the patient and may detect subtle communication in advance of the professionals. “Families can provide valuable insights into the patient’s character, choices and ambitions, as well as important information on the presentation of difficulties in the home setting. This is essential in initial assessment, and in the monitoring of rehabilitation gain, to minimise underreporting of difficulties when the brain-injured person lacks insight” (From: Rehabilitation following acquired brain injury: national clinical guidelines, BSRM, ).

• Inpatient rehabilitation: This involves intensive specialist rehabilitation for people who are not yet ready to return home after discharge from hospital. Neurological rehabilitation centres provide an ideal setting for further treatment, where a structured rehabilitation programme is in place throughout the day. • Outpatient rehabilitation: Some people may be well enough to return home and receive further treatment as an outpatient, either at a local hospital or at a separate rehabilitation centre. • Community rehabilitation: Following an inpatient rehabilitation stay, some people may be transferred to a residential transitional living unit. Here people can develop their independent living skills so that they may be able to live in a place of their own. Others will go straight back to their homes, with a community rehabilitation team or outreach team helping them to make further progress; this may involve therapists working with the person in their home or community environment.

The role of family members in rehabilitation after brain injury

What if no rehabilitation has been provided? If your relative has been discharged home without any access to rehabilitation, and you have reason to believe that they would benefit from it, there are still options available. You are perfectly within your rights to actively seek rehabilitation services, even if you have been told that there are none available or needed. The first thing to do is discuss the matter with your relative's GP and/or consultant. They may be able to provide a referral.

The British Society of Rehabilitation Medicine (BSRM) has produced guidelines on rehabilitation after acquired brain injury. The guidelines recognise the important role family members and carers play in the rehabilitation process:

PAGE 25

Clever Therapy for the Upper Limbs Over the last few years there have been several innovations using robotics for gait training and every time I visit a Neuro/spinal expo, another new brand from overseas, appears with either a robotic treadmill or exo-skeleton. However there hasn’t been such investment in the upper limbs, which always surprised me considering how useful they can be for activities such as eating, teeth cleaning and video gaming! Well that’s now changing and probably the world’s leading company in upper limb rehabilitation robotics, Tyromotion from Austria has what it believes is a complete solution for upper limb rehab assessment and training. Complete because it can claim to train all the movements of the hand, arm and shoulder and bi-laterally too. In this it is unique, since other brands’ devices train only one limb or hand (unless of course you buy two).

The solution consists of the Amadeo for robotic finger/hand training, Diego for bilateral robotic arm/shoulder training, finally, as mobile units or on the impressive looking table (known as Tyrostation) are the Pablo and Tymo sensory devices for interactive therapy. All the devices can be hooked up to a server and share data, so the therapists can view reports for the patients progress on whichever device they are using, or elsewhere on desktop computers and tablet-pc. The principles are very intuitive and all are easy to learn and use. Windows based software allows you to set up patients, complete movement and force assessments, then select from a growing range of therapy programs and games to train repetitive movements, shaped to the patients individual ability, so at all stages of rehab they can be pushed beyond the edge of their ability. Diego When I asked Tyromotion’s CEO and founder David Ram why he chose to focus on the upper limb he told me “In Austria there have been studies done to show the full cost on society of stroke survivors returning home and continuing to depend on a carer and not able to return to work. When we saw what limited equipment therapists had to work with, we knew there must be a better solution. Since I studied robotics, that’s where I looked for the answer”. Things have moved a long way from the first version of the Amadeo, which trained finger movements. The latest device is the Diego, which has an intelligent gravity compensation system that supports the arms and allows the patient to train in an active way, even when they have the smallest flickers of activity. During therapy, working both arms or just the one, they can play games and try the swim simulation.

RECOVERY & REHABILITATION

The Diego is for use in hospitals but the solution doesn’t stop there. It offers two more portable devices using clever sensors which can help continue the rehab work in the hospital and when the patient goes home. The Pablo is a hand held sensor, which plugs into a desktop pc or notebook and allows the patient and therapists to assess and train all the movements of the hand, wrist and arm. It comes with accessories like the multiboard and multiball, which allow bilateral training with the same therapy games as the Diego and Amadeo. The Tymo is a therapy plate connected by Bluetooth, which you can stand, sit or support on, or add rolling elements, to train balance, posture and core strength. These can be used at the very stylish Tyrostation, which includes an in-built PC and motorized height adjustment, which is how I saw it used in the Royal Buckinghamshire hospital where stroke survivor Sue was training with OT Abi Copperwheat. Sue has been training at the Tyrostation for 5 months and told me she has improved “core strength and stability” and enjoys the therapy games. Abi told me that Sue has developed trunk control and posture and isn’t slumping anymore. In general “and the assessments and visual feedback encourages more training”.

Sue Training as an outpatient at Royal Bucks hospital With the Pablo and multiboard

PAGE 27

This was significant because guidelines suggest that neuro rehab requires daily activity to train the affected limbs whereby the motivation to train is a key factor. If repetitive training is dull and boring then the frequency slips and some people give up completely. The robots also manage to generate many more repetitions than therapists can do by hand, (or want to do manually as this is obviously boring), literally hundreds of repeat movements can be done in one session on the Amadeo.

The Amadeo Robotic Hand/ Finger Training system has recently been updated to use all the therapy games available on the newer Diego and provide therapy for Tone/Spasticity, as well as interchangeable child size supports. Stoke Mandeville Spinal Injury Unit has recently implemented the Amadeo, Pablo and Tymo in the newly furbished St Francis ward for pediatric patients, but they are using a second Amadeo to see what benefits they can offer the adult spinal injury inpatients. Its early days but the system is proving popular with the OT team and their patients. However nowadays stroke patients are sent home sooner than they did in the past to be cared for in the community and this is where the Pablo comes into its own, since it can be easily carried by the Physio or OT visiting patients at home. Colin Domaile in Bristol has been using a Pablo for three years now and wouldn’t go anywhere without it. He’s also benefited from the software updates which have added and changed the therapy games to keep them fresh. Colin recently told me a story about one of his patients that had been training with the Pablo, who without thinking about it was able to grasp and fasten her seat belt in the car using her affected arm. Its an everyday task we take for granted, its anecdotal too but to this lady it meant much more! Evidence Based Technology If you would like to read deeper into the details of the research that’s available on robotics in rehab and for the Tyromotion devices specifically, then visit their site at www.tyromotion.com and for the devices goto “Publications”. Dr Iris Binder is Tyromotion’s Scientific co-ordinator and can help with details on studies and evidence. You can reach out to her via the website. Tyromotion’s UK partner is Ectron Ltd and can be contacted via www.ectron.co.uk

Making assessment easier for you and your child

RECOVERY & REHABILITATION

Expert integrated therapy assessment in a single appointment Children with neurological conditions can require many different types of specialist care. At The Portland Hospital, our rehabilitation programmes bring together the country’s leading paediatric experts across a range of neurological specialties. In just one outpatient appointment, your child will be assessed by an experienced team brought together to suit your child’s specific requirements, including: ✔ speech and language therapists ✔ occupational therapists ✔ physiotherapists ✔ psychologists ✔ dietitians

As part of the UK’s number one private children’s hospital, we are able to draw on the skills and expertise of the country’s largest group of private paediatric specialists to ensure that your child will receive the highest standards of care.

Call us on 020 7390 6553 to arrange an appointment at a time that suits you – same day and next day appointments are normally available.

We can also arrange for your child to see other experts such as orthotists, and posture and seating experts, if required. You’ll receive an assessment report and recommendations regarding further treatment and rehabilitation.

www.theportlandhospital.com PAGE 29

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10/06/2015 17:30

A busy year for Tracscare! ABI specific personcentred support plans

We have had a busy and productive year. We have implemented the new ABI specific support plans and outcome measures, which ensure greater clarity on an individual’s specialist support requirements. This means the people we support have greater input into the design of their support and can clearly see their progress and goal outcomes.

Three Tracscare ABI Services achieved Approved Provider status!

We are delighted that three Tracscare Acquired Brain Injury (ABI) services have successfully achieved Headway Approved provider status.

The teams at Isfryn (Ystragynlais, Wales), Chesterwood (Birmingham) and Oakhill (Swansea) have worked extremely hard to achieve this award. The process is rigorous, and Vicki Morris Home manager at looks for specialist ABI support for individuals Tracscare Evergreen said “The and their families in 33 domains. It now “Both staff new support plan and goal means Headway are able to recommend and the people we system helps focus the support appreciate these services as a specialist provider. individual and the team on Fallon Head of ABI services key areas. I have noticed seeing the progress Lucy (Tracscare) said; “I am delighted for the people supported have and having a sense all of the teams, it is wonderful that the taken greater autonomy in of achievement.” excellent work they do to support people their goals, with a significant post-injury is recognised. It has been great increase in people initiating working with Headway in such a constructive tasks and suggesting new goals. process to ensure we are continually looking for Both staff and the people we support appreciate improvement and maintaining excellence for the seeing the progress and having a sense of people we support.” achievement.”

The Headway Approved Provider Scheme The scheme utilises standards developed to reflect the specific needs of people with ABI, using these to evaluate a range of facilities including hospitals and neuro-rehabilitation units, residential and nursing homes and respite facilities. The process involves units signing off a statement of compliance against each required standard and undergoing a robust on-site assessment, within an inspection system that also involves unannounced interim reviews. This process ensures that units gaining Approved Provider status can demonstrate their provision of appropriate specialist care for those with complex, physical and/or cognitive impairment due to acquired brain injury. Key aspects of the process include ensuring staff working in the unit are aware of and responsive to issues associated with ABI, and that the unit gives consideration to the information and other needs of the service user, their family and carers. Each successful unit is accredited by Headway for a two year period as an Approved Provider, able to meet the needs of those affected by ABI. As outlined above, accreditation lasts for two years, with an initial assessment and an unannounced review during this time.

New service Manchester, opening September 2015

Byron Lodge, Blackley, Manchester Tracscare are pleased to announce the opening of their new community based Acquired Brain Injury (ABI) Service in Central Manchester. The service is designed to enable individuals to relearn skills, in a positive, empowering environment fully integrated into the community.

The service will comprise of twelve individual apartments, and two en-suite rooms, which can be adapted to meet the bespoke physical needs of individuals post injury. The modern apartment style enables individuals to have their own space, to practise independent life skills and offers a more natural environment to support the rehabilitation process. The design of the service will allow individuals to use the pre-independence apartments/ rooms to develop their independent skills within the safety of the core service, whilst more independent service users have the opportunity to benefit from transitional

A busy year for Tracscare.indd 1

‘Embracing life now’ apartments with risk assessed external access. The service is wheelchair accessible throughout. The en-suite rooms are accessible and can be adapted to need. Most apartments benefit from ‘rise and fall’ kitchens surfaces and room can be fitted with tracking hoist systems as required. The service also has an assisted bath, a lift to the first floor and environmental assistive technology such as falls monitoring, adapted call aid communication, assisted door opening can be integrated into rooms where required. The service also benefits from a gym/ physio

11/06/2015 12:12:12

A bus

2:12:12

Brain Injury Awareness Week 2015 Tracscare ABI services across England and Wales took part in the Brain Injury awareness week to promote brain injury awareness. Neuro-cafe, South Powys Isfryn supported the launch of the new Headway neuro café in Ystradgynlais on Wednesday 20th May 2015. This café will enable peer support amongst ABI survivors and the families in South Powys and surrounding areas, and Tracscare are very happy to be a part of such effective partnership working with several neurological charities and organisations to create such a valuable service. Hats for Headway Other services supported the national ‘Hats for Headway’ on 22 May 2015. Hats for Headway Day is a simple, fun, and easy way to raise money for Headway, people wear hats (as novel and wacky as possible!) for the day in return for a donation. Tracscare Chesterwood (Birmingham) held a garden party, which was well supported by people across Birmingham, along with neighbours and local people. Mike Horton (Home manager, Chesterwood), said “It was a really fun day, the guys here really enjoyed themselves. Whilst raising money for Headway, it meant local people learnt about the difficulties people face post-injury; as well as seeing the strength, skills and sense of humour that is so clear in the people we support.

RECOVERY & REHABILITATION

Tracs Acquired Brain Injury (ABI) Services Our Acquired Brain Injury services across England and Wales are person-centred and dedicated to providing specialist support to the complex needs of individuals with an Acquired Brain Injury. We understand that no two people and no two brain injuries are the same, therefore, we offer different pathways of personalised support to suit different needs.

Individualised Support Pathways Tracscare can offer varied specialised brain injury support: Transitional (short or medium term) rehabilitation goal focused placements Short term community skill assessments/cognitive assessment placements Specialist emotional/behavioural support placements Slow stream rehabilitation Long term residential care Supported living tenancies Specialist outreach support in your own home Vocational support

room, IT/ activity room and separate quiet lounge. There is also a spacious lounge/ dining room, and kitchen for group and family gatherings and catering for more dependent individuals. There is a pleasant courtyard garden with raised accessible flower /vegetable beds and a barbeque area.

Therapeutic Input At Byron Lodge we believe in a holistic approach to rehabilitation; engaging the individual, supporting family members, the therapists, the support team and community network to find practical solutions and ways to achieve an individual’s aspirations. The service has clinical neuropsychology overview, with more intensive psychological interventions available if required. The people we support have access to neuro-OT, neuro-Speech and language therapy psychiatry, and neuro physiotherapy which can be adjusted to adapt to an individual’s changing rehabilitation needs.

Respite placements We also have neuro-disability services to support individuals with conditions such as early onset dementia and Huntington’s care.

Therapeutic Support All therapeutic input is integrated into daily strategies or functional measured goals in line with the individual’s aspirations. Progress for individuals on a rehabilitation pathway is monitored through recognised outcome measures and reviewed regularly by the multi-disciplinary team.

We are able to support individuals who have: Traumatic brain injuries Stroke/ aneurysms Alcohol related brain injuries (including Korsakoff’s syndrome) Brain injuries as a result of hypoxia, encephalitis, meningitis and tumours Physical and mobility needs Diabetes, epilepsy and PEG care Behavioural, psychological, emotional and forensic needs Cognitive and executive functioning difficulties (memory, attention skills, information processing, insight, social, problem solving & planning difficulties) Dual diagnosis with Mental Health or substance misuse

Individuals are able to access the local Tracscare ‘Positive Steps’ and ‘Thinking Ahead’ workshops, to develop their cognitive and social skills under the guidance of our Clinical Lead Nurses, in a friendly and supportive atmosphere. These groups use cognitively based therapeutic work, with the aim of providing a focus on executive, attention and memory skills and social functioning. Participants are encouraged to increase their levels of cognitive functioning whilst having fun and engaging in social interactions.

For more information call 0333 24 07770, email info@tracscare.co.uk or visit www.tracscare.co.uk A busy year for Tracscare.indd 2

11/06/2015 12:12:13

Improving Life After Brain Injury Headway Cambridgeshire is a charity that improves lives after brain injury and is affiliated to the national charity Headway UK. Headway Cambridgeshire provides specialist services and support to people with a brain injury and other neurological conditions and their families, across Cambridgeshire and Peterborough. The NHS and Social Care provide an excellent service treating people with brain injury and helping them to recover through rehabilitation. However, budgetary constraints mean that the resources available to people, particularly after they have been discharged from hospital or rehabilitation, is severely limited. Headway Cambridgeshire works alongside the NHS delivering essential services that the public sector is not resourced to provide. The charity recognises the far-reaching practical and emotional impact that living with brain injury can have on a person and their family, friends and carers. Headway Cambridgeshire supports people with brain injury throughout their journey at two hubs in the county as well as in the community and at Addenbrookeâ&#x20AC;&#x2122;s Hospital. What services does Headway Cambridgeshire (HWC) provide? Structured social rehabilitation The hubs in Fulbourn and Peterborough offer a programme of activities aimed at recovery and social rehabilitation following brain injury, however the injury was caused. They provide a therapeutic environment where individual needs, skills and contributions are valued. Clients can choose from a range of sessions that support individual goals. This could be building physical fitness and stamina as well as general wellbeing, improving daily living skills, or understanding and managing the effects of the injury. Information, advice and support With funding from the Big Lottery, HWC offers information, advice and emotional support to anyone affected by brain injury as well as families, carers and professionals. This includes information on brain injury and what is offered by Headway, links to other appropriate services across Cambridgeshire and advice on benefits. Community enablement/rehabilitation The Independence Service provides specialist rehabilitation workers to help clients to manage the effects of brain injury, achieve goals at home or in the community including re-ablement following discharge from hospital or residential services, support with daily living, building confidence in community facilities and help to engage in social, learning or volunteer opportunities.

Therapies Life can change following a brain injury. HWC has several therapists and psychotherapists who work with clients to encourage the expression of feelings and thoughts as well as improving or maintaining function and independence. HWC therapists include an art therapist, occupational therapists and a horticultural therapist. Social inclusion and leisure Because social isolation can be a significant problem for people with a brain injury, HWC facilitates a number of social and friendship groups across Cambridgeshire, as well as opportunities to use the gym at Fulbourn, and access to an allotment in Cambridge. Motivational/goal setting courses During 2014, HWC introduced adult learning courses, focusing on motivation, and tailored to meet the specific learning needs of people living with brain injury or cognitive difficulties (memory, concentration, fatigue, processing). The courses promote goal setting, skills development and health improvement and have been delivered in Wisbech, St Neots and Cambridge.

Mind Your Head

An Initiative Of Headway Cabridgeshire Making gingerbread men at the hub.

RECOVERY & REHABILITATION

PAGE 35

Susan’s Experience at St Cyril’s Rehabilitation Unit Susan was admitted to St Cyril’s Rehabilitation Unit following a severe brain injury and had spent several months in an acute hospital; she required assistance with personal care and supervision throughout the day for her own safety. During her stay at the acute hospital, Susan demonstrated confusion and poor memory, conversations with her were extremely difficult, it was clear that she needed the specialist care St Cyril’s had been developed to offer. After being assessed by our Consultant in Neurorehabilitation, Susan was admitted to St Cyril’s for assessment and treatment by the interdisciplinary team who all share a wealth of neurorehabilitation expertise including Psychologists, Physiotherapist, Occupational T herapists, Speech and Language therapists, Nurses and Rehabilitation Co-therapists. Initially, Susan remained confused and required constant supervision; however after settling into the unit and as therapies commenced, Susan’s confusion began to reduce. Susan soon began to enjoy the sociable atmosphere at St Cyril’s, enjoying time in the sen-sory garden and hydrotherapy pool and benefitting from all elements of her personalised rehabilitation care plan. Susan has regained her enjoyment of some of the activities she used to enjoy before her accident. Communication is no longer a problem, and she enjoys a full social life. The interdisciplinary team and Susan are now planning for her discharge to her own home, Susan has benefitted so much from the rehabilitation offered at St Cyril’s that she is now a resident in one of our pre-transitional bungalows prior to her return home. Susan has asked to comment in her own words: “My Brain injury was severe and I was airlifted to hospital to have a serious brain operation. Since being in St. Cyril’s I have recovered and improved – enough to even write this letter, which I am happy to do so, because it is here where I had individual personal care for all of my needs. I have received attention, dedication, medication and serious therapy which was given to me, with patience and care. T hat is why I am improving on a daily basis. With the help of my therapists, my mind has learnt and developed to accept things as they are, but I can change things for the better. I have grown with my development which is of a positive attitude and nature with the therapists’ coaching I am now strong. I learnt a lot about my character which I am using to gain inner strength. I am a diabetic and all of my medication (insulin etc.) is dealt with professionally. All of my blood monitoring was hay-wire before, however since being at St. Cyril’s it is now under control. I am proud of St. Cyril’s Rehabilitation Unit and furthermore, I am grateful. The Doctors, nurses and carers are here to help you. Whatever your disability, you will have utmost help and care. It is St. Cyril’s dedication that makes progress with good results.” Susan is one of St Cyril’s Rehabilitation Unit’s many success stories.

Specialist Neurological Rehabilitation Service “The nervous system is vulnerable to various disorders, which can severely impair and/or damage a person’s physical and mental abilities”. Neurological disorders can be helped through specialised rehabilitation St Cyril’s Rehabilitation Unit, in Chester, provides specialist neurological rehabilitation programmes to help individuals return to the highest possible level of functioning and independence by improving overall physical, emotional and social wellbeing. Treatment programmes can be provided for inpatient and outpatients and tailored to the specific needs of the individual.

Examples of treated conditions:

Day therapy services:

Brain injury including degenerative disorders Hydrotherapy Chronic Fatigue Syndrome Neuropsychology Huntington’s Disease Occupational Therapy Multiple Sclerosis (including relapse service) Physiotherapy Musculoskeletal Disorder Speech & Language Therapy Neuromuscular Disorder Patients with Challenging Behaviours Patients with Low Awareness Patients with Tracheotomy Spinal Injuries Stroke

St Cyril’s Rehabilitation Unit welcomes referrals from across the UK and Internationally. All referrals can be made via our referrals team by telephoning 0808 178 1900 or by completing a referral form via the website.

All Referral Enquiries:

Tel: 0808 178 1900 Fax: 01925 423307 referrals@stgeorgehealthcaregroup.co.uk

General Enquiries:

St Cyril’s Rehabilitation Unit Countess of Chester Health Park Liverpool Road Chester, CH2 1HJ

www.stgeorgehealthcaregroup.co.uk

Tel: 01244 665330 Fax: 01244 665331 info@stgeorgehealthcaregroup.co.uk

What is one-to-one care from Helping Hands?

The Home Care Specialists

One-to-one care is a term that we hear so often, and yet its meaning has become somewhat ambiguous over the years. More and more, the media has brought to our attention the lack of personalisation and Carer contact experienced by our society, despite promises of a ‘one-to-one’ model. Unfortunately, this so often isn’t possible in residential and care home environments, where Carers have to divide their time between numbers of residents with very different healthcare needs. “Going from being so independent to relying on someone and putting your trust in them was difficult. In the beginning, I was advised to stay in hospital, but I just wanted to get home and thanks to Helping Hands I was able to return home with support from one of their Live-in Carers.” Fourteen years down the line, Simon is embracing independent living with support from his permanent Helping Hands Live-in Carer, Anna. Photo courtesy of Simon, pictured above with his Live-in Carer, Anna.

With Simon and Anna, one of our long-standing Live-in Care partnerships, it is clear to see why one-to-one care works so well. Simon, who previously sustained a C5/ C6 spinal cord injury at the age of nineteen, has been receiving Live-in Care from Helping Hands since 2000. Immediately after sustaining his injury, Simon was understandably anxious. An independent young man, he was unsure about what the future would hold and how the direction of his life would change.“ For the first few years after my accident, I closed myself off and didn’t want to do anything as I was originally worried what other people would think.

“When a Carer first arrives, I am a little bit nervous about whether or not we will get on,” Simon remarks.“ I prefer Carers to be a similar age to me, as then we generally have a similar taste in music and films. My permanent Carer, Anna, is just great.” “You really can’t fault Helping Hands”, Simon remarks. “The matching process is great and Anna is perfect in terms of personality and competence.” Helping Hands is committed to supporting individuals to live independent lives. To find out more about how we can support you or a loved one, please call: 0808 250 6675 or visit: www.helpinghands.co.uk

At home with care Supporting those living with a Brain and Spinal Injury Helping Hands has been providing award winning quality live-in support since 1989. A family run company we apply our local knowledge and 25 years of experience to offer you one to one support that enables you or your loved one to remain at home with compassion and dignity. We understand that each condition and individual is completely different, needing a unique approach for all. Our Live in Carers focus on enhanced re-enablement, independence, choice, dignity and respect and can provide 1-2-1 support at home, work, college or university. We are able to balance independent living with creative personalised bespoke care needs by assisting with: • • • •

Personal care and individual support needs Complex nursing led care Companionship Social Activities

• • • •

Housekeeping Mobility Supporting with medication Hospital discharge

To find out how we can help you, call: 0808 250 6675 or visit: www.helpinghands.co.uk

PAGE 37

A charity leading innovation in mental health

National Brain Injury Centre St Andrewâ&#x20AC;&#x2122;s Northampton

For over 35 years our purpose has been to transform lives and optimise the potential of people in our care by engaging them in innovative neurobehavioural models that help to restore autonomy and support re-integration to community. Our specialist services support over 120 people each year, offering: neurobehavioural rehabilitation to manage cognitive, emotional and behavioural challenges multi-disciplinary teams from the most established service in the UK care pathways for men, women and adolescents including admissions wards, slow stream rehabilitation and community based independent living.

We focus on identifying and treating the underlying causes of challenging behaviour and supporting patients through a pathway to re-integration and independent living. Our neurobehavioural services include: Bespoke adolescent brain injury and neurobehavioural service Admission and rehabilitation wards with a pathway to community living Dedicated pathways for people with neurological conditions, specialising in dementia and Huntingtonâ&#x20AC;&#x2122;s disease We are the UKâ&#x20AC;&#x2122;s largest mental health charity, providing more services to the NHS than any other charity. We are committed to becoming a national centre of excellence and we are the first national teaching hospital outside the NHS.

RECOVERY & REHABILITATION

Registered Charity No: 1104951

Brain injury and neuropsychiatry service for young people Removing the barriers to rehabilitation We improve the futures of the young people in our care by understanding the neuropsychiatric cause of the challenging behaviour first and foremost. Then, by building on the improvements in behaviour, we can introduce therapies, education and recreation to overcome the other challenges the young person is facing. Through our principles of early intervention during the neurodevelopmental stage we have seen proven, significant improvements in challenging behaviour.* Our adolescent results speak for themselves:

100%

of our pupils achieved or exceeded their educational targets

84%

reduction in serious incidents

88%

of incidents resolved using no or low level de-escalation techniques

Getting in touch For more information about our neurobehavioural rehabilitation services or to make a referral: t: 0800 434 6690 e: enquiries@standrew.co.uk w: standrewshealthcare.co.uk/ neuropsychiatry

*Patient outcomes, April 11 â&#x20AC;&#x201C; June 12

PAGE 39

UK launch of The SEM Glove Anatomical Concepts (UK) Ltd has brought leading edge technology into the UK rehabilitation sector since 1995. It’s new sister business Fixxl Ltd also intends to break now ground starting with the UK launch of the SEM Glove. The SEM Glove (Smart Extra Muscles for you) developed by BioServo Technologies in Sweden is a an assistive device that helps individuals with a weak grip. This truly novel “soft” robotic technology is easy to set up and even easier to use - it can transform quality of life when grip is an issue following spinal cord or brain injury or other neurological condition. Fixxl are presenting RehaCom software as a must-have tool for therapists working with brain injured people. RehaCom is a very powerful software suite now established in most countries of the world. In Germany where it was developed it is used in 95% of clinical facilities involved in brain injury rehabilitation. It’s not intended as a replacement for therapist - it is a powerful tool to be used by the therapist to maximise recovery. The scope and depth of RehaCom is unmatched in this Þeld.

SEM Glove

RehaCom

An assistive device to remedy a weak grip

Software for Cognitive Rehabilitation

www.better-grip.co.uk

www.rehacom.co.uk

8–10 Dunrobin Court, Clydebank Business Park, Clydebank G81 2QP Rehabilitation Engineers www.anatomicalconcepts.com T: +44(0)141 952 2323 E: info@anatomicalconcepts.com

29 Brandon St, Hamilton, Lanarkshire ML3 6DA www.rehacom.co.uk www.fixxl.co.uk T: +44(0)141 628 6798 E: info@fixxl.co.uk

RECOVERY & REHABILITATION

Overcoming Swallowing Problems:- An alternative to thickened fluids. The first line of treatment for anyone with dysphagia (difficulty swallowing) is to modify consistency of solid food and thickness of liquids. Few studies consider patient’s views on this modification to their diet, compliance with thickened fluids can be poor, which can results in other nutritional problems.(1) One alternative to thickened fluids is the use of ‘free water protocols’. Patients are allowed to consume water (un-thickened) between meals; as part of a guided programme (1). In addition to allowing patients to follow a free fluid (clean water) protocol, they highlight the importance of oral care in prevention of pneumonia. A study in Japan in 2002 was able to reduce the incidence of pneumonia in nursing home patients, simply by following an aggressive oral hygiene routine.(2) Professor Catriona Steel of the Swallowing Rehabilitation and Research Laboratory - University of Toronto advises ‘Can we safely give dysphasic patients water to drink? Answer: In conjunction with rigorous oral care, and controlled water delivery, the answer is probably YES” (3). Choosing the most appropriate drinking aid can help make a difference; Kapitex Healthcare provides a full range of drinking devices to promote safer hydration including the controlled flow Drink RITE cup. Kapitex Healthcare has 20 years’ experience in Dysphagia and Oral motor rehabilitation, we are happy to help guide you and/or your therapist about our products. References 1) Sura L et al.(2012) Dysphagia in the elderly: management and nutritional considerations. Clinical Interventions in Aging 2012 12.7 287-298 2) Yoneyama T et al(2002) Oral care reduces pneumonia in older patients in nursing homes. Journal of American Geriatrics 50(3), 430-433. Enable_half_page_Ad_Layout 1 19/06/2014 10:28 Page 1

3) Steele C. (2012) Water Protocols: Can I safely recommend oral water intake for my dysphagia patient? UK Swallowing Research Group Conference 2012.

T OP EC H IR S D E E LIN BL N A O IL A UR AV O M O

DRINK-RITE

Safer hydration with every sip

Providing safe, controlled flow of fluids • Drink-Rite allows only 5cc or 10 cc of

fluid into the mouth with each tip of the cup/beaker, assisting those with swallowing problems.

Available in cup and beaker options, each supplied with 5cc and 10cc flow controllers

• Drink Rite allows careful fluid delivery without having to tilt the head.

• Drink-Rite is Ideal for domestic as well as nursing home use.

For more information on our comprehensive range of dysphagia and oral motor therapy tools visit our website or contact our customer care team

www.kapitex.com • tel: 01937 580211 Kapitex Healthcare Ltd, 1 Sandbeck Way, Wetherby, West Yorkshire, LS22 7GH Tel: 01937 580211 Fax: 01937 580796 Email: sales@kapitex.com Web: kapitex.com

TAKE BACK CONTROL OF YOUR BLADDER The bladder acts as a storage vessel for urine and as it gradually fills with urine, the stretch receptors in the bladder wall send messages to the brain that it is time to think about emptying. When functioning normally, signals from the brain cause the urethral sphincter to open and the bladder walls to contract. Urine is then discharged from the bladder through the urethra. Normally the bladder will be virtually empty when you finish urinating, but in some people the process of urination remains incomplete, leaving a residual pool of urine in the bladder. Residual urine provides a haven for bacterial growth and may lead to a urinary tract infection. If the bladder cannot be emptied completely through normal urination, it can be drained by using a thin tube passed up the urethra into the bladder. The tube, called a catheter, is removed when drainage is complete. This simple procedure called Intermittent selfcatheterisation (ISC), drains urine from the bladder and can be carried out safely at home, at work, or when travelling so it need not restrict or impede a busy life. ISC is taught by specially trained healthcare professionals – such as nurse specialists – who provide training and advice to ensure correct procedures are followed to minimise risks. HYDROSIL® Gripper and HYDROSIL® Rose are Hydrophilic Intermittent Catheters for men and women and have many special features that make them soft and comfortable to use.

Male Hydrophilic Intermittent Catheter

Female Hydrophilic Intermittent Catheter

Soft. Comfortable. Discreet. The Only Hydrophilic Silicone Catheter for ISC Unique outer layer becomes slippery when wet, for virtually friction-free insertion and removal. Gripper device on Hydrosil® Gripper allows the catheter to be held firmly without touching the catheter surface Specially designed handle on Hydrosil® Rose allows a firm grip and control. Tapered, seamless catheter tip is designed to pass smoothly through the urethra and into the bladder

For further information call or email on: Freephone 0800 0121 699 Email ukcustomercare@crbard.com Bard, Hydrosil and Script-easy are trademarks, and/or registered trademarks of C. R. Bard, Inc. or an affiliate. All other trademarks are the property of their respective owners. Copyright © 2015, C. R. Bard, Inc. All Rights Reserved. 0615/4682

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10/06/2015 14:16

RECOVERY & REHABILITATION

The Invisible Patients: New report reveals the alarming state of neurology services The Neurological Alliance has announced the launch of its new report, The Invisible Patients: Revealing the state of neurology services. Bringing together the findings of the Neurological Alliance’s inaugural quality of commissioning audit and neurological patient experience survey, the report identifies significant variation in the quality of the commissioning of neurological services among clinical commissioning groups (CCGs). Findings include: • • • •

Only 14.7% of CCGs have assessed local costs relating to the provision of neurology services Only 20.4% and 26.2% of CCGs respectively have assessed the number of people using neurological services and the prevalence of neurological conditions within their area Only 33% of CCGs obtain vital feedback from patients in regards to the neurological services they commission These issues have a significant impact on patients’ care, with 58.1% of patients having experienced problems in accessing the services or treatment they need.

In response, The Invisible Patients sets out a number of recommendations including: • • • •

Every CCG should collate up to date and accurate local neurology data, underpinned by routine and rigorous assessments of the prevalence of neurological conditions and of the number of people using neurological services locally All CCGs should ensure that mechanisms are put in place to encourage and capture patient feedback and input in regards to the quality and development of local neurology services CCGs should work in partnership to identify clinical and research trial opportunities locally and support the appropriate sharing of information on such opportunities with patients

Commenting on the report, the Neurological Alliance’s Chief Executive, Arlene Wilkie, said: “For too long, people living with neurological conditions have been the ‘invisible patients’, often marginalised by a system that doesn’t understand their conditions or their needs. This has to change. I am delighted that this report provides a vital first step in exposing the true state of neurological services today. It is time for the health and care system to open its eyes to the needs of the millions of people who live with these complex and challenging conditions. They must be invisible no longer.” PAGE 43

Following a spinal cord injury some years ago Thomas found that his whole life changed. Rather than let this get him down Thomas followed his dreams by participating in the Six Day track cycling race and similar wheelchair race events and decided to become a professional athlete. Thomas is a person who is extremely driven to reach his life’s goals; already managing to achieve most of what his heart desires. Thomas competes in triathlons comprising of swimming, hand biking and wheelchair racing events. In 2008 Thomas competed in his first half-ironman competition where he achieved a new personal-best. Additionally in his spare time Thomas enjoys partaking in scuba diving, kitesurfing and water-skiing. Thomas has one motto in life which is ‘don’t worry, be happy and do your best’.

Voyager Evo Every day is a journey! Ottobock · 0845 600 7664 · www.ottobock.co.uk

Voyager Evo advert 180314_SM6030v2.indd 1

19/03/2014 14:27

Jim’s traumatic accident changed his life forever, but a microprocessor controlled leg has put his active lifestyle back on track. Glaswegian Jim Bruce enjoys the usual everyday activities that most people do, like going to the gym, doing the gardening and supporting his local football team Glasgow Rangers. Except the difference is, he does it all with a prosthetic leg. In 1995 Jim had a freak trauma accident that would change his life forever. Whilst working with heavy machinery his leg was severely injured by a fork lift causing extensive damage to his knee and shin. Jim explained, “I went straight into intensive care following my accident; I couldn’t feel a thing. I think I was in shock and passed out shortly after being admitted. When I woke up I knew something was seriously wrong. Doctors kept injecting my leg but I still couldn’t feel anything and I could see the physical severity of my injury.” After a week of doctors trying their hardest to save his leg, they had no option but to amputate above the knee. Although his foot was absolutely fine, the damage to the leg and knee was so extensive that it was irreparable. “When they told me they were going to amputate my leg, it felt strange but didn’t really hit me until afterwards. It was only after the amputation that it dawned upon me that this would change my life forever. I was in hospital for three months which gave me time to reflect and then it was another seven weeks until I got my first NHS leg. The amputation had a huge impact on my day to day life. It left me unable to do the small things I didn’t even realise that I would miss, like using a step ladder and doing DIY.” Jim’s first NHS leg used a hydraulic system which he found very tiring and often stumbled and fell. Later on in life, Jim found out about the C-Leg microprocessor knee from Ottobock from his active involvement in the amputee patient community and was given the opportunity to try it at the University of Strathclyde in Glasgow. “Everybody was talking about the C-Leg in the amputee community which uses something called a microprocessor to control the knee. I was lucky to be able to try it out and I was immediately impressed and knew it would improve my lifestyle significantly and let me get back to some of the activities I enjoyed prior to my amputation. With the C-Leg I can be active again; I’m back at the gym and have a bluetooth remote control that lets me change the settings to use the treadmill or the rowing machine. I’m also having gait training which is helping me build up speed and pace and improve my walking pattern.” As well as getting back to his active lifestyle, Jim has been giving back to the community by volunteering on the prosthetics course at the University of Strathclyde. He regularly participates to help aspiring prosthetists learn. Although Jim was lucky enough to gain a C-Leg privately, he hopes in the future microprocessor knees will be available on the NHS to all amputees. “I really hope that in the future the NHS will be able to provide C-Legs or other microprocessor knees. It has helped me to continue the active lifestyle I led before my injury, and I believe that if a patient had a C-Leg as their first leg it would help greatly with healing and lead to faster recovery times. I would recommend a C-Leg to anybody in my position.” To learn more about Ottobock products visit www.ottobock.co.uk or call T: 01784 744 900 About Ottobock Ottobock is a world leading supplier of high quality, innovative and practical solutions that restore human mobility and help people to rediscover personal independence. Ottobock is part of the Ottobock global group of companies established in the UK in 1976. Its wide product range includes high quality prosthetic and orthotic components, wheelchairs, rehabilitation and mobility products available through the country’s leading clinics and dealers. For private patients, Ottobock offers a full range of rehabilitation services at our private clinics across the country. With a highly motivated and skilled team of professionals offering expert advice, product sales, service, support and medical care, Ottobock solutions enhance the physical comfort, confidence and mobility of the individual.

Specialist services for adults and children with brain and spinal injuries We offer: • Over 15 years’ experience of Case Management • Specialist Case Managers, and Neuro-OTs • Professionally qualiﬁed staff • Bespoke care and support packages • Managed over 200,000 hours of support in 2014 • Manual Handling assessments and training • Experience of working with the UK’s leading law ﬁrms • Fully CQC compliant

We also provide Expert Witness Care Reports. The team is led by Caroline Ferber.

For more information, please visit www.angliacasemanagement.co.uk or call 01359 271900

Catching Every Last Drop Our Cost Consultants have over 20 years experience in dealing with complex catastrophic injury and high value cases giving them the expertise they need to increase your profit costs Contact: 01978 721558 www.cheshirelawcosts.co.uk

Our Cost Consultants Have Over 20 Years Experience In Dealing With Complex Catastrophic Injury And High Value Cases Giving Them The Expertise They Need To Increase Your Profit Costs

1 Sewardstone Close Sewardstone Close is a purpose built units for people aged 18+ with an acquired brain injury. We offer residential and nursing placements including respite services and intermediate placements to clients with all different levels of physical or cognitive ability. For further information about the service or to make a referral, please call 0845 190 1870 or email info@enablecare.co.uk 1 Sewardstone Close Sewardstone Road, Waltham Abbey London E4 7RG www.enablecare.co.uk

CASE MANAGEMENT

What is Case Management? Case Management is a collaborative process which: assesses, plans, implements, co-ordinates, monitors and evaluates the options and services required to meet an individuals health, social care, educational and employment needs, using communication and available resources to promote quality cost effective outcomes.

Choosing the right case manager Case Management has eveloved over the past ten years and has become an integral part of a compensation claim. It is a process devoted to the co-ordination, rehabilitation, care and support of people with complex clinical needs. It aims to facilitate their independence and improve their quality of life. A Case Manager will assess the needs of the client and the client's family and identify relevant and cost-effective resources which they can access to inprove their quality of life. A plan, tailored to the individual will be drawn up which provides a basis for a package of support to be created from.

PAGE 47

Living with a spinal injury: James’ story Five years ago I damaged my spine whilst playing polo. My injuries left me unable to walk and wheelchair dependent. After 12 months in hospital, I was keen to return home and a team from Pulse Community Healthcare were employed to support me. As a farmer by trade the accident had a severe impact on my life. I continue to run my own business so having the team around allows me to get on with my day-to-day activities. Importantly, their presence means my family can get on with their own lives too. I wouldn’t hesitate to recommend Pulse Community Healthcare. I’ve done so previously and will continue to do so. We’re like one big family.

Contact us for more information on how we can support you and your loved ones: 0845 459 7417 service.enquiries@pulsecommunityhealthcare.co.uk

P1110_PCH_Advert_176x110mm.print.indd 1

“

Life would be much more difficult without my Pulse Community Healthcare team

”

20/05/2015 14:27

Inspire ▪ Excel ▪ Achieve ▪ With Integrity Proclaim Care devise and implement rehabilitation programmes to help people deal with the consequences of serious or catastrophic personal injury and medically related absence from work. Our nationwide team of highly experienced clinically qualified Severe Injury Rehabilitations Managers provide expert rehabilitation management. Spinal Cord injuries are often traumatic and the spinal cord can either be partially injured or completed severed resulting in varying levels of recovery. Head injury can have a varied effect on an individual resulting in cognitive and functional problems. Treatment for both Spinal Cord and Head Injury should start as soon as possible and continue until maximum potential has been reached.

    

Initial Needs Assessment (INA) Rehabilitation Management Vocational Evaluations Functional Evaluations Return to work

www.proclaim-care.co.uk Telephone: 01698 207755

FINANCIAL PLANNING

Specialist Legal Help For Serious Injuries It takes seconds to change a life and time and money to re-build it after a devastating accident. Wilkin Chapman LLP solicitors has the specialist expertise to help you deal with a serious injury claim. The following case study is an example of how Wilkin Chapman has helped a recent client secure compensation to help him support his family’s future and rebuild his life, when the prospect of a successful claim seemed remote. Mr S was a young man who fell down stairs where there was no handrail, suffering a severe and life threatening brain injury. The law did not require a handrail at the location of the fall, so liability and causation were always going to be difficult. Because his injuries were so significant, following investigations, the firm decided the risk of a claim would be worthwhile. Following a Letter of Claim, liability was denied, but at the same time, a six figure “without prejudice” offer of compensation was put forward. This was doubled following a settlement meeting involving the parties and the client and his family, led by experienced Counsel. The firm knew they could never obtain an award sufficient to support this client for the rest of his life, but the sum agreed on allowed him to buy a house suitable for all the family so he could return to their care following successful rehabilitation. There are so many ways those with brain and spinal injuries can be helped to lead a full life, but assistance is difficult to come by through the NHS. Appropriate compensation is the key to accessing this help - therapy, aids and equipment, accommodation, care, extra costs. Money may need to be managed through the Court of Protection. As a large law firm with 9 offices in the Lincolnshire and East Yorkshire region, Wilkin Chapman offers a personal, local service for all aspects of a serious injury claim, funded by insurance backed conditional fee agreements, to help you achieve the best outcome. The firm also holds a Legal Aid Agency contract and can offer Legal Aid for children with severe neurological injuries caused by alleged negligence. Wilkin Chapman LLP’s solicitors are accredited to the Law Society Personal Injury Panel and the Law Society and Association of Personal Injury Lawyers Clinical Negligence Panels. For specialist advice from experienced lawyers dedicated to handling your case with the utmost care and attention, please contact Brenda Gilligan or Jonathan Baker on 01522 512345 for a free initial discussion or visit www.wilkinchapman.co.uk.

PAGE 49

Protect disability benefits from means testing Setting up a Personal Injury Trust can play a major role in protecting an injured personâ&#x20AC;&#x2122;s assets from means testing and other risks. Please see our article (opposite) for a case study on how some simple steps can protect a compensation award and improve your finances. Contact Ian Potter for a free no obligation discussion about how a Personal Injury Trust could give financial help to you and your family.

t: 0114 267 5588 e: ian.potter@wrigleys.co.uk w: www.thecpservice.co.uk

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FINANCIAL PLANNING

Don't put disability benefits at risk… Ian Potter looks at some simple legal planning that could protect and improve your finances. A settlement following a personal injury, medical negligence or similar claim may mean that an injured person suddenly receives a substantial amount of money in compensation. A common problem for injured people is that they may lose entitlement to means tested welfare benefits once they receive a compensation award. Any award which takes combined savings above £6,000 could lead to a reduction or loss of welfare benefits. The injured person will still have their daily living costs to meet, and might well need their normal benefits to help them get by. In these circumstances, a ‘Personal Injury Trust’ (or ‘PI Trust’) can be invaluable. What is a Personal Injury Trust? A PI Trust is a legally binding arrangement in which named trustees hold and manage a compensation award for the benefit of another person. For example, parents or guardians may act as trustees for a child awarded compensation for injuries arising from medical negligence at birth.

The advantages of a PI Trust: • places the compensation award outside means test calculations • preserves compensation by reducing the risk of claims from unscrupulous others • allows for optional help from professional trustees (or ‘deputies’) and administrators on matters such as tax returns, investments and benefit claims • offers an alternative for children and young people under 18 to compensation held by the High Court (arrangements sometimes known as CPR 21.11 Trusts or Infant Trusts) Would a PI Trust be right for me? A PI Trust is a wise consideration for anyone who has received substantial compensation for any kind of personal or criminal injury. We recommend that you seek expert advice on the best route forward as it could make a substantial financial difference, both now and for the future. Case Study Tom is 34. He was involved in an accident aged 22 and received compensation of £250,000 in 2004. Tom was left with severe disabilities and unable to earn any income other than from investments that had been funded by his compensation award. Tom only received Disability Living Allowance; however, as a consequence of his award he and his wife did not qualify for Employment Support Allowance or Housing Benefit Our advice We advised Tom to set up a PI Trust. The trustees were his wife, Jane and Wrigleys Trustees Limited as professional trustee. It is not essential to have a professional trustee, but Jane and Tom opted for this to help oversee the complexities involved with tax returns, investments and benefit claims. The fees of setting up the Trust and ongoing fees were offset by the financial gains obtained through the receipt of Employment Support Allowance and Housing Benefit. We estimated that in 2014, the couple received an extra £15,000 in benefits.

Wrigleys has a special focus on meeting the needs of individuals who are or may be vulnerable, injured, disabled or suffering from illness. For further information on Wrigleys' Compensation Protection Service please visit www.thecpservice.co.uk t: 0114 267 5588 e: ian.potter@wrigleys.co.uk

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The Care Act 2014 - In Brief The Care Act 2014 came into force on 6th April 2015, promising major changes to the funding that those who need care can receive. State Funding for Care The responsibility for providing care and for an individual’s wellbeing is now squarely on the shoulders of the local authority, and there has been a standardisation regarding eligibility across all areas. “Wellbeing” incorporates personal dignity, control (as far as possible) by the individual over his or her own life, physical and emotional wellbeing, and facilitating domestic, family and personal relationships, in the setting of suitable accommodation.

The Care Cap

by the local authority.

The Care Cap is due to be implemented in April 2016. It should mean that any individual requiring social care will have their contribution capped at a certain monetary amount, depending on age. For people who develop eligible care needs in later life, the cap will be £72,000. For those who develop eligible care needs before they reach 65, there will be a limit lower than £72,000 although, to our knowledge, this lower limit has not yet been disclosed. For individuals assessed as having an ongoing eligible need for adult social care support before their 18th birthday, the cap on care costs will be £0.

Finally, the interaction between the Care Cap and personal injury awards is unknown. One view might be that as awards are disregarded in any event, they cannot be taken into account against the £72,000 limit.

Interaction with Damages Awards

The local authority also now has a duty to liaise with relevant Clinical Commissioning Groups when appropriate to coordinate care for the individual concerned.

The new act maintains the position that capital derived from a personal injury award is disregarded in terms of eligibility for state funded care if held in trust or under the Court of Protection.

An individual should be able to access an outcomes-based, person-centred care regime through a collaborative process anywhere in the UK. In addition, the Act also caters for carers and their needs and rights.

The anomalous position regarding treatment of income under the previous regime has now been rectified, with income being disregarded whether the claimant occupies his own home or is cared for in a home run

How all of the broader aims of the Act can be achieved against the background of funding cuts and an aging population will be the subject of much ongoing scrutiny. Nestor is at the forefront of financial advice for those receiving damages awards. Should you require any advice about how the Care Act 2014 will affect you, a dependant or client, our directors will be pleased to help.

Personal Injury Services Personal Injury Trusts

Investing Damages

Welfare Benefits Review

Periodical Payments

Court of Protection Investment

Accountancy Services

Controlled House, Waterfold Business Park, Rochdale Road, Bury, Lancashire BL9 7BR

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Nestor is a trading style of Nestor Financial Group Limited which is Authorised and Regulated by the Financial Conduct Authority. FCA Reg No. 592783 and registered in England & Wales No.08201442. Vat Registration 855355994.

FINANCIAL PLANNING

EMG SOLICITORS PROVIDES SUPPORT …. What should have been the happiest time in Lisa Davies’* life became one of the saddest, when her baby was injured at birth due to the hospital’s negligence. Now 20, Sue still lives at home with her parents and her day to day needs are managed professionally and competently, thanks to the support given by solicitor Emma Gaudern. Emma, who runs EMG Solicitors, has years of experience in working as a Professional Deputy, and ensures that the compensation granted to Sue because of her cerebral palsy, is used properly. “We trust Emma completely,” said Lisa. “We know she’s an excellent solicitor but she’s also become like a part of our family and we consider her a friend. I certainly couldn’t have managed without her.” Emma previously worked for the law firm which handled the Davies’ compensation case and because of her excellent reputation, was chosen by Lisa to manage Sue’s affairs. “Many people think that if you get awarded compensation that the family just get a big lump of money to spend as they want,” said Lisa “But it actually must be managed properly and applications have to go into the court if we want to buy anything. For us doing this kind of paperwork would have been a nightmare so it’s fantastic having Emma to manage everything.” The family have just built a new kitchen at their home, divided into two so that Sue can have one side adapted for her use, allowing her to have some independence. “It would have been far more complicated if we’d had to do this ourselves and apply for the money,” said Lisa. “Emma just handles everything for us. We have a meeting once a year to look at where we are and how Sue’s money is being looked after, but she is at the end of a phone if we ever need her.” When Emma set up EMG Solicitors just over a year ago, clients like Lisa and Sue came with her. Emma is a deputy for more than 45 people and is also a trustee of around 20 other trusts, managing around £60m for her clients. Quite apart from her professional reputation and skill, it’s the kindness and sympathy with which Emma treats her clients which makes her services in such demand. “A Professional Deputy is likely to be with you for a long time so it’s really important that you find someone that you get on well with,” Emma said. “We are always happy to talk to people who may be looking to use a deputy for the first time or perhaps don’t have that kind of relationship with their existing deputy and would like to see if they have a better rapport with someone else.” Emma’s deputyships range from cases like Sue’s to young people and adults who have been injured in road traffic accidents or through injuries at work. The solicitor was also one of the first professional health and welfare deputies to be appointed in the country and works closely with a number of families as co-trustee for incapacitated adults. Her expertise takes a great deal of strain off families already under pressure, helping them lead normal lives knowing their finances are being properly looked after. “We like to think that at EMG we become part of the family,” said Emma. “And that means doing what families should do – be there when it counts.” (*The names have been changed to protect the confidentiality of the clients, however the facts and quotes are genuine.) FOR FURTHER INFORMATION CONTACT EMG SOLICITORS ON 0191 383 7425 or email emma.gaudern@emgsolicitors.com

The most important relationships in your life aren't always with family When you choose someone to act as a Professional Deputy they become part of your world - which is why it's important to pick the right one. At EMG Solicitors we pride ourselves on our sympathetic and professional approach, with years of experience in providing legal support to protect the rights of our clients. We work with people with a variety of complex needs and can give you advice if you are considering employing a deputy for the first time or aren't happy with your existing arrangements. Contact us at

enquiries@emgsolicitors.com or call for a chat on 0191 383 7425

www.emgsolicitors.com

Mike Talbot discusses Organic Brain Injury and why a Specialist Solicitor is needed in cases of Utmost Severity. Where a brain injury is suffered significant physical and mental disabilities and behaviour changes can occur and the consequences for the victim and their families are life changing. We have dealt recently with a number of organic brain injury claims and the support of family and solicitors in these cases is crucial. Organic Brain Injury causes cognitive and functioning deficit, whilst the client may not appear to be struggling physically, they do often undergo personality changes. Pearson’s specialist solicitors help victims get compensation and rebuild their lives. Claims can often take between 3 and 5 years and we build a relationship with our clients over this period. We are always working in your best interests and your future needs will be assessed and taken into consideration at all times. By starting off with a face to face discussion with the solicitor who will be dealing with your case we try to put our clients at ease and promise your case will not be passed around. We offer help at every stage, from arranging expert advice on specialist equipment, rehabilitation and accommodation needs where appropriate, as well as arranging expert medical opinion in all the relevant fields which would apply in such a case e.g. Neurology and Neuropsychology. Your solicitor will explain how your claim will be conducted and this could seem complicated, particularly following a brain injury so we suggest you to bring a friend or relative along to help and to take notes. We will explain the various options for funding your claim, how costs can be recovered and how your position in relation to legal costs can best be protected. Head injuries occur in a variety of ways and have a variety of seriousness. Injuries at work, during sport, through accidents and traffic incidents vary in severity, a minor head injury can cause long-lasting symptoms such as headaches, vision problems and dizziness. The more serious ones can be permanent, life-changing and sadly sometimes result in death. It is not generally the client who does anything in the first instance in organic brain injury cases, the family have a massive part to play. The client may be in hospital and or incapable of providing instruction, family and friends will be crucial at this time to provide support an d take care of everyday needs, buy essentials, pay bills, ensure that the injured parties employer, school, college, university etc are informed and are kept informed of the event and recovery. Instructions to a solicitor are likely to come from family or friends and we would always advise legal advice should be obtained as soon as practicably possible. There are numerous problems which are associated with any personal injury case, tracing a defendant, obtaining insurance details, admission of liability. The challenge here is managing expectations and not just in terms of monetary value. The challenges are more to do with rehabilitation, ensuring that interim payments are received at regular intervals so that money or the lack of it is not a worry, bringing together the right team of experts to ensure the Claimant receives the right advice at the right time, treatments and therapy as and when needed, not when a waiting list will fit them in, taking the stress and strain off the injured party, family, friends and if relevant, an employer or employees. The right result for a client in these cases is very satisfying, knowing that as much as possible you have rebuilt a family’s life after a devastating event is very rewarding. During the course of a claim, you become their friend and confidante, someone they can always turn to and who they can confide in.

Specialist Personal Injury Solicitors

Brain injuries are life changing... We will help you secure the support and maximum compensation you deserve by working closely with you and your family or carers. Helping you with: • Head Injury Claims • Serious Injury Claims • Compensation

Call and chat to us now

0161 785 3500

• Rehabilitation • Financial Advice • No Win No Fee

www.pearsonlegal.co.uk

enquiries@pearsonlegal.co.uk

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FINANCIAL PLANNING

Liftime Cashflow Modelling and why it is important for catastrophic injury clients Chris Williams – Managing Director – Concerva Chartered Financial Planners At Concerva we are involved in advising on catastrophic injury claims where there are considerable lump sums received by claimants and their families. Whether the lump sum is ultimately held within a trust, by a deputy or the claimant directly, the majority of claimants have never had access or control of significant amounts of money before. We at Concerva have the task of showing clients how the compensation can be used to help them achieve what is important to them during the rest of their lives, and to work with them to ensure that the financial objectives that are set are reasonable. Clients are paid a one-off lump sum payment of money and the urge to spend is very strong. At Concerva we re-iterate to the clients that this money is to last for all of their lives and it must be used wisely To demonstrate this requires that their financial objectives be put into a Lifetime Cashflow Model which ultimately creates a budget for them to live from. Lifetime cashflow modelling as part of a financial plan is a powerful tool for discovering what a client really wants. Instead of simply asking what the clients wants to do with the money, it allows Concerva to get to understand the clients’ real needs and to establish what really matters to them. This can be beneficial for all parties concerned. For the client, they achieve a much better understanding of what is important to them, and by setting their financial objectives; they become much more enagaged in the whole process. Caution needs to be exercised with regards to the assumptions that are made when building the cashflow model. The required level of investment return will have a significant impact on future cashflows and therefore achieving a predictable level of return is far more important than trying to outperform any particular stock market index. Risk profiling the client will identify whether the level of investment risk they are comfortable with matches that required. If there is a mismatch difficult decisions may have to be made. The modelling process is dynamic and will be updated on a regular basis. We find that this allows Concerva, the client and their advisors to work together with the claimants best interests at heart.

Serious Injury Financial Planners

Making your personal injury award last Conçerva are specialists in providing advice to recipients of substantial personal injury awards as a consequence of serious and catastrophic injuries. ■ ■ ■ ■ ■

Decades of experience dealing with vulnerable clients 10 years experience in the Personal Injury Market Welfare Benefits & Trust Advice Cash management Cashflow modelling

For further information please contact

Martin Kettle APFS CHARTERED FINANCIAL PLANNER

07414 924 250 martin@concerva.co.uk

■ ■ ■ ■ ■

Investment portfolio contruction Investment portfolio management Tax Planning Chartered Financial Planners Highest levels of Professional service assured

Conçerva Limited Barnfield House The Approach Manchester M3 7BX t: 0161 819 3636 www.concerva.co.uk

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Recharge

Reconnect

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6/10/2015 9:41:47 AM

Revitalise steps up to step-down challenge. The national charity Revitalise has earned an enviable reputation through its modern twist on conventional respite breaks. By combining specialist nursing care with all the enjoyment and excitement of a proper holiday, Revitalise is reinvigorating the lives of thousands of disabled people each year and achieving outcomes other providers can only dream of. People in rehabilitation from or living with the effects of brain or spinal trauma are already among those who visit Revitalise’s three UK centres for refreshing holidays. In fact the charity routinely caters for guests with around 150 different physical impairments. But now Revitalise’s Sandpipers respite holiday centre in Southport has teamed up with the North West Regional Spinal Injuries Centre, part of the Southport and Ormskirk Hospital NHS Trust, to support people recovering from major spinal trauma during the crucial transition period when they no longer require a hospital bed but are not yet ready to go home. Because of Sandpipers’ unique, informal atmosphere, the patients supported by the scheme have recovered faster and been discharged significantly earlier than before with, needless to say, significant costs savings. While the work with the Spinal Unit continues, Sandpipers gets on with its core activity of providing respite holidays for disabled people, alongside Revitalise’s two other centres in Chigwell in Essex and Southampton. Accessible excursions, activities and entertainments are a vital feature of each Revitalise break. The charity aims to offer holidays to suit all tastes through a wide range of themed weeks, giving its guests allimportant opportunities to make new friends and experience new things. In this way Revitalise is enhancing the lives of thousands of disabled people each year by giving them an energising change of scene and the chance to immerse themselves in a truly social experience. Many of Revitalise’s guests return year on year to top up on the ‘Revitalise effect’, which, as Sandpipers’ spinal patients are already finding out, can accelerate healing too! For more information about Revitalise respite holidays, call 0303 303 0145 or visit www.revitalise.org.uk.

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Adrian Ganderton

Ian Johnson

Charlotte Sutton