B&SI
2019 /2020
EDITION
Brain & Spinal Injury Handbook
A HIDDEN DISABILITY Katy James of The Children’s Trust discusses ABI
HOW DO WE LEARN? Joining forces to make a profound difference in rehabilitation
FINANCIAL & LEGAL Protecting families, litigation, personal injury claims & more legal advice
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B&SI WELCOME Dear Reader, Welcome to the 2019/2020 edition of this essential publication for patients, families, friends, case managers, lawyers, neuro rehab providers, caregivers; and all those affected by brain or spinal injury. The Brain & Spinal Injury Handbook is a well-needed and equally well-received publication for occupational therapists, lawyers and healthcare professionals, who will no doubt agree that this annual handbook creates an important platform for sharing knowledge and experiences, raising awareness around this field of medicine, related law and rehabilitation. Our aim is to provide hope and comfort as well as information to our readers. With this said, we’d especially like to give gratitude to the contributors of this issue. If you have something to share on the subject of brain and/or spinal injury please email the editor: lee.gatland@sevenstarmedia.co.uk Until next year. The B&SIH Team B&SI 3
2019 /2020
EDITION
B&SI CONTENTS
RECOVERY & REHABILITATION AND LONG-TERM SUPPORT
6 Promoting excellence in neurorehabilitation 9 Neurological services 11 Neurorehabilitation following an acquired brain injury (ABI) 13 A village community 15 Raising standards 16 How do we learn? 19 Dedicated rehabilitation 20 Personalised, goal-driven rehab for injuries of all severity levels 22 Sustained improvement after brain injury 26 Acquired brain injury: A hidden disability 31 Environment design in recovery and rehabilitation 32 A BI Alliance continues rehabilitation prescription campaign 34 Spinal Injuries Association leads the way for support for SCI people 38 Your questions answered 41 Looking for a neuro superhero? 42 The use of Saebo devices in rehabilitation 45 On a mission! 47 Why support makes all the difference 51 The personal touch 53 Inspiring. Recovery. Together 55 The ultimate goal 56 Working together 61 Your rehabilitation, our priority 63 Finding your perfect match 64 Don’t survive - thrive 65 Expert rehabilitation case management services 66 Providing therapies since 2008 66 Raising the bar 71 Tailor-made to support our clients 73 Access all areas 75 How a WC is helping one man get his privacy back 81 Fast-track nationwide access to UK hospitals 4
FINANCIAL & LEGAL
83 Meat the experts 84 Funding solutions - an essential for greater financial flexibility 85 The benefits of outsourcing 87 Putting your customers at the heart of everything we do 89 A proven record 91 Strength in depth 93 Civil and public law barristers 94 Leading experts 95 A voice for the injured and bereaved 97 Fighting for what’s right
99 B rain-injured biker hopeful for future after Simpson Millar intervention 101 In praise of cooperation 107 Leading brain and spinal cord injury solicitors 109 Specialist medical knowledge 115 Periodical payments 117 Can a deputy withhold knowledge of the amount of a personal injury settlement? 119 Protecting families
REFERENCE
120 Personal profiles 122 Brain and spinal injury contact information 124 Special thanks to our contributors
Brain & Spinal Injury Handbook Executive Editor Lee Gatland Art Director Adrian Brown welovecreativemedia.com Sales Team Claire Hollingdale & Joanne Lewis 01959 543 659 sales@sevenstarmedia.co.uk All other enquiries contact@sevenstarmedia.co.uk
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CREATIVE
MEDIA
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PROMOTING EXCELLENCE IN NEUROREHABILITATION The Independent Neurorehabilitation Providers Alliance (INPA) was established in 2012 with the aim of improving neurorehabilitation (NR) standards in the independent sector.
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ember companies are independent forum in which to share best practice and experiences specialist health and social care NR in the sector, to discuss common challenges, and to providers for individuals affected by speak as one voice on key health issues. Acquired Brain Injury, and those with Working together with a common goal INPA long-term neurological conditions. members recently explored Members have the outcome measures currently Members have a common aim of ensuring that NR is delivered in high a common aim used across their services, to assess quality facilities, by trained and suitability for capturing the of ensuring that their experienced staff, in a caring way, to diverse characteristics of NR is delivered neurobehavioural disability, and the assist the individual’s rehabilitation process, and to provide NR in high quality effectiveness and outcomes of excellence. The members come neurobehavioural rehabilitation. facilities from around the UK and have all The project stemmed from concerns undergone an inspection process to ensure that that the measures in the UK Rehabilitation Outcomes they meet INPA’s membership requirements. Collaborative basket may not be sensitive to the Although to some extent members are in complexities of neurobehavioural rehabilitation. competition with one another, INPA provides a valuable Four measures were assessed; UK Functional
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RECOVERY & REHABILITATION
but do not yet meet the membership criteria, and a Independence Measure and Functional Assessment Partner category for those companies providing Measure (UK FIM + FAM), St Andrews-Swansea services to INPA members. Neurobehavioural Outcome Scale (SASNOS), Health of the Nation Outcome Scale (HoNOS-ABI) and the HOW CAN I JOIN? Mayo-Portland Adaptability Inventory-4 (MPAI-4). The criteria that companies have to meet in order to All the measures demonstrated that they are valid join INPA is based on standards set by means of tracking change in levels of The info the British Society of Rehabilitation impairment and disability attributable to participation in neurobehavioural generated by the Medicine in terms of goal planning, outcome measures, coordinated care, rehabilitation, especially UK FIM+FAM, study will help and the client management pathway. SASNOS and MPAI-4. The information generated by the commissioners, The company is contacted in advance to make an inspection study will help commissioners, service and clinicians appointment for its NR units, and then providers, clinicians and families gain a better understanding of the strengths, limitations and a template is sent outlining the standards required, as scope of each measure. well as examples of the evidence-base required. ■
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THREE MEMBERSHIP CATEGORIES AVAILABLE INPA’s membership structure changed recently to reflect the diversity of companies wanting to join the organisation. There are now three categories of INPA members; Standard members are companies that meet INPA’s membership criteria, an Associate category for companies who want to be full members
For further information about INPA Email: info@in-pa.org
www.in-pa.org
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Specialist Complex Neurological Care & Rehabilitation Elysium Neurological provides specialist rehabilitation and care for people with neurological illnesses, acquired brain injuries and spinal cord injuries at:
Badby Park Northampton Stanley House Herefordshire Adderley Green Stoke on Trent The Bridge Middlesbrough St Neots Cambridge
Our specialist neurological care and rehabilitation centres provide extensive facilities to cater for the specific needs of people aged over 18 years who have complex neurological care and rehabilitation requirements.
Get in touch
How to make a referral/enquiry
24hr Referral Line on 0800 218 2398 Email us at: referrals@elysiumhealthcare.co.uk
RECOVERY & REHABILITATION
NEUROLOGICAL
SERVICES
Elysium Healthcare launched in December 2016 and is a young, dynamic company with a passion for the delivery of person-centred care.
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lysium Neurological is the neuro division of Elysium Healthcare. Having acquired a number of sites over the last two years, it is now one of the leading providers of neuro care in the UK. The company ethos is very much based around sharing best practice, education, family involvement and personalised approaches. Together with rehab professionals, legal experts and charities, services work hard to drive the neuro field forward for both residents and families alike. The centres provide both neurological rehabilitation and long term complex care for people with acquired brain injuries, spinal cord injuries, progressive neurological conditions such as Huntington’s and Motor Neurone Disease (MND). Elysium delivers a high quality service which is there to support the resident group, give them the best Sharing Best Practice days and a variety of CPD events expertise, rehabilitation and quality of life pathways. to support those involved in the neuro community. This Features at their sites include fully-equipped gyms, is alongside further involvement with wider initiatives accessible kitchens, treatment rooms around Huntington’s Disease and brain Residents’ and mobility equipment. Residents’ injury awareness. The portfolio of activities include art therapy, cooking, activities include Elysium Neurological services include face yoga, craft days, excursions out, Badby Park in Northants, Stanley House art therapy, sensory and relaxation sessions, dance in Herefordshire, St Neots in and music workshops and seasonal Cambridgeshire, Adderley Green in cooking and celebration days. Staffordshire and The Bridge in face yoga The neurological therapy teams use Middlesbrough. This geographical reach advanced techniques to deliver customised enables Elysium Neurological to offer placements programmes bespoke to the individual and these are across the country and support for those families and measured through nationally accredited outcome individuals who require much needed care. ■ tools. The teams at site are incredibly dedicated, caring, knowledgeable and driven to give the best care.
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BEAUTIFUL OUTDOOR AREAS FOR SPACE IN WHICH TO RELAX
The environments offer clean, homely atmospheres including residents own artwork on the walls, and have some beautiful outdoor areas for space in which to relax, carry out activities and enjoy the visits from pet assisted therapy animals, such as dogs, cats and horses. Elysium hold annual Service User Conferences,
For further information about Elysium Healthcare’s Neurological Services please contact: Central Referral Line: 0800 218 2398 Email: referrals@elysiumhealthcare.co.uk
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Brain Injury Services Priory provides specialised, high quality, rehabilitation-focused treatment programmes for those living with an acquired brain injury or progressive neurological condition. We support individuals who require immediate post-acute support, active or slow stream rehabilitation, or continuing care.
Neurobehavioural services • Neurobehavioural rehabilitation and complex behavioural support for those managed under the Deprivation of Liberty Safeguards or the Mental Health Act • Positive behavioural support • Vocational rehabilitation • Psychoeducation • Neuropsychiatry • Neuropsychological assessment and cognitive rehabilitation
Neurophysical services • Highly specialised nursing • Complex nutritional management • Tracheostomy support • Mechanical ventilation • Speech and language therapy • Physiotherapy • Occupational therapy • Neuropsychological assessment and cognitive rehabilitation
We have 11 sites across the country. Our services are delivered within environments ranging from hospital settings to transitional living homes.
Find out more For more information or to make a referral, please call 0808 291 2162, email prioryenquiries@nhs.net or visit priorygroup.com/braininjury
RECOVERY & REHABILITATION
Neurorehabilitation NEUROREHABILITATION following an ABI FOLLOWING AN ABI Following an acquired brain injury (ABI), individuals may experience varying degrees of physical, behavioural, cognitive and social impairments. Dr Caroline Malone, Consultant Neuropsychologist, and Dr Martine Stoffels, Consultant Psychiatrist, detail two case studies with differing presentations and review the treatment programmes developed for each person.
Neurophysical rehabilitation Michelle was in Cambodia when she contracted bacterial meningitis. The infection caused an ABI, which required Michelle spending 95 days in an ICU. After she stabilised, Michelle flew back to the UK to begin her post-acute rehabilitation. Here, she was admitted to Priory Mount Eveswell, Wales. On admission Michelle was unable to stand without assistance, was anxious about home visits, her short-term memory was affected, and she had mild confusion and incontinence issues. Her multidisciplinary team, which included physiotherapy, occupational therapy (OT) and nursing, developed a tailored plan, with clear goals focusing on improving her independence and quality of life. Focusing on muscle strengthening, balance, mobility and posture, Michelle's physiotherapy team helped her to progress towards more independent movement. The OT team worked closely with her care team to ensure that her physical progress translated into everyday functional activity. Michelle’s thinking skills and anxiety were also addressed, and strategies were developed to optimise her independence. The nursing team worked closely with Michelle to improve her incontinence needs, enabling her to have her urethral catheter removed and use the toilet independently. Michelle was discharged back home after establishing continued support from her local community teams.
Neurobehavioural rehabilitation Andrew was in his mid-60s when he suffered a brain bleed, leaving him with an ABI. After Andrew stabilised and was discharged home from hospital, it became apparent that his ABI had caused behavioural and cognitive challenges. He was frustrated, confused and emotional, and was unable to remember his family or how to carry out simple tasks. Andrew was in need of a rehabilitation programme to address his memory deficits, and increase his cognitive and processing abilities. Andrew was admitted to Priory Elm Park, a specialised centre that was able to provide the support he needed. Here, he was supported to develop his daily living, processing and socialisation skills. Andrew’s programme also focused on his cognitive functioning, in particular, supporting him to remember his family. Initially, Andrew was shocked every day to learn that he had children and grandchildren, however, over time and with persistence, Andrew began to remember and engage with his family. Andrew’s transition back home took place over six months, enabling him to re-engage with his family, and for his family to build their confidence to support him at home. Andrew now enjoys retirement at home with his family and enjoys walks, DIY projects and gardening.
P: 0808 291 2162 W: priorygroup.com/braininjury E: info@priorygroup.com 11
“ “ rehab team, He’s He’s a a new new man. man. Thanks Thanks to to the the Askham Askham rehab team, we we now now have have the the “ He’s a new man. Thanks to the Askham rehab team, we now have the husband, father and grandfather we knew before he became ill, we know husband, father and grandfather we knew before he became ill, we know He’s a new man.and Thanks to the we Askham rehab team, we now have the husband, father grandfather kneware beforeamazed he became ill, we know that that he he still still has has a a little little way way to to go, go, but but we we are so so amazed at at the the progress progress husband, father grandfather before he became we know that he still hasand a little way to go,we butknew we are so amazed at theill,progress he he has has made made at at Askham Askham that he still has a little way to go, but at weAskham are so amazed at the progress he has made he has made at Askham
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Read Read Read Read
more more about about how how Askham Askham has has helped helped individuals individuals and and families families more about how Askham has helped individuals and families quality of life at www.askhamvillagecommunity.com/rehab quality of life at www.askhamvillagecommunity.com/rehab more about howat Askham has helped individuals and families quality of life www.askhamvillagecommunity.com/rehab quality of life at www.askhamvillagecommunity.com/rehab
@askhamvillagecommunity @askhamvillagecommunity @askhamvillagecommunity
@askham.rehab @askham.rehab @askham.rehab
@askhamvillage @askhamvillage @askhamvillage
regain regain regain regain
RECOVERY & REHABILITATION
A VILLAGE COMMUNITY A
Askham Village Community, working to improve quality of life through rehabilitation. skham Village Community’s state-of-the-art neurological services have a proven track record of achieving excellent patient outcomes. The powerful combination of nurse-led care and therapy-led rehabilitation with a ‘mind and body’ focus has seen Askham become a centre of choice for both goalfocussed and slow stream rehabilitation.
words would appear muddled and out of context. The psychology and SALT team then began work focusing on Mr. M’s aphasia and cognition, first using picture cards and engaging in basic picture naming tasks. Before the Christmas period, the assistant psychologist worked alongside the occupational therapist to arrange two home visits, the first supervised by staff, the second FROM MUDDLING WORDS unsupervised for 2 hours. TO SELF-CORRECTING Mr. M became orientated to time, place, date and Mr. M was admitted to Askham for a period of person through visual aids and errorless learning, and rehabilitation from hospital after contracting Herpes was able to go home for a broken period of 10 days, returning to Askham for therapy during working days, Simplex Encephalitis. Herpes Simplex Encephalitis (HSE) over the festive period. is an acute or subacute illness that causes both general Mr. M then began going home at weekends and was and focal signs of cerebral dysfunction. The exact to engage in all the activities pathogenesis is unclear, and factors The combination able that he used to love such as that precipitate HSE are unknown. of nurse-led care gardening, walking the dog, On arrival to Askham Village working on his motorbike and Community, Mr. M was disorientated, and therapy-led spending time with his family. confused and exhibited high levels of rehabilitation Mr. M was able to form complete confabulation. Mr. M would wander around the unit, believing he was there for an overnight sentences, and although at time of discharge still struggled with people and place names, Mr. M’s stay and would be returning home the following day as severity of aphasia had decreased significantly. Mr. M his “mother” would be picking him up. Mr. M was fully began self-correcting, had insight into his difficulties, mobile and able to tend to all aspects of his personal and was able to find ways to be understood if he care but required significant prompting, and was could not find the correct word. Mr. M was discharged disorientated to person, place, date and time. after 12 weeks of consistent rehabilitation and Mr. M received therapy input from the psychology returned home to his wife and dog. ■ and speech and language therapy (SALT) team. During formal psychology assessment, Mr. M showed difficulties with immediate and delayed memory as well as sustained and divided attention. It also became apparent that Mr. M was severely aphasic. With this, For more information about types of outcome-based the psychology team referred Mr. M to be assessed by rehabilitation, care and lifestyle that Askham Village the SALT team, who concluded that Mr. M was Community provides, call 01354 740269 suffering from Wernicke’s aphasia, meaning he was able or email info@askhamvillagecommunity.com. to speak in fluent sentences, however almost all of the
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Christchurch Group is an award-winning neurological rehabilitation specialist. We are proud to achieve life-changing, evidence-based outcomes for adults with neurological conditions resulting from injury, illness or disease. With rehabilitation centres in six UK locations, Christchurch Group provides neurological rehabilitation as well as specialist neurobehavioural rehabilitation, spinal injury rehabilitation, ventilated care and the management of progressive neurological conditions.
York
Lincoln
Birmingham
Northampton
Bedford Oxford
Make a referral – call 01904 430 600 or 07595 655 239 email referrals@christchurchgroup.co.uk For further information visit christchurchgroup.co.uk
LONG TERM SUPPORT
RAISING STANDARDS Raphael Hospital, rebuilding lives through rehabilitation with Exoskeleton.
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really does change lives.” his year, The Raphael Hospital in Kent The Raphael Hospital has been providing acute acquired a full body Exoskeleton in a bid to improve the quality of life for patients neurological and neurobehavioral rehabilitation services since 1956 and believes in a goal-oriented with neurological needs, harnessing person-centred approach to care and technology to promote independence. treatment. Through the use of The remarkable powered Exoskeleton This new technology, the team at the Raphael uses a system of electric motors, pneumatics, and hydraulics to provide technology has hope to improve outcomes and provide a limb movement in a range of complex a great deal of more intensive rehabilitation programme. acquisition of the Exoskeleton patients whose ability to walk psychological wasThefuelled by a desire to do more for independently has been limited by a and social people with neurological conditions neurological event. The equipment is which in turn will support the group’s designed to help people with mobility benefit research and development efforts in issues to maintain an upright posture publicising the distinct and often unrealised potential and become more mobile through the motorized of using technology to improve quality of life and “muscles” that provide strength and stability rehab potential. ■ for movement. Gerhard Florschutz, Executive Director, said “whilst the Exoskeleton provides intensive physical rehabilitation, this new technology also has a great deal of psychological and social benefit, in that users feel more independent and active and seem to want to engage more. It provides a newfound confidence Tel: 01732 833924 Email: info@raphaelhospital.co.uk and through this people realise that rehabilitation
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Specialist neurological rehabilitation Specialist neurological rehabilitation Specialist neurological rehabilitation by people that care by that people that care by people care
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HOW DO WE LEARN? Daniel Thomas
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Learning to combine our voices and drive excellence in brain and spinal rehabilitation: By Daniel Thomas, Joint Managing Director & Neurologic Music Therapist, Chroma.
ow do we learn? How do things last-ditch attempt to grab; and the prize at stake – a develop? When do tipping points and new CCG relationship or a leadership role. moments of change happen? What can Since its inception in 2013, Chroma has always been an we do right now to positively influence outward looking and collaborative organisation. Our links the brain and spinal injury rehabilitation sectors with arts therapy colleagues in this country and around across both NHS and independent providers? the world have enabled us to collaborate on many One answer to these fundamental questions might be therapeutic intervention projects across the Health to redouble our commercial efforts to align our own Education and Social Care sectors. Looking outside separate brands (Chroma, HCA Healthcare or Exemplar ourselves we ask, “What’s working around the world; for example) with the nuances and does it have an evidence base; do we intricacies of CCGs and commissioners. There are clear have patients in the UK who would That way, so this answer goes, brands are funds available to pay for it?” opportunities for benefit; fight amongst themselves for referrals One such collaboration was a project the sector and all for at-risk families with children under 5 and market dominance. Given that Private Equity finance and ownership is called Sing & Grow. Chroma partnered its providers increasingly influential within the brain the Australian creators of Sing & Grow, a and spinal injury rehabilitation sector, going it alone might program that has been government-funded since 2001, be a reasonable and instinctive reaction; much less 'All for and brought it to the UK. One of our at-risk cohorts was One', much more 'One for One'. families who have adopted children, and they responded Another answer which has its roots firmly in the well to Sing & Grow. It was often not the act of adoption physiology of brain development is to create links and that was the issue; the underlying cause of most families’ opportunities for collaboration, partnerships and talking problems was the brain and developmental damage with a shared single voice. As the brain creates synaptic caused to the child(ren) by their birth families, which led links between regions and the spinal cord sends to them entering the care system. messages around the body to recruit various functions Organisations such as the Independent for a single goal, so this collaborative answer takes an Neurorehabilitation Providers Alliance (INPA) who underlying physiological (and social) strategy and brings it represent privately owned services such as Cygnet into the organisational world. Healthcare, some of whom Chroma work with, are normally more used to dealing with brain injuries as a result of a stroke, a car crash or an incident of medical CHROMA HAS ALWAYS BEEN AN OUTWARD LOOKING ORGANISATION negligence. But within our adoption work, Chroma supports children and their families who often present There are clear opportunities for the sector and all its with similar issues to those seen by INPA’s members – a providers (NHS and independent) that arise through lack of impulse control, speech and language difficulties, collaborative approaches. What context would enable dis-regulation of emotions and challenging behaviours. organisations to step aside from their own brand for a Over the past five years the Government has recognised while and combine their knowledge, experience and the huge impact early life trauma has on the brain and passion for a single goal – driving forward excellence in development of children in the care system and did neurorehabilitation? Such a collective vision also has something amazing, which I believe can, and should be, risks attached to it, the least of which is that we all replicated within the brain and spinal injuries sector. happily work together until such time as the “prize” is Especially as the issues around ABI/TBI have been pushed too valuable for us not to make a single-minded
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RECOVERY & REHABILITATION or private resources. Families whose children contracted meningitis at birth or a father who suffered a stroke in his early 50s and believes he still has a valuable contribution to make to society and those around him would benefit. Chroma is delighted to have become a Partner member of INPA, and to be part the collective attempts that INPA, as a respected and energic umbrella organisation, are making to drive excellence in neurorehabilitation. Being a Partner of INPA means our neurologic arts therapies services have been inspected and judged to; “provide a strong infrastructure to support clinicians with regards [to] documentation, legal compliance and ongoing support and training thereby ensuring a high quality service is maintained. Chroma is committed to providing a high Chroma Art Therapy for Teenagers quality clinical service to their clients as well as accessible and comprehensive administrative support to those working for them.” to the forefront of British political life through the But more importantly for the brain and spinal injury collaboration between Chris Bryant MP and sector as a whole, Chroma aligns with the collaborative organisations such as UKABIF, INPA and the ABI Alliance way to answer the fundamental questions that started to name a few. Now is the time. this article. It is through joint working, learning to speak In 2013, Michael Gove, the then Education Secretary with a single voice and partnership working across all and an adopted child himself set up the Adoption Support Fund, or ASF as it’s become known. Over the last organisations in our sector including NHS, charitable and independent, that we can and will make a profound 6 years, the Government has provided over £125 million difference to the lives of those we exist to service and pounds specifically for the provision of therapy services support. Championing initiatives such as the Neurosuch as Chroma’s to support adopted families and their Rehabilitation Support Fund (NRSF) and supporting children. With the introduction of Fair Access Limits and influences such as Chris Bryant MP and a rigorous application process managed We can make others to engage effectively with jointly by local authority social workers policy and decision makers is one of and an independent agency, the ASF has a profound our collective key roles. The helped 1000s of families. Comments difference to the physiology of the brain and spinal cord such as these from an adopted parent shows us what is possible when reflecting on the everyday impact of lives we support connections are made and different Chroma’s therapeutic interventions structures are recruited in the advancement of a single demonstrate the value the ASF makes to families; goal – walking, talking, feeling love, anger and empathy. “Our son was noticeably calmer - especially straight Now is the time when organisations within after the sessions and the effect lasted a few days. This neurorehabilitation should come together, mirror that has had a huge effect on our family life, as there have physiology, and create a legacy of excellence and been fewer outbursts and less shouting and violence. He rehabilitative potential made good for those living with has also blossomed at school. He’s made very little the effects of a catastrophic injury and those who love academic progress in the past 4 years but now is making them. Now is the time. ■ steady progress - I think largely because he is more emotionally stable and therefore able to engage.” Focusing back on brain and spinal injury patients and their families, and the work of umbrella groups such as UKABIF and the ABI Alliance, now seems the time for us all to collaborate and jointly put to Government, For more information about Chroma Neurologic Arts currently in the form of Matt Hancock MP the Health Therapies within neurorehabilitation settings, Secretary, the vision of an Adoption Support Fund for please contact Daniel Thomas, Chroma via our sector. The Neuro-Rehabilitation Support Fund, or daniel@wearechroma.com or 0330 440 1838 NRSF as I have just named it, could provide profound www.wearechroma.com benefits for those without access to insurance pay-outs
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LET OUR FAMILY TAKE CARE OF YOURS Residential Neurorehabilitation
BAGSHOT PARK NEUROREHABILITATION 01276 450 800 KINGSTON REHABILITATION CENTRE 0203 961 6920 WWW.CHD-REHAB.CO.UK
Stroke rehabilitation Brain injury rehabilitation Specialist nursing & tracheostomy care Orthopaedic rehabilitation Long-term complex disability management
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RECOVERY & REHABILITATION
DEDICATED iioonn DEDICATED
t t a a t t i i l l i i b b rreehhaa
Established in 1984, CHD Living is an award winning, family owned operated provider Established in 1984, CHD Living is an award winning, family owned andand operated provider of of care services. With rehabilitation centres located in Greater London, CHD Living provides care services. With twotwo rehabilitation centres located in Greater London, CHD Living provides neurological rehabilitation specialist nursing care to adults over of 18 neurological rehabilitation andand specialist nursing care to adults over thethe ageage of 18
CHD Living's rehabilitation centres CHD Living's rehabilitation centres by expert GP's suported are are led led by expert GP's andand suported a Consultant by abyConsultant in in Rehabilitation, experienced in the Rehabilitation, experienced in the management of long-term conditions management of long-term conditions complex disability. Both centres andand complex disability. Both centres purpose built, state-of-the are are purpose built, state-of-the art art facilities, located conveniently facilities, located conveniently in in Kingston-upon-Thames Bagshot. Kingston-upon-Thames andand Bagshot.
Each facility a choice of private Each facility hashas a choice of private rooms, en-suite wetrooms. rooms, withwith full full en-suite wetrooms. centres wheelchair TheThe centres are are wheelchair accessible throughout accessible throughout withwith lift lift access tofloors. all floors. There access to all There are are a a number of lounge dining number of lounge andand dining facilities, which tastefully facilities, which are are tastefully decorated accessible gardens decorated andand accessible gardens to enjoy in the Summer months. to enjoy in the Summer months.
A truly state of A truly state of centre thethe artart centre forfor excellence excellence in in rehabilitation. rehabilitation.
Therapy facilities include Therapy facilities include fullyfully equipped gyms, treatment rooms, equipped gyms, treatment rooms, hydrotherapy occupational hydrotherapy poolpool andand occupational therapy kitchen. therapy kitchen.
-Esther McVey -Esther McVey MP MP Former Minister for Disabled People Former Minister for Disabled People
CHD Living's in-house highly CHD Living's in-house highly experienced MDT provides a robust experienced MDT provides a robust inpatient therapy service: inpatient therapy service: PhP y shi yost ihoet rhaepr ya p y ca u tpi a o ln T ah l eT rhaepr ya p y O cO c uc p o tni a Se pcehe c&h L&a nL g au na gg u ea gTeh eT rhaepr ya p y Spe
At CHD Living's Rehabilitation At CHD Living's Rehabilitation Centres, there a strong focus Centres, there is aisstrong focus on on facilitating possible recovery facilitating the the bestbest possible recovery of those in their care, combined of those in their care, combined withwith enabling patients to live enabling patients to live as as independently as possible independently as possible in in stimulating, home-like environments. stimulating, home-like environments.
c lhoogl yo g y P s yPcshy o
Both centres registered Both centres are are registered withwith the the Care Quality Comission have Care Quality Comission andand have been inspected rated GOOD. been inspected andand rated GOOD. TO FIND OUT MORE TO FIND OUT MORE OR OR MAKE A REFERRAL MAKE A REFERRAL PLEASE CONTACT HELEN PLEASE CONTACT HELEN Bagshot Park 01276 450 800 Bagshot Park 01276 450 800 Kingston Rehab 961 6920 Kingston Rehab 0203 0203 961 6920 www.chd-rehab.co.uk www.chd-rehab.co.uk
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RECOVERY & REHABILITATION
Personalised, goal-driven rehab for injuries of all severity levels The Wellington Hospital has the technology and experts on-hand to provide rehabilitation at the earliest opportunity‌ Neurological rehabilitation can be a challenging and complex journey for patients. To effectively rehabilitate those who may have suffered a stroke, spinal cord injury or traumatic brain injury, it’s crucial that a patient not only has access to expert-led care and the latest in evidence-based practice, but that personalised plans are created which ensure patients can advance and rebuild their life after rehabilitation. At the Acute Rehabilitation Unit at The Wellington Hospital, London (part of HCA Healthcare UK), we can care for patients from within the UK and overseas and deliver a rehabilitation programme to meet their needs, no matter how serious or complex their condition. Here they undergo a comprehensive assessment, receive a personalised treatment programme and set goals. Goal orientated, expert led programmes The unit is the largest private neurorehabilitation unit in the UK and our intensive rehabilitation programmes are led by consultants who are experts in their field. We can care for patients who are in a critical state with the support of an intensive care unit and full diagnostic capabilities.
Our consultants are supported by skilled and experienced therapy and nursing teams that include physiotherapy, neuropsychology, music therapy, occupational therapy and speech and language therapy. The patient, their family and the team work together to identify goals that are motivating and meaningful and will act as stepping stones towards a successful discharge and life beyond hospital. Specialist assistive technologies At the unit, patients can access a range of pioneering assistive technologies to support their rehabilitation programmes. This includes a Lokomat, an Indego Exoskeleton, a Functional Electrical stimulation (FES) Bike, an Armeo Spring and Bioness Hand Rehabilitation system for upper limb programmes. Outstanding clinical outcomes The unit retains an international reputation for clinical excellence. We use standardised outcome measures to track progress and to ensure that we are always delivering the very best of care. We are exceptionally proud that we have achieved CARF accreditation consistently over the last seven years, benchmarking ourselves against other rehabilitation units. This demonstration of clinical excellence makes it a first choice for patients no matter how severe or complex their condition.
Visit www.thewellingtonhospital.co.uk T: 020 7483 5348 or 020 7483 5363 F: 020 7483 5588 E: rehabilitation.wellington@hcahealthcare.co.uk The Wellington Hospital North Building, Circus Road, St John’s Wood, London, NW8 6PD
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Celebrating 20 years at the forefront of rehabilitation. Case study: Rebuild a life through rehabilitation After falling ill whilst on holiday, Sophie needed urgent medical attention. She was able to walk to the ambulance when it arrived – but that was the last time she would ever walk. A series of blood tests and scans revealed that she had suffered a cervical spinal cord stroke. Sophie was then flown to The Wellington Hospital, before being transferred to its Acute Rehabilitation Unit. She had experienced an incomplete injury, where the spinal cord is only partially damaged,
020 7483 5348 or 020 7483 5363 www.hcahealthcare.co.uk
running from C6/7 to T8 of her spinal cord. At this level of injury, Sophie was expected to have minimal use of her arms and legs. Sophie underwent an intensive six month rehabilitation programme which included the use of the FES bike, Lokomat and hydrotherapy pool. Sophie is still at the beginning of a long journey but does now have the use of her arms and hands giving her the independence to now live at home. Sophie now returns to the rehabilitation unit twice a week and she feels positive that, with a strong mind and a positive outlook, she can achieve far more than might be expected.
SUSTAINED IMPROVEMENT AFTER BRAIN INJURY
Gary has decided, with the help of his family and staff at The Richardson Partnership for Care, to tell the story of how his life has changed since his brain injury. He gives us some insight into the rehabilitation process, and what seemingly small things you can do to initiate the construction of continuing improvement and fulfillment.
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t the age of 40, Gary was the pedestrian victim of a hit and run accident and sustained a serious traumatic brain injury. After five months in hospital, he was transferred to a specialist medical unit, where he stayed for three years. He was moved to a rehabilitation unit, then to another one a year later. In 2009, six and a half years after the accident, he came to The Richardson Partnership for Care, where he has been for nine years.
had turned into him engaging in an activity and asking to remove himself when he became tired and wanted normal time out. Now Gary enjoys mixing with other people and experiencing the wider community. Bespoke, sensitive intervention The combination of these two techniques has resulted in Gary now being able to participate in communal activities such as a Headway group or an in-house activity, or joining a group of friends on a meal out. This process has only been possible by the combination of psychologists understanding his emotional and cognitive state and the staff using this information to construct a sensitive intervention, with their understanding of what this means on a practical level.
Coming to terms with his brain injury Before the accident, Gary was very outgoing and had a good sense of humour. On admission to The Richardson Partnership for Care, very basic interaction was extremely distressing for Gary. Coming to terms with his new environment, compounded by the constraints that short-term memory loss Multi-disciplinary approach affords, meant that even coming out of his Psychological support runs in conjunction room was a challenge. with Speech & Language Therapy, Gary was The care team devised a plan to which has enabled Gary to improve encourage and promote more activity. the pedestrian his communication skills and manage They discovered that Gary enjoyed a his dysphagia, both contributing to victim of a drive in the country and this raised the more effective interaction and greater possibility of outings. Very gradually, enjoyment of the social aspects of eating hit and run a stop was introduced, then a coffee, out. Physiotherapy has helped Gary accident then lunch. Then the drive was not just a to increase his strength. Occupational country drive, as the focus was lunch or coffee. Then Therapy has also enabled Gary to increase his skills in a this became an activity, and gradually Gary was able range of areas, contributing to an improvement in many to participate in other activities, such as going to a aspects of his life. Headway group. Outcome Social interaction The outcome for Gary is life changing – the difference The fear of social interaction was looked at in a between being able to share an everyday experience similar way. Initially Gary would spend ten minutes in (like having a cup of coffee) compared with wanting a communal area and gradually this was built up to to be alone all the time and distressed, should not having a cup of coffee, then lunch, and by 2014 this be understated.
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LONG TERM SUPPORT
Greg and Laur a Richardson-Che ater
Different elements of Gary’s life have combined to enable him to be the person he is today. He has improved in the following areas: l Communication l Cognition l Mood l Behaviour l Personal care l Food and nutrition l Mobility l Social interaction l General health and well-being The relationship that he has with his family has been transformed. Initially, family contact was quite difficult but he now enjoys a close and supportive relationship with his loved-ones.
Gary’s increased confidence and cognition, the trust he shows to his support staff and his willingness to engage have all contributed to a reduction in physical and verbal aggression and challenging behaviour. This reduces the risks to himself and others and means that he requires less intensive supervision. Gary’s care and support at The Richardson Partnership for Care is a fine example of how the right care and intervention can lead to sustained improvement in the quality of life for someone with a serious traumatic brain injury, even several years after they have sustained the injury and received initial treatment. ■
For more info contact the Admissions & Referrals Team Tel: 01604 791266. Email: welcome@careresidential.co.uk The Richardson Partnership for Care The Richardson Mews, Kingsland Gardens, Northampton NN2 7PW
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PUTTING THE PATIENT FIRST We work collaboratively with all stakeholders to assess their unique needs, ascertain required bespoke objectives and agree timescales for achieving them.
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For 40 years our purpose has been to transform lives and optimise the potential of those in our care. Our specialists support over 200 people each year and help to restore autonomy and support a return to community. We offer: Specialist pathways for brain injury, dementia and Huntington’s disease
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ACQUIRED BRAIN INJURY
A HIDDEN DISABILITY Authored by Katy James, Head of Brain Injury Community Service at The Children’s Trust.
Katy James
A
cquired Brain Injury considered to be a conservative one. Each year, 1.4 million people (ABI) is the leading attend emergency departments cause of mortality in with a head injury, in England and children and young Wales; between 33% and 50% of people worldwide. Thousands of these are children aged under 15 children and their families are years2. Of the large number of affected by acquired brain injury head injury presentations to every year. Statistics presented emergency by NHS England1 in Each year, departments, 90% 2013 indicated that of injuries are the condition 1.4 million considered to affected 18 in every people attend be mild3. 100,000 children in emergency provided at The Children’s Trust. There are trends England alone, with Others may be referred onto local seen, particularly an incidence of departments therapy services and receive some with TBIs: they are around 35,000 with a head support in the early stages of more likely to occur new traumatic returning home. Children who brain injuries injury, in England in boys than girls; sustain a mild injury may only the most common (TBI) per year. and Wales require minimal medical input at cause of TBIs is falls, Of this number, the time of the injury and are followed by road traffic incidents approximately 2000 were discharged home from the and sports injuries; the most classed as severe injury, 3000 as emergency department very common age groups for TBIs are moderate and the remainder, quickly with the the 0-5s (think about approximately 30,000, as mild These hidden view that they have developmental TBI which includes concussion. recovered. The milestones and the Additionally, the incidence of difficulties tendency for good news is that non-traumatic ABIs (those typically include many children, toddlers to fall) resulting from medical and teenagers. conditions such as infections, problems with including those have sustained Non-traumatic ABIs tumours and stroke) was skills such as who a severe ABI, do are usually less outlined as approximately attention and make a good initial specific to gender. 4000 moderate-severe recovery, return Some children and concentration encephalopathy per year, to their usual every young people who 500 ABIs resulting from brain day activities and go back to their have been in hospital for a period tumours, and childhood stroke previously attended school. of time following their brain injury occurring in 200-300 children The Children’s Trust Brain Injury may receive rehabilitation during per year.
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But the reality is that many mild injuries often go undetected and so this overall figure is generally 26
their hospital stay, or may be referred on for specialist intensive rehabilitation, such as that
Community Service works with a large number of children and young people with ABI who are
LONG TERM SUPPORT seen to have made a good recovery early on, but are experiencing what is often described as ‘hidden disability’ – put simply this means the physical difficulties they may have experienced at the time of the injury have resolved, in part or in full, but they have ongoing difficulties that aren’t so visible from the outside. Hidden difficulties typically include problems with skills such as attention and concentration, planning and organising, problem solving, understanding and using inferential language, memory, and emotional changes. Children and young people also frequently report struggling with fatigue and headaches, and these symptoms can be persistent, particularly if not managed well.
HIDDEN DIFFICULTIES ARE OFTEN MISSED
Typically we see children and young people present with what are described as spiky profiles of ability – some areas remain within the normal limits on standardised testing and this may mask the other problems, often making them difficult to clearly identify, particularly for those less well experienced in working with acquired brain injury. Sadly, as a result, these hidden difficulties are often missed or misattributed to other causes and the right support is often not provided. Research shows that the brain continues to develop throughout childhood and adolescence and is not fully developed until our early 20s. One of the last areas of the brain to develop are the frontal cortical regions (in the frontal lobe) which are responsible for advanced or higher level cognitive functions such as reasoning and abstract thinking, decision making and problem solving and often referred to as our ‘executive skills’. ▲
CONTINUED OVER
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▲
LONG TERM SUPPORT So, the impact of an ABI in placed on them just like their and daily activities. For example, childhood isn’t just at the time of peers, the child may not seem to manage and plan their own time the injury; changes can be seen struggle. The effects of the injury and studies and find their way over time as the brain matures might only start to appear when around a new, large school, and and the neural pathways and child turns 10 manage their networks are laid down. The or 11 (often It is important to emotions and effects of the ABI may be subtle coinciding with with social recognise that ABI deal or may not come to light until the a move to interactions and is a lifelong and injured part of the brain starts to secondary relationships in be used, or needs change. An school) when a more ‘grown dynamic condition Involved they in the example might be a five-year-old are care of a child who up’ way. with an injury to their frontal expected to make use of their In summary, following ABI a has a concussion or other type of lobes. While the child is young and cognitive and executive skills change to cognitive, motor, acquired brain injury? well supported by parents and more in order to become behavioural and social functioning teachers, with minimal demands independent with their learning If yes, we’re on hand to provide the support commonly occurs, even with more mild injuries and can impact they may need. on development, education, relationships, behaviour and We are The Children’s Trust, the UK’s leading charity self-regulation of thoughts, for children with brain injury. We work with children and young people aged 0-18 from across the UK with acquired feelings, emotions and actions. All brain injury, neurodisabilities and complex health needs of which can impact on the child delivering rehabilitation, education and community and young person’s ability to carry DELIVERED ATthrough HOME, INteams. SCHOOL, services highly-skilled Supporting children and young people with acquired out activities and participate in OR A COMBINATION OF BOTH Our Brain Injury Community Service provides them. It is important then to brain injury in the community goal-orientated rehabilitation delivered in the recognise that ABI is a lifelong and If you are a parent of aenvironment. child with a mild to moderate child’s dynamic condition, and can be so We provide: brain injury, or are somebody involved in their care, Delivered by specialists from a range of clinical backgrounds, even for a more mild injury. • clinical screening, advice the child we workBrain with the child and their family focusing on the The Children’s Trust’s Injury Community Service Positively, those around needs which result from an acquired brain injury. These areand wellonward placedreferral to support them provides advice, support and rehabilitation delivered may be social, emotional, cognitive, communicative andcompletely help themfree-of-charge implement at home, in school, a combination of both. With a andor behavioural needs. • advice, support and strategies and techniques to member of our community service basedtheinchild/young four of the Our ultimate goal is to maximise rehabilitation delivered minimise the impact of the ABI UK’s major hospitals, and a dedicated person’s participation in their everyday life. home, in school, or a■ andatits consequences.
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SUPPORT AND REHABILITATION
multidisciplinaryForteam based at our national specialist combination of both children and young people with an acquired brain • a dedicated multidisciplinary including those with a concussion, we from provide a centre in Surrey, injury, we are able to support children REFERENCES: range of support centred around the child or young teamEngland supporting children 1. NHS (2013) 2013/14 NHS right across the UK. person, including clinical screening, advice and onward referral completely free-of-charge. Subject to funding we also offer community-based neurorehabilitation Anybody can refer a child who has a suspected or skills packages delivered by our multidisciplinary team.
confirmed acquired brain injury into the service, This service initial support needed when a including concussion, andprovides we cantheprovide clinical child is discharged from hospital to home and can also screening, advice,beand onward referral completely free accessed after an initial injury or illness which, in some cases, can be many years later. This may be because of charge. For some children this may be sufficient and the effects of the injury may not be obvious for some time. no further support will be required. If additional specialist support is needed and this isn’t available Making a referral is simple, get locally, there are a number of assessments and rehabilitation packages we can 01737 365offer. 864 Delivered by our multidisciplinary community team, we will work to thechildrenstrust.org.uk/bics secure funding for these packages on the family’s behalf.
from across the UK Standard Contract for Paediatric • assessment and rehabilitation Neurosciences: Neurorehabilitapackages forNHS children with tion, England, England.
on-going needs* • a long-term register to NICE 2. Head Injury Guidelines, helpand monitor (2014) NICEsupport Clinicalneeds Knowledge at key stages. Summaries (2016)
3. Kay A & Teasdale G, (2001) Head
in the United Kingdom ininjury touch today. World Journal of Surgery.
bics@thechildrenstrust.org.uk
*subject toabout funding. the Brain Injury You can learn more Registered Charity No. 288018. TCT_422 V1 February 2019. Community Service by visiting thechildrenstrust.org. uk/bics or by calling 01737 365 864 TCT_432 Brain and Spinal Injury Handbook 2019 Full Page V0.1.indd 1
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Tel: 01737 365 864
01/03/2019 16:25:45 thechildrenstrust.org.uk/bics
Involved in the care of a child who has a concussion or other type of acquired brain injury? If yes, we’re on hand to provide the support they may need. We are The Children’s Trust, the UK’s leading charity for children with brain injury. We work with children and young people aged 0-18 from across the UK with acquired brain injury, neurodisabilities and complex health needs delivering rehabilitation, education and community services through highly-skilled teams.
Supporting children and young people with acquired Our Brain Injury Community Service provides brain injury in the community goal-orientated rehabilitation delivered in the child’s environment.
Delivered by specialists from a range of clinical backgrounds, we work with the child and their family focusing on the needs which result from an acquired brain injury. These may be social, emotional, cognitive, communicative and behavioural needs. Our ultimate goal is to maximise the child/young person’s participation in their everyday life. For children and young people with an acquired brain injury, including those with a concussion, we provide a range of support centred around the child or young person, including clinical screening, advice and onward referral completely free-of-charge. Subject to funding we also offer community-based neurorehabilitation skills packages delivered by our multidisciplinary team. This service provides the initial support needed when a child is discharged from hospital to home and can also be accessed after an initial injury or illness which, in some cases, can be many years later. This may be because the effects of the injury may not be obvious for some time.
We provide: • clinical screening, advice and onward referral completely free-of-charge • advice, support and rehabilitation delivered at home, in school, or a combination of both • a dedicated multidisciplinary team supporting children from across the UK • assessment and rehabilitation packages for children with on-going needs* • a long-term register to help monitor support needs at key stages.
Making a referral is simple, get in touch today. 01737 365 864 thechildrenstrust.org.uk/bics bics@thechildrenstrust.org.uk *subject to funding. Registered Charity No. 288018. TCT_422 V1 February 2019.
Wood Hill House ”Our Family, Caring For Your Family…”
HealthcareNursing CareHydrotherapy Day CareTherapyShort Breaks
New Care Centre! Specialist Neuro Care, Rehabilitation, Nursing and Residential Care Pathways If you would like more information give us a call, or pop along to see us and one our team will be happy to help! Wood Hill House, 524 Grimesthorpe Road, Sheffield, S4 8LE 0114 243 0983 woodhillhouse@horizoncare.org www.woodhillhouse.org
Rehabilitation
stage of a condition or stage perience, we are rooms have en-suite wet roo RECOVERY REHABILITATION porting an individual Specialist Neuro Care, Rehabilitation, Nursing and&Residential each suite has Care Pathways n individual’s overall wellbeing and As a Registered Provider working in to lounges, di fer continued engagement with the world Yorkshire, we have supported around them. We innovate in the useand tre rooms clients with wide ranging needs and of creative and design to bring the abilities through a number of areas in addit outside spaces inside, personalise rehabilitation pathways. individual spaces and offer sensory The care pathways that we therapy atrium ent areas for individuals with a high level offer are designed in partnership with of need. gym. The in-h the individual and are focused on We believe our services offer supporting individuals to achieve the ideal environment forand respite,wellbeing outcomes that matter in their lives. Our rehabilitation and recovery. They are skills services include specialist clinical care, include; designed to support pathways for hydrotherapy, multidisciplinary therapy reablement and rejuvenation andat any café, hyd and lifestyle and wellbeing support. stage of a condition or stage of life. All y, Specialist neuro In our experience, we are care, rehabilitation, nursing and residential care pathways. pool, hair and rooms have en-suite wet rooms and successful in supporting an individual each has access suites s a Registered in the suite use of creative to progress when therapy to lounges, and design todining bring the we areProvider able to offer rooms and treatment as games roo outside spaces inside, accessworking to an in areas in addition to Yorkshire, personalise individual adaptable and we and sensory h therapyand atriums and flexible environment have supported clients spaces offer sensory gym. The in-house day peop throughout with wide ranging needs areas for individuals with Outside, and wellbeing services rehabilitation and and abilities through a high level of need. skillsour kitchen relax andainclude; entertain visitors o y business our ethos recovery. number of rehabilitation We believe services and café, hydrotherapy TheFamily, care offer the ideal verandas “Our garden, in shaded aringpathways. For Your pool, hair and beauty pathways that we offer environment for respite, therapy suites as well Caring For patios. rehabilitation are designed in heart and hat ethos at the as games room, library Yourwith the partnership recovery. They are and sensory hubs. d layout of our Built inpeople flexibility is an individual and are designed support Family…” Outside, to can focused on supporting individuals to achieve pathways forrelax reablement and rejuvenation any e build in flexibility become for us, the basis for and entertain visitors onatthe roof As a familyand business our ethos outcomes that matter in their lives. stage of a condition or stage of life. All rooms garden, in shaded verandas andhave is “Our Family, Caring For Your or the people thinking and innovative pathw OurFamily…” services we include specialist en-suite wetpatios. rooms and each suite has access to With that ethosclinical at the care, heart hydrotherapy, multidisciplinary therapy and lifestyle lounges, dining rooms and treatment areas in addition ofrecover, the design and layout of our Built in flexibility isIn andaddition has hemand to;wellbeing rehabilitation. to support.we In build our experience, are to therapy atriums andforgym. in-house and environments, in flexibilitywe and become us, The the basis for day forward in supporting individual wellbeing services skills kitchen and their café,in lives in ell as,successful rebuild skillsforanor ourinclude; clients to live physical space the people to weprogress thinking and innovative pathways when support we are able to offer access to an adaptable hydrotherapy pool, hair and beauty therapy suites as to allow them to; recover, rehabilitation. In addition to supporting they want to live, a flexible and flexible environment throughout well as games room, library and recuperate as well as, rebuild skills or our clients to live their lives in thesensory way Our family, rehabilitation andskills. recovery. hubs. Outside, can relax and learn new they want to live,people a flexible rehabilitation environment su pecial attention to As a family business ethosattention is “Our to caring for your rehabilitation entertain visitors on the roof garden, in environment supports We give our special individuals to patios. maintain their o Family,ensure Caring For Yourhave Family…” shaded verandas and ave open andpeople individuals to maintain their overall openWith and family… that ethos at the heart of to thespend designtime and on Built inand flexibility is and has become wellbeing personal resilience on accessible spaces wellbeing andand personal resili s to layout spend time what often thinking be a very challenging of our environments, we spaces build in flexibility for us, the basis forcan forward innovative their own. We on also offer to rehabilitation and recovery journey. and physical space for people support pathways in rehabilitation. In addition tobe supporting welcome friends familywe and the to what can often a very cha so offer spaces to theand wider to; community into their personal allow them recover, recuperate as well as, rebuild our clients to live their lives in the way they want to and recovery jo and family the space. At the same time, we create skills or learnand new skills. live, a flexiblerehabilitation rehabilitation environment supports safe and secure locations and gardens individuals to maintain their overall wellbeing 0114 and 2430983 into WE their personal where familySAFE and friends can be personal resilience on what can often be a very CREATE LOCATIONS info@horizoncare.org confident loved ones protected challenging rehabilitation and recovery journey. ■ We give special attention to are ensure people have open me time, we create www.horizoncare.org from harm. Wetomake use of and accessible spaces spendimportant time on their own. We ocations and gardens inside and outside spaces to support also offer spaces to welcome friends and family and the wider community friends can be into their personal space. At the info@ same time, we create safe and secure locations and nes are gardensprotected where family and friends can be confident ones are protected from harm. We make www makeloved important use of important use of inside and outside spaces to support Tel: 0114 2430983 Email: info@horizoncare.org individual’s wellbeing and continued e spaces tooverall support www.horizoncare.org
ENVIRONMENT DESIGN IN RECOVERY AND REHABILITATION
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engagement with the world around them. We innovate
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ABI ALLIANCE CONTINUES
REHABILITATION PRESCRIPTION CAMPAIGN
As part of its ongoing campaign for the use of Rehabilitation Prescriptions (RPs) in the management of Acquired Brain Injury (ABI), the ABI Alliance is now supporting the recently revised version RP2019, which is now available for children as well as adults.
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he ABI Alliance believes that every The RP is a valuable tool that documents child, young person and adult with an comprehensively the NR needs of the individual with an ABI should have an RP, on discharge ABI and identifies how those needs will be addressed in from hospital, and a copy sent to their the longer term. An effective RP improves the General Practitioner (GP). This will then provide a communication along the care pathway and optimises useful resource for the GP to work access to NR services. Post-discharge the The RP is a individual and their family/carers should with the individual and facilitate access to neurorehabilitation (NR) valuable tool have a copy of the RP, an appointment services in the community, leading to the GP to discuss its contents, and a that documents with maximised health outcomes. plan for accessing the rehabilitation needs of the The ABI Alliance launched this ongoing services as detailed in the RP. campaign in April 2018, highlighting the Previously Major Trauma Centres individual role of the RP in the management of (MTCs) were incentivised to complete adults with ABI. The Clinical Reference Group (CRG) for RPs but often neither the individual with the ABI or the Major Trauma recently reviewed the format and use of GP received a copy, so access to NR services could not the existing RP and announced the new version RP2019, be planned effectively or implemented. The incentive available for children and adults. for RP2019 completion is still limited to MTCs so it remains to be seen if individuals treated TABLE 1: Core items to be included in RP2019 for adults and children outside a MTC will receive an RP.
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Patient demographics
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Safeguarding assessment relating to circumstances of the injuries
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Actions for the GP and/or community paediatrician team plus parents/carers
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Actions for the GP and patient
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List of relevant injuries
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Management list for each injury
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Ongoing rehabilitation needs
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Services that patient has been referred to
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Services that the patient has been referred to including an educational plan
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Contact number for advice
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Section where patients can record comments
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Section where the patient and/or parent or carer can record their comments
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RP2019 OVERVIEW FOR ADULTS AND CHILDREN
The Major Trauma RP 2019 has two versions; one for adults and one for children. For the purposes of the new RP, individuals injured before their 16th birthday should have the children’s version. The RP stipulates that a rehabilitation assessment should take place within 48-72 hours of the patient’s admission and has to be completed for all major trauma patients who need rehabilitation at discharge. All major trauma patients will require an evaluation of their rehabilitation needs and this process must be recorded on the Trauma Audit and Research Network (TARN). If
RECOVERY & REHABILITATION which recently launched its report ‘Acquired Brain Injury and Neurorehabilitation: Time for Change’. The report outlines the critical role of NR in the ABI care pathway, and the need for RPs for all brain injury survivors following discharge from acute care so they know what NR they need. The report reviews the implications for children and young people with ABI when most of their NR takes place in the education system. The high incidence of ABI amongst offenders is discussed, as is the impact of neurorehabilitation on behavioural change and reoffending. The current issues in sport-related concussion are outlined as well as the need for an improved welfare system that is easily accessible. The report summarises the key issues and makes a number of crucial recommendations. Chris Bryant, MP and Chair the patient is found to have no rehabilitation needs, of the APPG on ABI called for action: “ABI impacts on the full rehabilitation prescription outlined below does many government departments so a task force is not need to be completed and the patient is still required to address the issues and recommendations eligible for the best practice tariff. as a matter of urgency. The APPG on ABI intends to The RP must contain core items (see Table 1) and be unite all the departments involved in order to drive developed with the involvement of the individual and/ change for brain injury survivors”. or their family/carers, and administered by a specialist Copies of the report can be obtained health care professional in rehabilitation. One of the key from: www.ukabif.org.uk/ The RP should be completed by health APPGreport care professionals after a objectives of multidisciplinary team assessment and the ABI Alliance ABI ALLIANCE CAMPAIGN signed off by senior staff members; at a minimum, a consultant or specialist is to increase ACTIVITIES Established in 2016, the Acquired Brain trainee in rehabilitation medicine, Band-7 awareness Injury (ABI) Alliance is a collaborative specialist rehabilitation clinician or major venture between charities, professional groups and trauma co-ordinator. It can be provided as a single industry coalitions who all work in the ABI sector and document for both the patient and professionals, or as provides a collective voice for people with ABI, their two separate documents to be given at the point of carers and those working in the field. ABI Alliance discharge. MTCs will be asked to provide templates of members will continue to identify opportunities to their documentation to the CRG and an audit of the RP speak at meetings about RP2019, raise awareness will form part of the national peer review in 2019. amongst key health professionals and government, educate primary care about the need for NR, and ‘TIME FOR CHANGE’ APPG ON ABI REPORT utilise the media to communicate key messages. ■ One of the key objectives of the ABI Alliance is to increase awareness of ABI and seek improvements in the support and services for those people directly affected by ABI, and also for their families and carers across the whole of the United Kingdom. The For further information please contact Alliance used its expertise to feed information into info@abialliance.org the All-Party Parliamentary Group (APPG) on ABI
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SPINAL INJURIES ASSOCIATION LEADS THE WAY FOR
SUPPORT FOR SCI PEOPLE
We are the Spinal Injuries Association (SIA), the expert voice and leading source of support and information to people with spinal cord injury and for over forty years, we have been helping spinal cord injured people throughout the UK lead fulfilled lives.
W
e provide support to both more people across the UK that will suffer a SCI people and their spinal cord injury every year is stark. However, families, as well as it is not just the increased numbers; it is the representing the wider decreasing provision of specialist services SCI community to Government and other alongside that, that is truly shocking. The NHS decision makers. and wider government must dramatically From the moment of injury and increase vital and extremely specialist health Written by throughout their lives, SCI people, their care and support to the 2,500 people each year Sophie Davis families and carers want expert advice and who have to come to terms with a life of support. However, often they do not know where to paralysis from spinal cord injury. We will not stop fighting turn. And, with our advice and support, we show until that change in investment happens.” people that they are not alone. We are also incredibly WHAT IS SPINAL CORD INJURY? proud to be a user-led organisation that reflects the The spinal cord can be damaged by either accident or views of our 10,000 members. injury, because of another health condition such as a NEW ESTIMATES tumour, or is diagnosed at birth. Just over LAUNCHED SCI people half of all new cases result from injury In the UK there are around 50, 000 people whilst the rest are due to infections or also have to with a spinal cord injury and around 2,500 tumours of the spine. face inequality are injured or diagnosed each year – one For many this is a life changing and every eight hours. permanent disability that causes paralysis and adversity Recently new estimates showed that and loss of sensation below the level of the number of people paralysed by a spinal cord injury is injury. This results in, for example, being unable to walk or much higher than previously estimated and because of have control over bladder or bowel function. Those with this, SIA is calling on all government departments to a higher-level injury may also have limited or no hand and ensure that every spinal cord injured person has the care and support they need and deserve to lead a fulfilled and independent life. Using the NHS’s own statistics, as well as data from other countries, the charities estimate that the number of people injured or diagnosed with a life-changing spinal cord injury in the UK is 2,500 per year, whilst the total number of people living with a spinal cord injury in the UK is 50,000. Previously it was widely believed, including by the NHS itself, that only 1,000 people were injured or diagnosed each year and that the total number of people living with a spinal cord injury was 40,000. Nik Hartley OBE, Chief Executive of Spinal Injuries Association said, “The revelation that there are hundreds
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LONG TERM SUPPORT
arm function, or be reliant on a ventilator to breathe. However, for some it means retaining their ability to walk, but they experience other complications. The news that some may never walk again or have control of their bowel and bladder is devastating. SCI people and their families and friends will also have to come to terms with the psychological impact of sustaining a life-changing disability that affects every aspect of their own lives and those closest to them. Alongside others with disabilities, SCI people also have to face inequality and adversity. The inaccessibility of buildings and transport, discrimination, poor care packages and an assumption of mental incapacity are just a few of the challenges faced by SCI people in their lives. Nonetheless, SIA believes that with appropriate support, SCI people can and do lead fulfilled lives, making a worthwhile contribution to society and family life.
HOW WE CAN HELP
OUR SUPPORT GOES A LONG WAY
SIA Member Miranda Jenks sustained her spinal cord injury when she was 21 and after six weeks in a District General Hospital, she was discharged home with little information. “Being in hospital was a really scary time. I was a young woman surrounded by old people, and there was certainly no peer support available. “I was feeling lost and alone and was searching for information,” says Miranda Jenks on the search that led her to SIA. That search took her to SIA’s Freephone Advice Line and finally to SIA’s Peer Support Officer for the West Midlands, Paul Rhodes. “Sometimes I wonder where I would be now if I hadn’t picked up the phone that day. It is so nice just to know that he is there – and he has so much knowledge and experience! It’s just been amazing.” Our Peer Support Team, who all have personal experience of SCI, help newly injured people from the moment of injury or diagnosis, through their CONTINUED OVER
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● Our Peer Support Team, who all have personal experience of SCI, help newly-injured people from the moment of injury or diagnosis, through their rehabilitation and beyond. They also support those with longer established injuries. ● Our Public Affairs Team campaigns for change and fairness, lobbying Government and other decision makers, as well as an Advocacy Team that supports health and social care. ● Our SCI Nurse Specialists help drive improvements to the quality of care and nursing standards across the SC community.
● Our Freephone Telephone Advice Line receives over 1,600 calls a year on a wide range of topics from access to specialist rehabilitation, to benefits information. ● Our bi-monthly magazine, FORWARD provides the SCI community with a wealth of information on topics including health, daily living and employment. ● Our SIA Academy provides education and training for professionals, including study days, competency training and training days for solicitors, caseworkers and expert witnesses.
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LONG TERM SUPPORT
rehabilitation and beyond. They also support those with longer established injuries. Spinal Injuries Association (SIA) is the leading national user-led charity for spinal cord injured (SCI) people. We understand the everyday needs of living with a spinal cord injury, meet those needs by providing services to share information and experience and campaigning for change, ensuring each person can lead a full and active life. ● The number of people being injured or diagnosed each year in the UK with a spinal cord injury is now estimated to be around 2,500 – 35 per week. Previously the estimate was 1,000. ● In the UK, it is now estimated that there are around 50,000 people living with a spinal cord injury. Previously
the estimate was 40,000. ● The annual NHS Specialised Spinal Cord Injury Services Annual Statement has now been published for the last two years. In 2017/18 (the most recent year for which we have full statistics), 2429 new patients were referred to the eight specialist centres in England and there were 864 new admissions. However, many more people with a spinal cord injury are not referred at all and do not benefit from the specialist care and support available. ● Whilst we know we will never have a precise figure, we have used a variety of sources and methods to triangulate the yearly incidence of SCI as well as the size of the total population. This has included an examination of the NHS’s own national statement, discussion with NHS statisticians, consultants as well as looking at comparative international studies which give incidence and prevalence per million of population. ■
Freephone Advice Line: 0800 980 0501 Email: sia@spinal.co.uk Registered Charity No. 1054097
www.spinal.co.uk
Providing bespoke care nationwide for clients with spinal injuries and neurological conditions
Your Life, Your Care, Your Team Total Community Care is not like other care providers. Our team of professionals has extensive experience in complex care provision, helping clients achieve lifestyle goals. This approach places you firmly at the centre of your care package, giving you control of your life back.
Get back control of your life. Call us today to find out how we can change your life. T: 01858 469790 E: Sarah.Tennent@totalcommunitycare.co.uk W: totalcommunitycare.co.uk
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queen elizabeth’s foundation for disabled people
Specialised Neurological and Respiratory Care Services AT HAWTHORNS CARE CENTRE Hawthorns Care Centre provides care and rehabilitation services for those who require Specialist and Complex Neurological and Respiratory Care. At the heart of the Hawthorns team is a shared passion to provide the best care possible for each individual. We enable individuals to regain control and independence where possible and ensure that not only the individual, but their families and friends, are supported through challenging times. Our approach to care is to provide a safe, homely environment in which our clients can achieve their maximum potential.
We facilitate this through open and honest communications with the client, their families and all healthcare professionals involved. Regular MDT meetings in which goals are set and reviewed enable us to ensure we are meeting the individual needs of our clients, using a holistic approach to their rehabilitation journey. Hawthorns Care Centre O’Neill Drive, Peterlee, SR8 5UP 0191 587 1251
www.barchestermentalhealth.com/Hawthorns
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YOUR QUESTIONS
ANSWERED PJ Care have just been named by the Sunday Times as a Top 100 Company to Work For. We caught up with the team behind the care centres for 10 minutes to get some of our questions answered…
PJ
Care is an award-winning care provider with two centres in Milton Keynes and one in Peterborough. They offer specialised care for individuals aged 18 onwards with degenerative and acquired neurological conditions. Specialist Neurological Care is a complex field tell us in a nutshell what you do? The residents we care for in our three Centres are individuals who cannot be supported in nursing homes and traditional care centres due to the intricacies of their conditions and challenging behaviours. This is why our service is so important to so many and why we
care for people from all over the UK and beyond. And what do you specialise in, what sort of conditions do you care for? We care for a huge range of conditions from Dementias, Huntington’s disease, Multiple Sclerosis and Korsakoff’s Syndrome, to acquired and degenerative conditions such as road traffic collision injuries and Stroke. Our care models allow us to care for individuals from age 18 and onwards, through to end of life care. So if you’re not a traditional nursing home, what could someone expect when visiting one of your centres? We encourage visitors and think it’s great to be given an opportunity to help more people understand what we do here. All our units (there are four in Peterborough and three in Milton Keynes) have their own character – colourful, bright and airy with access to gardens and outdoor spaces – and residents are involved in decorating their ensuite rooms to ensure it feels like home. Our centres are their home, whether it be permanently or for a short period of time. It’s important everyone feels comfortable and happy. And what does day-to-day life look like in one of your centres – for both staff and residents? Every day is different and having an in-house multidisciplinary team means we are flexible enough to adapt to anything. The benefits of having our own Dietician, Neuropsychologist, Neuropsychiatrists, Speech and Language Therapists, for example, are far-reaching. Facilities are important too. In Eagle Wood, we have a Hydrotherapy Pool, Occupational Therapy Gym and Kitchen and Sensory Rooms. What this all means for our residents is they receive the care they need, when they need it, without the time and resource constraints we see elsewhere. It’s not all work and no play here, though. We have dedicated activity teams who put together
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LONG TERM SUPPORT
individualised activity plans for each resident based on their hobbies and interests. We regularly enjoy trips out, be it to the theatre, beach or just to the local café for a coffee and a change of scenery. Our aim is to enable people to live life to the fullest and maximise their capabilities. And as for our staff… they are simply all passionate about care and what we do. We are privileged to be entrusted with the care of others and we do not take that responsibility lightly. Care is at the heart of all we do and we’ve received countless awards for our commitment to training, investment in people and end of life care.
decision can be made as to whether our care is right for someone or not. Pricing is decided based on individual needs and the support they will require from our skilled team. Some residents may be privately funded while others have NHS Continuing Healthcare funding in place which covers the cost. No matter the funding route, we will provide a quote post-assessment. We’re here throughout the entire process to support and have a wealth of experience in this area.
Thank you for giving us more insight into your busy world. If anyone needs more information or wants to speak to you, how can they get hold of you? So, this all sounds amazing – but what We have Thanks for speaking to us! Lots of ways – we have a website: www. about the cost? How much is it, who a dedicated different pjcare.co.uk email: enquiries@pjcare. pays, and how do people get to stay in Referrals and co.uk or people can call 0330 20 20 304 one of your centres? Naturally, we get asked this a lot! The Placements for advice or to request a brochure with even more information about our centres. challenge for us isn’t getting people to Team You can reach our Referral and understand the value we add to people’s Placements Team on 0330 20 20 305. Like you said, lives, but to understand how it all works. We have a our world is busy and we’re ever-growing so if people dedicated Referrals and Placements Team and their job are looking for a career in healthcare they can check is to speak to anyone who needs help understanding the job section of our website for opportunities or anything relating to our service or the general provision call our recruitment team: 0330 20 20 306. ■ of care for neurological conditions. We are also very mindful of the challenges and stress the process of a loved one moving into a care home can cause, so it is good to have a direct line to someone who can provide advice. In terms of funding, it all depends on the situation of the potential resident. Once we’ve received a referral (this can be from Tel: 0330 20 20 304 Email: enquiries@pjcare.co.uk anyone e.g. a family member or an NHS Commissioner) www.pjcare.co.uk and gather the information required to assess, a
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CHILTERN NEURO & MEDICAL SERVICES
NEURO & MEDICAL SERVICES
Neuro Physio Wales Ltd is a team of Our mission isNeuro to work hand experienced specialised physiotherapists. inWe hand with our clients, offer bespoke rehabilitation fortheir all neurological conditions both in our clinic and families and carers to create in your own home across South Wales.
tailored treatment plans that At Neuro Physioquality Wales we pride ourselves maximise of life and on providing high quality customer service promote greater and treatment that aims to maximise our independence clients quality of life and promote their greater independence.
For more information www.neurophysio-wales.co.uk call the clinic on 01656 858865
www.neurophysio-wales.co.uk 01656 858865
Providing award-winning, evidence-based Neuro and Medical Music Therapy services across the UK.
Brain injury, prolonged disorders of consciousness, neonatal and birth injuries. One-to-one assessments, treatment and home programmes. Full-day services in hospitals, care homes and rehabilitation units.
www.chilternmusictherapy.co.uk t: 01442 780541 e: info@chilternmusictherapy.co.uk Chiltern Music Therapy Community Interest Company No. 7702358
Hobbs Rehabilitation Specialist neurological rehabilitation for adults and children across the south of England - Residential, Outpatient, Community Rehabilitation - Neurotechnology - Research & Development - Clinical Education Specialist neurological physiotherapy, occupational therapy, speech and language therapy and neuropsychology as well as neurotechnology, music therapy and orthotics hobbsrehabilitation.co.uk 40
RECOVERY & REHABILITATION
LOOKING FOR A NEURO SUPERHERO? Find one at our multi-disciplinary neuro rehabilitation One Stop Shop Alastair White, Business Development Lead – Neural Pathways
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eural Pathways is an independent business We begin this process by listening. We listen to the providing life changing rehabilitation for people client, the people who love and support them and of all ages with complex neurological needs. the people who care for them on a day to day basis. Having started in 2003, we are now proud to We also listen to people who have worked alongside be one of the UK’s national the client including the wider leading providers of high quality Always working team of agencies and services that inter-professional neurological might have helped them on their to, and having my rehabilitation journey. rehabilitation. We build our reputation on our We aim to see the bigger picture best outcome as ability to identify an individual’s without missing the smaller details. the main focus of We will continue to listen to the potential to change at any stage of their rehabilitation journey. We client and the people around them our sessions then deliver flexible and integrated during their journey and will make NEURAL PATHWAYS CLIENT therapy, building bespoke and sure that the client understands sustainable rehabilitation around their rehabilitation and feels each individual according to their needs. central to all decisions that are made. Our team are community based, providing At Neural Pathways we make the complex simple. meaningful therapy wherever the person lives. We aim to work seamlessly across boundaries, www.neural-pathways.co.uk working alongside the family, carers and the wider info@neural-pathways.co.uk rehabilitation team, to ensure each person’s goals are Life Changing Rehabilitation Telephone: 0333 0069015 realistic and solutions focused.
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At Neural Pathways, we make the complex simple. Our superheroes provide life changing rehabilitation for people of all ages with complex neurological needs. Choose a therapist or join our team and help our clients reach for the sky. We provide: Physiotherapy, Occupational Therapy, Speech & Language Therapy, Psychology and Dietetics. Life Changing Rehabilitation
www.neural-pathways.co.uk 41
THE USE OF
SAEBO DEVICES IN REHABILITATION
The upper limb – often a deficit in neurological conditions, is frequently cited as the number one limitation in return to functional activities. Why therefore is it also often under rehabilitated?
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he upper limb He is a 68-year-old gentleman needs movement, who was involved in a road facilitation and traffic accident in 2015. He repetition in order sustained an incomplete spinal to recover. Patients will often cord injury at C4 which resulted need multi-modal in tetraparesis. Prior to his injury, rehabilitation in order to truly he was active, visited the gym optimise upper limb frequently and walked his dog The SaeboMAS , a gravity rehabilitation. Therapists will 4-6 miles per day. He had joint eliminating device get best results from upper stiffness with reduced range of limb rehabilitation by utilising a box of tricks. In movement in his shoulders, wrists and hands. There order to get the number of repetitions that was some activity in his upper limbs but this was patients need to see recovery, it is necessary to minimal and not through range. He utilised a utilise technology and adjuncts tenodesis grip. to allow not just repetition of movement, but On discharge from hospital, he had an intensive repetition of good quality movement. programme with physiotherapy and occupational therapy involvement for his upper limbs. He started with a programme of daily stretches and strengthening CASE STUDY exercises which he could do with his carers. He also had In this case study, this patient was only able to integrate his upper limb into activity or exercises with hydrotherapy twice a week. hands on assistance from therapists or his care team. It became apparent that the gentleman, who was He was getting increasingly frustrated highly motivated for rehabilitation He started would benefit from the about the lack of chance to practice introduction of further using his upper limbs and also the with a programme dependence of having someone else adjuncts. A Gloreha of daily stretches to physically assist him with every device was introduced for passive movement of the repetition. At the same time as this he and strengthening hand with visual and had an initial lack of motivation to exercises auditory feedback. attempt upper limb activities with assistive devices.
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RECOVERY & REHABILITATION
improvements in scores of The Saebo MAS , a gravity eliminating device for both ARAT and SCIM. The upper limb rehab, was trialled before purchasing to client was able to access the incorporate into his rehab. By reducing the effect of hydrotherapy pool using steps gravity with the Saebo MAS , this gentleman was able and upper limb facilitation rather to start more independent practice for range, strength than a hoist. There was increased training and task training. active and passive range in his upper The Saebo MAS was introduced to allow practice limbs with reduced pain. The client had of upper limb movements on multiple planes. It was increased motivation and engagement in initially introduced with zero gravity level to facilitate upper limb activities, grooming, self-care, and challenge the weakened shoulder muscles. eating and drinking. He was also able Carers were trained how to effectively There was to grasp and release his rollator frame fit the device so that daily use could be encouraged. It allowed the client to increased active independently where he previously assistance to manipulate his practice self-care and functional tasks and passive range required hands onto the frame. which had relevance. The Saebo MAS in his upper By using a wide variety of allowed joint working with technologies and adjuncts, an intensive, occupational therapy. It allowed limbs with graded, customised programme can be progression of relearning normal reduced pain tailored to suit individual needs. The movement patterns through highly inclusion of the Saebo MAS and Saebo Glove meant that repetitive task orientated drills. It was used in sitting repetition could be integrated with relevant activities and standing. We were able to change the resistance on the Saebo MAS in order to strengthen proximal and which engaged and motivated the client. ■ distal muscles through range. Written by Anna Wilkinson, Physiotherapist TAILORED TO SUIT INDIVIDUAL NEEDS and Managing Director of More Rehab Once the Gloreha had encouraged increased hand movement, Saebo Gloves were introduced to allow further practice of hand rehabilitation exercises. These light weight, dynamic orthoses allowed assistance at the finger and thumb joints with extension and allowed carry over to be established with further repetition of active hand exercises. For further information about Saebo With the integration of this technology it Tel: 01707 323 633 Email: ukinfo@saebo.com demonstrated improvements in thumb to finger uk.saebo.com opposition, hand grasp of a small object and
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LEADERS IN
No Plateau in Sight
NEUROLOGICAL REHABILITATION
Some of our leading products available on a 14 day money back guarantee COMING SOON
SaeboGlove
SaeboStim Micro
SaeboStim Go
SaeboStretch Saebo MAS Mini
ONLINE SHOP NOW OPEN Call 01707 323 633 Email ukinfo@saebo.com or visit uk.saebo.com for more information 44
follow / like / link / look / watch
RECOVERY & REHABILITATION
ON A MISSION!
STEPS Rehabilitation is a purpose-built, state of the art facility set in South Yorkshire, serving clients from the UK and overseas.
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e deliver intensive 7 day rehabilitation pathway as well as independent living trials. rehabilitation for people recovering We offer individualised rehabilitation packages, from neurological conditions, spinal including the only residential amputee rehab cord injuries, traumatic brain injuries, programme in the UK in partnership with Blatchford. orthopaedic and complex trauma We also offer a pain management injuries, enabling them to reach their full We offer programme and we are able to care for potential. We provide residential and with complex nursing needs. individualised people day rehabilitation packages. We accept referrals from clients, rehabilitation clinicians, solicitors and case managers. Our mission is to achieve the highest levels of recovery by providing intensive Please see our online referral form on our packages therapy, delivered by a carefully chosen, website. We would be happy to discuss specialist team of professionals, working in real any questions you have about possible referrals. partnership with individuals and their families, STEP by STEPS is a ‘centre of excellence’ for neurological and STEP along the journey to recovery. complex trauma rehabilitation, working to ensure there STEPS has 23 ensuite bedrooms, therapy gym, is a place to go for anyone who is as determined as we hydrotherapy pool, skills kitchens, games room, music are, to reach their maximum potential. ■ room, café/dining space and beautiful gardens in a non-clinical, comfortable and homely environment like no other care facility you will have visited. Four bedrooms form our transitional living unit and we also have one independent/supported living apartment. For general enquiries call 0114 258 7769 Together, they enable us to provide the complete
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STEPS is a dedicated and specialist residential and day rehabilitation facility for neurological conditions, stroke, spinal cord injury, acquired brain injury, orthopaedic and other complex trauma injuries. Complex nursing care & specialist therapy team: • physiotherapy • occupational therapy • speech and language therapy • psychology • neurologic music therapy vestibular rehabilitation / residential amputee programme / spasticity management functional electrical stimulation (FES) acupuncture / pain management programme independent living trials in house hydrotherapy pool
www.stepsrehabilitation.co.uk Alexander House, 30 Troutbeck Road, Sheffield S7 2QA enquiries: 0114 258 7769 email: hello@stepsrehabilitation.co.uk
> dmo> sock dmo sock
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DM ORTHOTICS CORE PRODUCTS FULL PAGE A4 + BLEED APRIL18_Layout 1 16/05/2018 15:26 Page 1
Dynamic Movement Orthoses Dynamic Movement Orthoses
DM Orthotics have successfully provided a range of Dynamic Movement Orthoses to both children and adults for over 10 years, with our orthoses DM Orthotics have successfully provided a range helping to manage the physical effects of a variety of Dynamic Movement Orthoses to both children of neuromuscular conditions. and adults for over 10 years, with our orthoses Strategically placed panelling on our orthoses correctly aligns helping to manage the physical effects of a variety the body and stimulates sensory systems throughout the body. of neuromuscular conditions.
All of our orthoses use elastomeric fabric with the single goal to improve function andpanelling encourage for the user. Strategically placed on independence our orthoses correctly aligns the body and stimulates sensory systems throughout the body. All of our orthoses use elastomeric fabric with the single goal to improve function andabout encourage independence forat the user. Find out more our products
www.dmorthotics.com Find out more about our products at www.dmorthotics.com DESIGNED AND MANUFACTURED IN THE UK DESIGNED AND MANUFACTURED IN THE UK
live your life. live your life.
ŠCopyright 2018 DM Orthotics Ltd. Patents and design regulations apply.
RECOVERY & REHABILITATION
WHY SUPPORT MAKES ALL THE DIFFERENCE
“I can achieve what I want to now,” said Chloe, an active teenager who loves ballet and drama. “My condition doesn’t dominate my life – it doesn’t define who I am.”
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ot so long ago, that wouldn’t have seemed possible. Aged 11 and crippled with pain from the curvature in her spine caused by Scoliosis, Chloe found it hard to just get dressed. “There was very little information about the condition,” said Chloe’s mum, Jo. “We saw a spinal surgeon and were told there were no alternative treatments and that surgery would be the only option once Chloe got older. “We searched for something that could help her as she was in agony. She had physiotherapy for a while but, by their own admission, physiotherapists aren’t specialists in Scoliosis. I found DM Orthotics later, through someone whose son had been receiving Lycra Orthosis treatment for a different problem. They were supportive about Chloe’s situation and arranged for me to meet Martin.” Martin Matthews is a Clinical Specialist Orthotist who founded DM Orthotics in 2005. The company has been designing, manufacturing and distributing made-tomeasure dynamic movement orthoses for children and adults (DMOs) worldwide ever since.
A WORLD LEADER IN MEDICAL REHABILITATION
“Working with Martin on such a personal level was an amazing experience for us. He recognised that Chloe’s needs were unique and for the first time we felt listened to,” said Jo. “We felt we could trust him and his team and what they were hoping to do. “The Scoliosis Suit has had an amazing effect on Chloe’s life. It was wonderful to see how the pain left her face when she was wearing it – as a parent, you never want to see your child suffer and seeing her able to get back to doing normal things was just incredible.” Chloe herself couldn’t be happier with the bespoke support that the orthosis provides. “I was so excited when I saw the suit but it was so small I wondered how I was going to get into it,” she said. “It was a little strange at first and threw my balance. Martin reassured me that this was the precise result we were after – the suit was working as it should, re-aligning
my spine and training my muscles to act in a new and corrected way. I soon got used to it and now feels like another layer of skin. “I found it really positive that the Lycra makes you use your muscles - unlike a structured brace - and it doesn’t affect your appearance. That’s really important when you’re a teenager. Combined with physiotherapy, the Scoliosis Suit has enabled me to stand more upright, improved my balance and given me greater confidence.” Now a world leader in medical rehabilitation and sports performance innovations, DM Orthotics has recently launched a revolutionary new product. Developed and researched over the last fifteen years to correct the effect of conditions such as drop foot, the DMO Medical Flexi-trode FES system allows users to walk more naturally by combining a specially made orthotic sock with neuromuscular electrical stimulation to help lift the foot. “The effectiveness of Flexi-trode comes from the complimentary way in which the two parts of the system work together,” said Dr Lane who has given masterclasses on the subject at the Naidex exhibition and, most recently, at the European Neuro Convention. “The DMO Dorsiflex Sock provides stability to the ankle joint at heel strike and the neuromuscular stimulation assists with lifting the foot to make walking easier and more natural.” Working with the NHS, the private sector and a number of Paralympians, DM Orthotics provides free training to qualified orthotists, physiotherapists and occupational therapists. “It’s a real privilege to be able to help people like Chloe live their lives to the full,” said Martin Matthews. “Even better, she won’t need surgery and, before long, since it’s done its job, she can stop wearing the suit.” ■ Chloe
For more information, visit
www.dmorthotics.com 47
SEEING POSSIBILITIES NOT BARRIERS OCCUPATIONAL THERAPISTS PHYSIOTHERAPISTS SPEECH AND LANGUAGE THERAPISTS REHABILITATION NURSING
At United Rehab Solutions Ltd our team of specialist physiotherapists, occupational therapists, speech and language therapists, nurses and therapy assistants work innovatively to provide bespoke transdisciplinary rehabilitation to adults, adolescents and children who have suffered catastrophic injuries as a result of an accident or medical negligence. Our rehabilitation packages offer more than just a therapy assessment and treatment plans. Through utilising our knowledge, the client’s experiences and tried and tested outcome measures, we are innovative and creative in our methods of achieving the desired outcomes. Being innovative, creative and bespoke in our methods of delivering our therapy is what drives us as a team. Some of the services that we offer include:
Communication and alternative and augmentative communication Spasticity management, splinting and casting
Minor and major adaptations, specialist equipment and environmental controls Vocational rehabilitation
Occupational health assessments ADL assessments
Postural management
Cognitive assessments and rehab Counselling and psychotherapy
Seating and wheelchair assessments
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Hydrotherapy
Acupuncture, Indiba Activ® radiofrequency treatment, FES
Respiratory and tracheostomy care and management
Swallowing and feeding Handwriting
Sensory integration
Functional neuro rehab e.g Bobath Training for families, carers, employers, schools
http://unitedrehab.solutions hello@unitedrehab.solutions 01745 583 156
OUR CLIENT:
Gentleman in his late 30s with a traumatic brain injury and orthopaedic injuries
Use of Indiba Active® Radiofrequency device and serial casting to increase joint range
Team approach to a 24-hour postural management routine that included seating, bed, activity.
Use communication to monitor pain & mood.
Tailored activities to previous employment, likes and dislikes to encourage responses and to provide leisure opportunities.
Diagnosis was persistent disorder of consciousness, overall low tone, no communication and inconsistent reports of responses to ad hoc stimulation and therapy input.
WHAT WE DID:
Interdisciplinary team assessment included joint OT, Physio and SALT, in different environments and utilising different postural sets.
Set GAS Goals with family
Functional approach to therapeutic input that promoted responses that were in context to everyday activities.
INNOVATION AND CREATIVITY:
Spread input across the week and at various times of the day to establish optimum opportunities to enable consistent responses.
Communication assessment Introduction of a structured approach to stimulation
Supported engagement in family decision making.
OUTCOME:
Improved active postural control at the pelvis, trunk, head and neck.
Improved range at the ankle
Engagement and choice making regarding daily activities and goals
Improved activity within the left upper limb
Evidence of humour being expressed during leisure activities and the choices made.
Consistent yes / no responses, able to communicate with friends, family and work colleagues.
Overall improvement in tone and posture management.
WHY CHOOSE US! We will see our clients in the best environment for them e.g. school, home, work, community, rehab unit, hospital. Wherever they are and wherever they need it! The client and team use the goal attainment scale amongst other outcome measures, to ensure that the therapeutic intervention is measured, timely, specific and achievable. We are a very passionate, skilled, creative and innovative team that care about our clients and their families. Call 01745 583 156 today to discuss your needs or visit http://unitedrehab.solutions B&SI 49
Tel: 0113 273 3638 | Email: info@enabletherapyservices.co.uk | www.enabletherapyservices.co.uk
WE OFFER: • Specialist Occupational Therapist Case Managers in clinical areas including Acquired Brain Injury, Spinal Injury, Complex Orthopaedic and other clinical conditions • Nationwide network of over 150 HCPC registered and highly qualified Occupational Therapists: - Full Indemnity Insurance - State registration with the HCPC - Membership of the British Association of Occupational Therapists and other special interest groups - Enhanced DBS clearance - Current report writing experience • 100% Quality assured clinical assessment reports identifying rehabilitation needs
WE DELIVER: Excellent relationship management,
• A wide range of comprehensive assessments including, but not limited to: - Immediate Needs Assessment - Vocational Assessment:
promoting successful partnerships to achieve the best outcomes
- Work Site Assessment/Job Demands Analysis
Trusted expertise; confidently
- Functional Capacity Evaluation
demonstrating integrity and adherence to professional standards
Specialised and bespoke
assessments, tailoring each intervention to the specific needs of the individual
- Ergonomic Assessment - Hand Assessment - Cognitive Assessment - Postural and Seating - Moving and Handling - Bespoke Assessment
To find out more about our services or to discuss a referral with a clinician please get in touch Tel: 0113 273 3638 | Email: info@enabletherapyservices.co.uk | www.enabletherapyservices.co.uk
RECOVERY & REHABILITATION
THE PERSONAL TOUCH Enable Therapy Services - we are an independent client focused rehabilitation company providing rehabilitation and vocational case management along with specialist OT assessment across the UK.
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e are experts in the specialism of acquired brain injury, complex care and neurological rehabilitation, offering a high standard of service to our clients who have experienced personal injury or illness.
difficulties and limitations early on, to help in setting out realistic rehabilitation goals. ETS OTs can offer specialist functional assessment to determine a client’s level of ability, we are then able to advise on how to maximise a client’s functional ability and promote independence. This may involve recommendations for adaptations/equipment, compensatory techniques, bespoke assessments or further specialist rehabilitation treatment.
Why instruct ETS? We offer dedicated Occupational Therapist specialist case managers. Our support through case management is flexible and responsive, we personalise each intervention. We understand that there will be changes over time, so we keep a close eye on a client’s progress How do you create a treatment plan for an to make sure that they are receiving the right level of individual’s rehabilitation? support. At different times in the I have recovery journey there will be a number We want each individual to be their best of services providing assistance/ instructed ETS after brain injury and we understand the intervention. A dedicated case manager of providing early on a number of importance with specialist clinical knowledge will be intervention for any client seeking catastrophic and rehabilitation. A bespoke plan will be the central contact for the client, their family and other services involved after created to support the client in poly trauma the injury and will support the client to achieving their goals. ETS use SMART cases. co-ordinate and deal with the different (Specific, Measurable, Achievable, SOLICITOR organisations and professionals that are Realistic and Timely) goals which will be involved in their rehabilitation and recovery. agreed and driven by the client to ensure that they feel included and engaged in their rehabilitation. What is involved in the assessment ETS have a flexible and responsive approach and the of a client with a brain injury? range of assessments offered is unlimited. We We take a whole person approach to assessment of the specialise in tailoring assessments to meet the client’s needs. We offer a free telephone consultation with an client, considering physical, cognitive, social and Occupational Therapist to referring parties, to psychological factors. ETS OT’s are highly skilled in using accurately assist in identifying the most appropriate cognitive assessment to gain a greater understanding of assessment for your client. ■ how a cognitive impairment can impact on an individual’s day to day life. Cognitive difficulties can include memory loss, concentration problems, difficulty with planning and problem solving, behavioural and personality changes, problems with expressing or controlling emotions and loss of motivation.
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When is the best time to refer my client to ETS? We believe it is important to identify the client’s
To find out more about our service please contact us: Tel: 0113 273 3638 Email: info@enabletherapyservices.co.uk
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Inspiring. Recovery. Together.
NPP Neuro Group provides Medico Legal and Neurological Rehabilitation to adults and children with acquired brain injury and spinal cord injury. Offering ambitious and forward-thinking treatment options we provide patients with a unique multidisciplinary team approach to deliver the best patient care. Leading in the field of rehabilitation NPP Neuro Groups multi-disciplinary team is led by healthcare professionals who have many years of neurological rehabilitation experience both in the statutory and private sectors, with Consultant Level Physiotherapy, Occupational Therapy, Psychology and Speech and Language Therapy. Our services: • Neuro Psychology • Adult Physiotherapy • Paediatric Physiotherapy • Occupational Therapy • Medico Legal • Speech and Language Therapy • Pain Strategies To schedule an appointment or to have a discussion about any of our services
Call: 0800 917 3330 Visit our website: www.nppneurogroup.com Or email: enquiries@nppneurogroup.com
Our Locations: Stourbridge Practice:
Sandford House, 6-7 Lower High Street, Stourbridge, West Midlands, DY8 1TE
Birmingham Practice:
22 George Road, Edgbaston, Birmingham, B15 1PJ
Stoke-on-Trent Practice:
1441 Leek Road, Stoke-on-Trent, ST2 8BY
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RECOVERY & REHABILITATION
Inspiring.Recovery. Recovery.Together. Together. Inspiring.
NPP Neuro Group provides a bespoke rehabilitation medico NPP Neuro Group provides a bespoke rehabilitation andand medico legallegal service both adults children alike. service to to both adults andand children alike.
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e offer our patients a complete e offer our patients a complete multi-disciplinary rehabilitation multi-disciplinary rehabilitation journey adapted to their needs, journey adapted to their needs, delivering Neuro Psychology, delivering Neuro Psychology, Adult Physiotherapy, Paediatric Physiotherapy, Adult Physiotherapy, Paediatric Physiotherapy, Occupational Therapy, Medico Legal, Speech Occupational Therapy, Medico Legal, Speech and and Language Therapy and Pain Strategies. Language Therapy and Pain Strategies.
Degrees in Neuro Rehabilitation and Cognitive Degrees in Neuro Rehabilitation and Cognitive Neuropsychology and was appointed Neuropsychology and was appointed as oneas ofone the of the first Neuro Physiotherapy Consultants in 2002. first Neuro Physiotherapy Consultants in 2002. Peter Peter believes in doing hisbest veryfor best for patients and believes in doing his very patients and this is this is the reason why Peter set up NPP Neuro Group. the reason why Peter set up NPP Neuro Group. Peter Peter feltdue thattodue to a number of constraints, patients felt that a number of constraints, patients were not being provided with the best care were not being provided with the best care and and quality of service they clearly deserve and Itneed. It quality of service they clearly deserve and need. Why we different this foundation of integrity andpractice best practice Why are are we different is thisisfoundation of integrity and best that that are unique in offering a range of specialities putsNeuro NPP Neuro in a league of itsand own and We We are unique in offering a range of specialities puts NPP GroupGroup in a league of its own within same organisation. specialty motivates our experts. within the the same organisation. EachEach specialty can can motivates all of all ourofexperts. offer expert individual interventions, as as well as AtNeuro NPP Neuro we ambitious offer ambitious offer expert individual interventions, as well At NPP groupgroup we offer and and working across Neuro Group to offer a multi- forward working across NPPNPP Neuro Group to offer a multiforward thinking treatment options that promote thinking treatment options that promote disciplinary input. makes the patient’s journey neurological disciplinary input. ThisThis makes the patient’s journey neurological rehabilitation keeping our patients rehabilitation keeping our patients at the at the more therapeutic, delivering quality clinical more therapeutic, delivering high high quality clinical centrecentre of all of weall do.we do. interventions thatthat adhere to standards of clinical interventions adhere to standards of clinical governance. By working as a as multi-disciplinary teamteam governance. By working a multi-disciplinary delivering compassionate and evidence-based care, care, To schedule an appointment or to have delivering compassionate and evidence-based To schedule an appointment or toahave a we we innovate recovery and and rehabilitation. discussion about any of our services innovate recovery rehabilitation. discussion about any of our services We We provide the best patient care care delivered by by provide the best patient delivered Call:Call: 08000800 917 3330 the the bestbest specialist practitioners, inspiring recovery 917 3330 specialist practitioners, inspiring recovery together. All members of the Neuro Group teamteam Email: enquiries@nppneurogroup.com together. All members of NPP the NPP Neuro Group Email: enquiries@nppneurogroup.com are are handpicked based on their knowledge, training handpicked based on their knowledge, training Website: www.nppneurogroup.com andand qualifications. WithWith overover 70 combined yearsyears of of Website: www.nppneurogroup.com qualifications. 70 combined healthcare experience, our team consists of some healthcare experience, our team consists of some of the UK’sUK’s highest quality practitioners, specialists of the highest quality practitioners, specialists andand leading Consultants. Our expertise ensures we we Our Locations: Our Locations: leading Consultants. Our expertise ensures Practice: do what is right for our patients, a principle which Stourbridge Practice: do what is right for our patients, a principle which Stourbridge Sandford House, 6-7 Lower High Street, Stourbridge, inspired our founder, Peter Harding. Sandford House, 6-7 Lower High Street, Stourbridge, inspired our founder, Peter Harding. WestWest Midlands, DY8 1TE Midlands, DY8 1TE Our story Birmingham Practice: Our story Birmingham Practice: Peter qualified as a physiotherapist in 1986 and 22 George Road, Edgbaston, Birmingham, B15 1PJ Peter qualified as a physiotherapist in 1986 and 22 George Road, Edgbaston, Birmingham, B15 1PJ continued to develop his passion for neurological continued to develop his passion for neurological Stoke-on-Trent Practice: rehabilitation whilst working in the NHS for twentyStoke-on-Trent Practice: rehabilitation whilst working in the NHS for twenty- 1441 Leek Road, Stoke-on-Trent, ST2 8BY two years. He completed a further two Masters 1441 Leek Road, Stoke-on-Trent, ST2 8BY two years. He completed a further two Masters
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Oakwood is a specialist service providing rehabilitation for people with acquired brain injury. Oakwood based in Stockport, works together with the service user to develop a bespoke person-centred rehabilitation programme, comprising goals and interventions that take into account the service users aims and wishes. We support those with:
• Cognitive problems with thinking,
memory, problem solving, planning, awareness and perception • Physical limitations affecting activities of daily living, mobility, core control, transfers, posture • Physical or verbal aggression • Challenging behaviour 54
For more information or a referral, please contact Service Manager Corinne Waters. Tel: 0161 419 9139 Email: corinne.waters@ leonardcheshire.org
RECOVERY & REHABILITATION
THE ULTIMATE GOAL Experts in Vocational Rehabilitation and Occupational Therapy.
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their work or home environment, identify and engage in ere at KMA, we offer dynamic appropriate vocational opportunities or return to their vocational rehabilitation services. We employed occupation following a period of absence. strive to assist individuals to return to We work collaboratively with the individual, their work and/or develop occupational employer and professionals potential in their journey back KMA Occupational involved in their care to ensure to work. Our experience includes working with Therapists consistently best outcomes for all. Our vocational rehabilitation individuals, employers, life and provide an effective services adhere to strict health insurers, general and efficient service professional codes of conduct insurers, legal services and and best practice in the industry. solicitors across the UK. in a friendly and All our consultants have achieved Accident, illness and injury can professional manner. the international Certified change a person’s life. Our Disability Management Professional (CDMP) accreditation. services aim to support individuals to overcome barriers At KMA we work with success in mind. We know that and return to or maintain daily activities. Our a healthier and productive workforce is key to the Occupational Therapists take a personalised approach, success of any business. ■ building step-by-step rehabilitation or vocational programmes which recognise that each individual is the expert in their recovery. The ultimate goal of vocational rehabilitation is to enable someone to engage in a meaningful, sustainable, Occupational Therapy Services occupational routine. This could involve supporting Tel: 01264 326308 someone to; become work ready, establish a sustainable www.katemeadsassociates.com occupational routine, make reasonable adjustments to
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KMA is a leading provider KMA is a leadingtherapy provider of occupational of occupational therapy services to clinical, private, services to clinical, private, corporate and public corporate and public sectors across the UK. sectors across the UK. KMA works across the key areas of physical, mental and across developmental health. KMA works the key areas of physical, mental and developmental health. Our occupational therapy services use evidence-based to establish Our occupationalpractices therapy services use and implement realistic, achievable and sustainable evidence-based practices to establish and goals to ensure a positive outcome. implement realistic, achievable and sustainable goals to ensure a positive outcome. As specialists in neurological conditions and injury, we provide outcome focused assessment As specialists in neurological conditions and and intervention and injury, we provideensuring outcomeachievable focused assessment sustainable outcomes. and intervention ensuring achievable and sustainable outcomes. Basepoint Business Centre, Caxton Close, Andover, SP10 3FG. BasepointHampshire Business Centre, Caxton Close, Andover, Hampshire SP10 3FG.
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WORKING TOGETHER T The role of case managers in serious injury litigation... communication is central to achieve the best outcome for our clients.
he role of a case manager is to manage a before their accident, of their preferences, “collaborative process of assessment, their family and of their lifestyle, and in turn planning, facilitation, care cothose interventions that can be shown ordination, evaluation and advocacy for practically and in evidence, to work to best options and services to meet an individual’s and facilitate quality of life and independence. If family’s comprehensive health needs through the interventions cannot be shown to work communication and available resources to promote for an individual, irrespective of best quality cost effective outcomes.” intentions, it will not be accounted for by the The role of a Claimant solicitor in the litigation Court in a financial settlement. process is to represent the needs of the injured In this respect, the role of the rehabilitation person and to manage all phases of the litigation and care package that a case manager puts in towards settlement or trial. It is a process of collating place for an injured person in the context of and presenting the evidence that is litigation is two-fold. Concrete required to ensure that the award agreed The package will work to restore a between the parties or made by the Claimant to increase independence and evidence is Court is fair and correct. In the context quality of life whilst simultaneously required by providing the concrete evidence that is of a serious injury claim, the roles of the a court case manager and solicitor accordingly required by a Court as to what a overlap considerably and it is to an injured person’s Claimant’s needs really are and how those needs are benefit when that relationship is open, cooperative best met. In turn, where that evidence is provided, and productive, placing the injured person at the the relationship becomes reciprocal as the evidence centre. It is further increasingly the case that is the key to a solicitor accessing the interim Claimant and Defendant solicitors work cooperatively payments and funding required to facilitate the in serious injury cases to achieve the best outcome case manager’s recommendations. for injured people through rehabilitation and the litigation process, and the case manager has a COMMUNICATION, GOAL SETTING AND DISCLOSURE central role in this relationship. For both solicitors and case managers, each case is as THE AIM OF COMPENSATION AND radically different as our individual clients and each THE ROLE OF THE CASE MANAGER raise different issues and challenges. It is the sad reality The aim of compensation is to restore an injured that our clients are almost invariably going through a person to the position that they would have been in period of crisis and learning to adapt to a life changing had their accident not occurred. In the vast majority of injury. To deal with these challenges, the key to a serious injury cases this is not something that is productive relationship between case managers and possible to do and the effects of an injury cannot solicitors is open communication and accessibility. simply be reversed. Nevertheless, the principle remains the core of any award of compensation made by a The case manager is an integral part of the team: Court. That award will be based on the financial l They will have a good relationship with the Claimant valuation of the therapies, care package, equipment and the Claimant’s family as they will often have the and accommodation that can be put in place to ensure most contact with them outside of the therapy team that an injured person’s life best resembles the life they and will have contact with the Claimant in their home would have had had their accident not occurred. This is environment. in turn a highly individualised assessment. It is an l They will have a good knowledge of how the assessment of the life an injured person enjoyed multi-disciplinary team are working together and any
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FINANCIAL & LEGAL
changes that are needed. l They will have a good knowledge of how the rehabilitation is going, of the challenges and issues faced by the Claimant, of what works and what does not, and what a Claimant needs.
interventions are required to tackle an issue such as brain injury education to assist the injured person and their family to engage with therapies. It may be that psychological support or even drug rehabilitation is required to tackle an issue with drug use. Interventions like these require planning and funding. In order to obtain funding, the solicitors need to be fully aware and putting in place the necessary evidence and applications for an interim payment. Similarly, a full understanding of the issues is central to a solicitor’s planning of the litigation. In a case where family relationships are increasingly difficult, it may well not be appropriate or sustainable to continue to factor in familial care of the injured person in the eventual settlement. It may be that a contingency in the settlement for family break-down in the future, or increased support from a paid care team, is required. In order to achieve this, the expert and witness evidence in the legal case will need to be gathered and the case will need to be pleaded along those lines. This can only happen where there is good and full communication between solicitor and case manager.
The case manager is at the ‘front line’ in any case. They hold a wealth of information which is useful for the Claimant’s litigation team to tap into in respect of ensuring the care and rehabilitation that has been put in place is working well and also to assist the solicitor to plan the litigation. The injured person will be Expert In facilitating full disclosure and best supported by the case manager and litigation team regularly exchanging and witness open communication, it is worth considering:information. If communication is slow or delayed, the whole process can break down. evidence will l Multi-disciplinary team meetings are a need to be fantastic opportunity for the litigation By way of example, it is a fairly frequent team to stay up to date in respect of the issue in these types of cases that an injured gathered therapy package and to get a better person struggles or fails to engage with understanding of dynamics and the challenges faced by therapies for one reason or another. In other cases, the injured person. A case manager that is willing to clients have difficult issues in their lives which may be amplified following their injury. Where a Claimant had a include the litigation team in such meetings is invaluable. In some cases, particularly those involving fractious relationship with their family, this may large expenditure for care and rehabilitation, the deteriorate following an injury. attendance of both Claimant and Defendant lawyers We see cases in which a client may have used drugs may well be beneficial. or alcohol recreationally before the accident but l Case managers and solicitors being able to access which, following their injury, becomes a much more each other when needed is vital. It is wise at the significant issue. Issues like this need to be tackled beginning of a case to figure out how each person jointly in the litigation and in case management and prefers to communicate in the circumstances of the they are invariably better understood by case managers than solicitors. It may be that alternative CONTINUED OVER
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particular case – whether that be by email or picking up the phone. l Formalities around documentation can slow the process down unnecessarily. If something important has happened during the period of case management, the litigation team should be updated as soon as possible rather than waiting until the case management update is formally prepared. l Full and open disclosure is important. It can be tempting to ‘protect’ a client by underemphasising their failure to engage or an issue that has arisen in their personal life. This is particularly the case where information may have come to a case manager in circumstances where a Claimant is speaking in confidence and on the back of a relationship of trust with their case manager. This, ultimately, does not serve to ensure that the appropriate support is in place and that the litigation is being planned to deal with that challenge. l Solicitors and judges are not clinicians. Documentation around interventions and case management should not be ‘sanitised’ and overly clinical, simply setting out numbers of physiotherapy sessions and increases in abduction/flexion of a particular limb in therapy. Solicitors and judges are ultimately interested in the functional impact of therapies and interventions, and in some circumstances, will need to be assisted to understand this within the clinical information provided. l Based on the knowledge and relationship a case manager has with the Claimant, a solicitor may call on a case manager to assist with the formal evidence in a case. For example, a case manager might be asked to attend a medico-legal expert appointment to provide a full view on the circumstances of a Claimant’s injuries and needs in the context where they or their family would struggle to do so. Similarly, a solicitor may ask a case manager to assist by providing a witness statement in the case in order to adduce as evidence their knowledge and understanding of the case and the Claimant.
FUNDING REHABILITATION: EVIDENCE AND COSTS ESTIMATES
In order that an injured person’s needs can be addressed, and challenges met as they arise in a given package, funds will be required. Funding for care and rehabilitation packages is accessed in a legal case via 58
interim payments, i.e. early payments of the eventual compensation. Insofar as a need is properly evidenced and reasonably required, the Claimant will be entitled to it and it will be fully recoverable, thus increasing the value of the final award. Where the necessary evidence is not provided for a particular intervention, it is possible for a Court to decide that the expense was not reasonably incurred and to not allow for it to be recovered, decreasing the award. To protect the Claimant’s best interests and eventual compensation it is accordingly central that solicitors have a full understanding of the funds that are being spent and the justification for the same. Documentary evidence such as thorough therapy and case management records, are central here. Further, where there is significant expenditure occurring, it may be necessary for a medico-legal expert involved in the case to review the decision and provide their views. It is frequently the case that medico-legal experts have six, nine or twelve-month waiting lists and accordingly proper planning of major spending decisions needs to be done. In this regard, solicitors need to be on notice of the long-term future plan, likely expenditure and costs estimates. Litigation does not move quickly and it will be a frequent frustration to many case managers that the recommendations that they have made may take many months to be funded. Whilst Claimant and Defendant solicitors are often increasingly working on a collaborative basis to meet a Claimant’s needs, it is not always the case that the parties are agreed about major expenditure. There are frequently disagreements about whether a Claimant’s needs are best met in the community or whether they would be well served by an expensive in-patient package of rehabilitation, for example, in those cases, detailed expert, witness and
FINANCIAL & LEGAL contributory negligence. A Court is not entitled to take into account the effect of contributory negligence before coming to a valuation in the case. For example, it may be assessed that a Claimant’s best interests are that they live in the community and require a 24 hour care package with a full complement of therapies to do so. In reality, it may be the case that on a 50% recovery in a case, a Claimant and their family will need to make some very difficult decisions about what they can afford and how best they meet a Claimant’s needs with the compensation provided. This may mean, for example, that while the experts in a case have DEALING WITH PARTIAL RECOVERY: CONTRIBUTORY recommended weekly physiotherapy for a period of NEGLIGENCE AND years, a Claimant may decide that those funds are best PRE MORBID DIFFICULTIES spent meeting their care needs. In these circumstances, the Court is not entitled to second guess what a It is unfortunately frequently the case that an Claimant will do in reality on the settlement of their injured person will not, at the settlement of case and compensate them along those lines. This their case, be entitled to the full award of would, in effect, lead to a double discounting as a compensation that the Court would result of contributory negligence. otherwise have made available to them. Case Because the law of compensation works in this way, managers and solicitors are frequently confronted as artificial as it may seem, challenges arise in care with Claimants who had a range of difficulties prior packages and for case managers making to their accident which increase their needs but recommendations. Even in cases where a Claimant will cannot be compensated through their case. For face a discount from their compensation due to example, a Claimant may have had arthritis prior to contributory negligence, their solicitors their accident which remains an issue A Claimant will still require evidence of their needs, following the accident. A Defendant insurer will not be may decide and how those needs are best met, to meet the burden set by the Court to responsible to compensate a Claimant for that those ensure a maximum award can be given. issues they would have had in any event This may mean for example that during and this leads to a significant issue for case funds are the lifetime of a case, a solicitor will put in managers to deal with. A case manager will best spent place the ‘ideal package’ of care and wish to see an injured person in the round meeting their rehabilitation with the aim of showing whilst recognising that physiotherapy for that this is what the Claimant needs. They the Claimant’s pre-existing arthritis, whilst care needs will do this knowing full well that, on the maximising their function, may not be settlement of the case, aspects of the package may recovered and will decrease their award. need to be cut away and other arrangements made. Perhaps even more commonly, the issue of In other circumstances, this is not possible and, contributory negligence arises. Where a claimant has particularly in cases where there is a very significant been contributory negligent, i.e. partially to blame for their accident, they will be assessed as being entitled to deduction to be made, early consideration must be made with a view to preserving the eventual only a proportion of the value of the case. For compensation. For example, it may be decided in all of example, in cases where a Claimant has failed to wear a the circumstances that where an injured person is seatbelt or stepped into the path of a speeding vehicle, deriving limited benefit from an expensive therapy, they may be assessed as being entitled to only 75% or vis-à-vis significant benefit from another therapy, only 50% or even 30% of their compensation, depending on the latter should be funded. Similarly, it may be that the circumstances of the case. If a Claimant is assessed some therapies will be required to be funded through as being 50% contributory negligent for their accident, the NHS, though provision of this may be more limited they will only derive 50% of their compensation. This and there may be a long waiting list. All of these will necessarily have an effect on how a rehabilitation considerations require a balancing act by solicitors and and care package is managed. case managers, negotiating the line between ensuring In assessing compensation, a court is required to that a Claimant is properly looked after and come to a valuation of a Claimant’s claim based on the rehabilitated whilst also preserving the final award. extent of their injuries and their needs. Once they have Whilst it is ultimately a matter for the Claimant and reached that valuation, they will make a deduction from the total value of the case to take into account CONTINUED OVER documentary evidence of a Claimant’s needs is required which can take months to put together. It may ultimately be the case that the matter will need to be put before a judge to decide and this process, again, can take a period of months. In order to avoid a care or rehabilitation package grinding to a halt, the earlier a solicitor is put on notice of funding requirements and issues, the better able they are to manage and expedite the process.
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their solicitors (and in the case of protected parties, the Court of Protection Financial Deputy) to make a decision about what expenditure should or should not be incurred, those decisions can only be made on the basis of an informed understanding of the injured person’s circumstances, progress and prognosis. A solicitor will be entirely reliant upon a case manager (and in turn medico legal experts) to determine the real and practical value of expenditure e.g. for a certain therapy, to a Claimant.
THE RIGOURS OF LITIGATION
Litigation can be a long and stressful process for an injured person who will be coping with potentially life changing injuries. It will work significantly better for the injured person when a collaborative approach is taken between the parties, alongside the case manager and a multidisciplinary team, putting the injured person at the centre of the process alongside an understanding of their needs and how they are coping. It is furthermore the case that case managers frequently build relationships of trust and confidence with Claimants who will rely upon them for reassurance and support. Whilst perhaps not strictly within a case manager’s role, many solicitors will welcome and value this support, particularly where a Claimant may otherwise lack a support network.
CONCLUSION
The injured person is, and quite rightly should be, at the centre of everything that we, as practitioners working with those who have suffered serious injury do. Only by working together as part of a multidisciplinary team can we provide the best service to our clients and ensure that they are able to benefit from the vital rehabilitation which a personal injury claim can provide. Communication is central to that process. ■
ARTICLE WRITTEN BY:
Sofie Toft
Senior Associate Solicitor Irwin Mitchell Solicitors
Stephanie Edwards
Solicitor Irwin Mitchell Solicitors
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This article was originally published in the CMSUK e-magazine
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FINANCIAL & LEGAL
RECOVERY & REHABILITATION
YOUR REHABILITATION,
OUR PRIORITY
Unite Professionals Ltd (UPL) deliver a model of national case management.
O
ur Occupational Therapist Case managers work regionally receiving support via our hubs where they go to receive training, supervision and moral support from their peer group. Our Case managers demonstrate specialist skills to engage with the client and their families at a significantly traumatic time in their lives. TBI and SCI are diagnosis which impact on the client and their family’s futures permanently. The case manager selected will have a background in these clinical areas, be local to the client and an individual who the client and family feel comfortable to have in their lives . The expectation of our Case manager is that they utilise their clinical experience to produce an INA with corroborated clinical detail of the injuries sustained and the resultant impact on the individuals functional, cognitive, behavioural and social lives to secure funding of the optimum rehabilitation and support packages proposed within the report. The Case manager will engage regularly with the litigating parties to ensure
funding is proactively released so that rehabilitation is delivered in the right environment and at an intensity that will promote a graded and sustained benefit. UPL Case managers are confident in navigating the labyrinth of benefits and health and social care funding pots representing the clinical evidence to support access to these funds. Experienced case managers are silent conductors of a significantly complex orchestral score. They are commercially aware and skilled in signposting treatment across numerous clinical interfaces. Our CMs regularly audit the integrity of the MDT goals set and challenge any “gaps” in performance, keeping the client at the center of all choices on their future. ■
Tel: 01704 508777
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The UK’s leading case management service focusing solely on childhood brain injury Working with the Child Brain Injury Rehabilitation Service, you and clients will benefit from: •
The expertise of two of the strongest brands in child brain injury and case management (Child Brain Injury Trust and Bush & Co)
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Support services accessed in one place including transitional services and behavioural support
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Expert advice and guidance from experienced case managers with national reach.
Contact us to discuss your children and young people ABI cases on 01327 223817 or email enquiry@cbirs.co.uk Visit www.cbirs.co.uk for more information.
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The largest UK-wide case management service working solely with adults and children following spinal cord injury. With a dedicated team for Spinal Cord Injury cases, SIA Case Management provides case management to the highest standards of clinical governance with passion and integrity for adults, children and their families. •
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Our case managers all have at least 7 years’ clinical experience of working with people following Spinal Cord Injury and are knowledgeable about statutory and private health and social care provision. For child cases, we have specialist knowledge of the education sector and of working with schools to coordinate return to education, transition across key stages including further and higher education opportunities. Families have access to an employment support service and accredited care delivery support service for those who wish to recruit their own support staff when required.
Contact us to discuss your SCI cases on 01327 223821 or email enquiry@siacasemanagement.co.uk Visit www.siacasemanagement.co.uk for more information. The SIA Case Management logo is a Trade Mark of Spinal Injuries Association
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RECOVERY & REHABILITATION
FINDING THE PERFECT MATCH Specialist case management services from the Child Brain Injury Rehabilitation Service and SIA Case Management.
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hen a case manager begins to work with someone following a catastrophic injury they become a key part of that person’s life; a new life that they are learning to navigate as they begin to engage in rehabilitation. In simple terms, a case manager will assess a person following the injury to understand their complex needs. They’ll then plan the rehabilitation insuring it involves all aspects of the person’s life, both today and in the future. This includes implementing the rehabilitation plan, co-ordinating services and monitoring and evaluating the rehabilitation, services and support. organised and aware of the whole process that the Underneath all this though, they become integral to client is going through and how this can impact on the clients. It’s for this reason that choosing the right case manager is one of the most important steps in a outcomes and rehabilitation goals. person’s future following a catastrophic injury. We’d always encourage a ‘meet and greet’ To find the right case manager you need to think session. You don’t start a job without an interview of wider than just a specific profession. some sort so why would you Experience and registration, the Choosing the welcome someone into your family locality in order to be able to respond support you through significant right case manager to in a crisis and so on, are clearly change without meeting them? is one of the most essential but a specific profession to A meet and greet is where the tackle one particular need may be too important steps case manager can talk about short sighted; meeting specific needs is themself as a person, their approach always addressed as part of the treating team. What’s and their experience. They can ask questions and give key is considering the case manager’s skill set and their a clear overview of the service and what to expect. ■ background as well as the type of person they are. This needs to be considered with a number of things in mind – the type of injury, the age of the client, their gender, ethnicity, diversity etc. You need to consider the needs of the client, as well as their lifestyle, living environment and what can be done to improve these.
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FACE TO FACE IS BEST
A good case manager will always be diligent, professional, effective and efficient but they’ll also have personable qualities too. They’ll be sensitive to what is happening around them, compassionate, understanding and consistent. Resilience is vital and coupled with a can do attitude; creativity and thinking outside of the box really is the best approach. They must remain cost aware and goal focused,
To find out more about specialist case management services for children with ABI or adults and children with SCI contact us at: The Child Brain Injury Rehabilitation Service:
enquiry@cbirs.co.uk SIA Case Management:
enquiry@siacasemanagement.co.uk 63
RECOVERY & REHABILITATION
DON’T SURVIVE – THRIVE
While While survival survival rates rates in in catastrophic catastrophic injury injury have have risen, risen, society society is is far far more more vocal vocal in in demanding that patients also thrive. HCML CEO, Keith Bushnell, explains why demanding that patients also thrive. HCML CEO, Keith Bushnell, explains why there there is is aa gap gap here here that that case case managers managers can can help help fill. fill.
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hanks hanks to to improvements improvements in in emergency emergency care care and technology, more people and technology, more people are are surviving surviving catastrophic catastrophic injuries. injuries. But But is is survival survival enough? enough? The increasing societal belief is that The increasing societal belief is that everyone everyone should should be be given given the the opportunity opportunity to to thrive thrive even even after catastrophic Spinal Cord and Traumatic after catastrophic Spinal Cord and Traumatic Brain Brain Injuries, Injuries, yet yet vast vast gaps gaps between between that that expectation expectation and and reality reality still still exist. exist. We We all all see see the the benefits benefits to to individuals, the NHS and society, in human individuals, the NHS and society, in human and and economic economic terms terms of of thriving, thriving, not not just just surviving. surviving. HCML’s HCML’s clients, clients, with with the the expert expert support support of of our our Rehabilitation Case Managers, continue to Rehabilitation Case Managers, continue to break break down down these these barriers, barriers, achieving achieving truly truly fantastic fantastic outcomes, far exceeding the act outcomes, far exceeding the act of of just just surviving. surviving. From From return return to to technical technical aerospace aerospace engineering engineering work work for for one one of of our our C5 C5 incomplete incomplete SCI SCI clients, clients, to to aa budding budding 2020 2020 Paralympic Paralympic hopeful hopeful who who is is close close to to achieving his competitive goal, after a T12 achieving his competitive goal, after a T12 complete complete SCI, SCI, barely barely able able to to care care for for himself himself after after discharge discharge from statutory services. from statutory services.
Case Case managers managers can can raise raise NHS NHS aspirations aspirations to to plan plan discharge and post-acute support with the discharge and post-acute support with the expectation expectation that that the the client client will will ultimately ultimately lead lead aa full full and productive life. Limitations to state resources and productive life. Limitations to state resources dampen dampen NHS NHS aspirations aspirations and and case case managers managers must must advocate at those early stages to plug advocate at those early stages to plug gaps gaps that that would would otherwise otherwise limit limit achievement achievement of of rehabilitation rehabilitation goals. Where the state cannot do so, goals. Where the state cannot do so, case case managers managers must must engage engage the the entire entire MDT MDT in in validating validating what what is is possible possible with with the the right right inputs. inputs. Case Case managers managers are are driving driving aa revolution, revolution, changing changing mind-sets among stakeholders. mind-sets among stakeholders. Being Being uniquely uniquely placed placed to to see see the the potential potential to to thrive thrive in in the the injured injured individual, individual, they they apply apply their their knowledge knowledge in in advances advances in in care through to technology, to enable clients care through to technology, to enable clients to to succeed. succeed. As As advocates advocates for for the the individual individual they they continue to work with stakeholders, continue to work with stakeholders, breaking breaking down down barriers barriers and and maximising maximising clients’ clients’ potential potential to to thrive. thrive. n n Call Call HCML HCML on on 0161 0161 831 831 6434 6434 or or visit visit www.hcml.co.uk www.hcml.co.uk
FIRST choice for Catastrophic Injury Rehabilitation HCML HCML is is a a leading leading independent independent provider provider of of rehabilitation rehabilitation case case management, management, treatment treatment and and occupational rehabilitation services. Since 2003 it has been at the forefront of occupational rehabilitation services. Since 2003 it has been at the forefront of rehabilitation rehabilitation and and case case management management excellence excellence making making a a real real difference difference to to the the lives lives of of injured injured clients clients and and their their families families through through appropriate appropriate and and timely timely intervention intervention to to accelerate accelerate recovery recovery and and independence. independence. In In the the last last financial financial year, year, our our nationwide nationwide team team of of highly highly experienced, experienced, skilled skilled clinicians clinicians were were appointed appointed to to support support over over 200 200 individuals individuals after after catastrophic catastrophic injury, injury, including including brain brain and and spinal spinal cord. cord. We We provide: provide: Case Case Managers Managers recognised recognised as as industry industry experts experts in in their their clinical clinical fields fields Bespoke INAs and case management for spinal cord and brain Bespoke INAs and case management for spinal cord and brain injury injury clients clients Access to to instruct instruct a a case case manager manager before before hospital hospital discharge discharge Access A A range range of of funding funding options options to to suit suit client client need need A clinically governed, audited network of A clinically governed, audited network of clinics clinics and and specialist specialist providers providers to to drive drive outcomes outcomes
T: T: 0161 0161 831 831 6434 6434 E: referrals@hcml.co.uk E: referrals@hcml.co.uk W: W: www.hcml.co.uk www.hcml.co.uk 64
RECOVERY & REHABILITATION
EXPERT REHABILITATION CASE
MANAGEMENT SERVICES Proclaim Care is UK’s foremost independent provider of rehabilitation case management.
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e are recognised by solicitors and insurers as independent and experts in what we do. Our specialist case management services include:
and this drives the quality measurement of our services. We have a team of clinically qualified and highly experienced Rehabilitation Case Managers located around the UK, ready to support your clients. ■
● Brain ● Spinal ● Amputee ● Paediatric
Our sister company, Obair Associates provides seamless vocational services to support your client when they are ready to return to work. We place the client at the centre of everything we do
For further information please call on 01698 207755, or email info@proclaim-care.co.uk or visit
proclaim-care.co.uk
Independent client-centred rehabilitation services Back to health • Back to work proclaim-care.co.uk
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RECOVERY & REHABILITATION
PROVIDING THERAPIES SINCE 2008 Maia Therapies is a case management company who specialise in acquired brain, spinal and catastrophic orthopaedic injuries.
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e were established over 11 years clinical team we design, works with the passion and ago and we are continuously growing dedication that runs through our company. and adapting our services to meet the This year, we are launching an exciting new aspect needs of our clients. to the company - SIRS. We strive to Since then, Maia has grown in Serious Injury Rehabilitation numbers with a team of Case Services is our new venture that will identify and Managers and Case Co-ordinators specialist care providers to a maximise potential supply to put together the best possible wide range of clients with ongoing and growth clinical team, bespoke to our requirements nationwide. ■ clients’ needs and requirements. We create and manage care packages, provide Occupational Therapy intervention, Rehabilitation and Expert care reports. Our aim is to get our clients back to the life and comfort they were accustomed to prior to their injury. We do this by working closely with not only them but their families as well. Maia For further details please contact: sources highly esteemed healthcare professionals Tel: (01234) 262863 Email: admin@maiatherapies.uk.com from all over the UK and abroad to make up our www.maiatherapies.uk.com talented teams of experts. Each member of the
“
”
RAISING THE BAR
Maia Therapies and Case Management has ventured into new ground. To expand our range of services, we have just launched SIRS a new service available in any location.
SIRS
are Specialist Injury Rehabilitation Specialists. These are Personal Assistants trained to the highest standard of care in Brain and Spinal Injury Rehabilitation by our in-house Care Experts, Neuro Psychologist and training team. This will be regulated and updated every 3-6 months to ensure the most recent medical developments are implemented and standards are maintained. We believe that in order for our clients to have effective and comfortable assistance for their long-term conditions, they must have a solid, reliable and enjoyable relationship with professionals they are comfortable investing a large amount of time with. Our process is to match the client with the most appropriate SIRS to their needs. This effectively will ensure a long-term basis of employment and consistency in care. l Personal Assistant’s need the support of their employers when dealing with clients who have
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complex conditions - This is why we promote Continual Professional Development. l Clients need Personal Assistants who are familiar with their condition and are fully aware of the risks that surround it to ensure safe day to day plans that do not pose risk to further injury - This is why we want consistency. l The client and the Personal Assistant are placed together based on similar interests, chemistry and trust - This is why we match them ourselves. ■
For further details please contact: Tel: (01234) 262863 Email: admin@maiatherapies.uk.com
www.maiatherapies.uk.com
Desktop, Multi-Trauma & Specialist Case Management Major Incident Response Service Treatment & Diagnostic Services Vocational Case Management
Award-winning Case Management With over 20 years’ experience, we are one of the UK’s largest impartial
and independent providers of award-winning rehabilitation case management, treatment and diagnostic services.
Let’s be friends. Follow us on Social Media
Medicolegal Provider of the Year 2018
@CorporeUK
Corporé
The UK’s leading independent provider of medical reports and rehabilitation A truly bespoke medical reporting service committed to supporting Serious Injury, Multi-track and Clinical Negligence cases. Dedicated case handlers with over 100 years’ experience Specialist in-house medical expertise Nationwide coverage – including over 500 highly experienced Clinical Negligence experts In-house ‘Clinical Advisory Board’ providing exceptional clinical governance T: 0844 4129 395 E: info@speedmedical.com W: speedmedical.com @SpeedMed
Speed Medical
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Case Management, Expert Witness, Rehabilitation and Specialised Care Recruitment Services. For over 20 years TBL have provided Case Management, Rehabilitation and Specialist Clinical Services for both adults and children. We offer a nationwide service with our consultant clinicians and case managers located across the country (including Scotland), all of whom are highly experienced with considerable skills to work alongside clients with complex cognitive, physical, emotional and behavioural needs. For more information visit us at www.taniabrown.com, email us janettewynn@taniabrown.com or call us 01257 473967.
Community Case Management Services promotes rehabilitation and independence for those with catastrophic injuries or life-long disabilities across the UK and internationally. Our professional Case Managers choose to work with CCMS because of the experience, knowledge and expertise within our independent company. We work closely with treating therapists and our well trained and supported care teams to ensure our clients achieve positive and measurable outcomes. We go above and beyond to provide opportunities, therapeutic holidays and retreats that allow and encourage clients to set their own goals. These activities assist re-engagement with the community and social activities, increasing confidence and enhancing the quality of life for our clients. www.ccmservices.co.uk 01602 682 522
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Life after traumatic injury can be challenging Blesma is here for all serving and ex-Service men and women who have experienced loss of limb, use of limbs, hearing, sight or speech, either during or after Service
Get in touch to find out how we can support you and your family Tel: 020 8548 7080 Email: membersupport@blesma.org Find out more: www.blesma.org 69
Premium Care Solutions is recognised nationally for our expertise in planning and providing the very best person centred complex care for individuals living independently in the community. PCS support children/young people and adults across the UK, with tailored packages of care. Premium Care Solutions is recognised nationally for our expertise in Our specialism is the provision of care packages for clients with complex care needs planning and providing the very best person centred complex care for including: living independently in the community. PCS support individuals Ventilator dependency children/young Spinal cord injury people and adults across the UK, with tailored packages of care. Tracheostomy support Ourspecialism is the provision of care packages for clients with complex care needs Neuromuscular conditions including: Neurological conditions Ventilator dependency Brain injuries Spinal cord injury For further informationsupport regarding our service, please contact: Tracheostomy Neuromuscular conditions Premium Care Solutions Ltd
63 Headlands, Kettering, Northamptonshire NN15 7EU Neurological conditions Tel: 01536 213680 Fax: 01536 482716 Brain injuries
Email: enquiries@premium-care.co.uk www.pcs.uk.com
For further information regarding our service, please contact:
Premium Care Solutions Ltd
63 Headlands, Kettering, Northamptonshire NN15 7EU Tel: 01536 213680 Fax: 01536 482716
Email: enquiries@premium-care.co.uk www.pcs.uk.com
LONG TERM SUPPORT
TAILOR-MADE TO SUPPORT OUR CLIENTS Premium Care Solutions Limited (PCS) is a national complex care provider that provides support to adults and young people across the UK.
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e provide bespoke packages of care (both within the community and within our specialist facility Headlands), tailor-made to support our clients with their requirements and rehabilitation goals. Our mission is to ensure that the needs, expectations and well-being of our clients are at the forefront of everything we do. In addition, we are skilled at assisting with financial matters such as managing personal health budgets, as well as providing advice relating to litigation and claims through personal injury solicitors. Through our knowledge and expertise in community-based complex care gained over 30 years, we excel at facilitating discharges from ITU or specialist centres safely into the community. Each of our client’s care package is tailored in terms of recruitment, implementation and on-going care management to that specific client. The clients we support are at various stages of their rehabilitation, and may be either pre or post settlement clients alongside CCG funded clients. We have a number of clinicians with appropriate skills, experience and qualifications to oversee adult and young persons’ complex care packages as well as care managers across the UK.
whilst empowering clients and their families to live as independently as possible. Our client-centred ethos and approach has been recognised in our latest CQC inspection where we were awarded outstanding in the category of whether we as a provider were “well led”. We engage closely with our clients to ensure that their every expectation is fulfilled. Our clients have said that we are a company who provide a holistic view ensuring that all aspects of care, from clinical to social care are covered. ■
HEADLANDS
Our purpose-built facility, Headlands, provides supported living accommodation with 24 hour care to our clients. It allows for the perfect transition from hospital to care at home, respite or long term care. This facility aids PCS in providing the very best, tailored, person-centred care packages to our clients
63 Headlands, Kettering, Northamptonshire NN15 7EU Tel: 01536 213680 Fax: 01536 482716 Email: enquiries@premium-care.co.uk
www.pcs.uk.com
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Complex Care Provider. Owned, led and managed by a team of Specialist Nurses. Working in partnership with you to deliver unparalleled care and outcomes H&SCS Ltd was born through a vision of a clinically sound and truly nurse led bespoke complex care provision. Fully nurse owned, led and managed, ensuring client safety and wellbeing is central to everything we do. Transparent in our approach, honest in our abilities and realistic in what can be done, we work in partnership with you to provide responsive and sustainable complex care at home.
We look to match personalities as well as clinical skills. As nurses we can provide training but also link up with specialists to ensure care staff are fully supported to provide excellent care. We believe in developing our teams and providing an employment package that not only attracts skilled care workers but also retains them. Sustainability is key to longevity and consistency. We also pride ourselves on our openness and how we communicate. Using IT to aid this further all care notes and plans can be viewed in real time to offer that reassurance to families but also for the wider multidisciplinary team. South East,West and Wales
South Coast and South East
Paediatric National Lead
Lena Walliman RGN
Riza Tongson-Espe RGN
Sarah Dennis RCN
07515542346
07786362953
07900512874
Lena.walliman@hascs.co.uk
Riza.tongson@hascs.co.uk
Sarah.dennis@hascs.co.uk
Telephone - 03300 020773 Email – info@hascs.co.uk www.hascs.co.uk Changing Lives, One at a Time 72
LONG TERM SUPPORT
ACCESS ALL AREAS
Abode Impact to provide wheelchair accessible apartments for private rent in London.
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bode Impact will purchase one and two-bedroom new build accessible apartments for private rent in Greater London. These homes will be adapted for wheelchair users and located close to accessible public transport links as part of larger developments by major house builders. Apartments should be available for rent in winter 2019/20. If you are working with a client who will require a wheelchair accessible apartment in London, please ask them to register their interest at abodeimpact. co.uk/register-your-interest.
households surveyed who have experienced barriers to accessing homes in the Private Rented Sector. Abode Impact will attract large-scale investment into the first fund dedicated to purchasing new build wheelchair accessible apartments for rent in Greater London. This will help to provide a greater choice of accessible properties for some of the 1.2 million wheelchair users in the UK today. â–
GREATER CHOICE FOR WHEELCHAIR USERS
Abode Impact has been set up to tackle the dire lack of wheelchair accessible properties to privately rent. They are responding to over 90% of wheelchair user
Email: info@abodeimpact.co.uk
www.abodeimpact.co.uk 73
e t a m i t l u e h T in intimate cleanliness
“The Closomat is the most wonderful thing of all the living aids we have added to our home, it’s beautiful! I now don’t have to get my wife to help me.” Karl van Gool, Halesowen
Quality • Service • Heritage www.clos-o-mat.com Tel: 0800 374 076 Email: info@clos-o-mat.com
LONG TERM SUPPORT
HOW A WC IS HELPING ONE MAN GET HIS
PRIVACY BACK
When electrician Kyle McAdam Whyte arranged to go out with friends four years ago, he little realised the consequences: it would involve him losing even his ability to go to the loo without help.
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he car in which he was passenger was involved in an accident, which left Kyle unconscious and with life-changing injuries. High level spinal damage has left him unable to do most things for himself, even daily activities such as going to the toilet. So, he has used some of his compensation to adapt his family home, and install the latest in smart toilet technology - a Closomat Asana. The contemporary, sleek wall-hung WC delivers what is claimed to be the ultimate in intimate care, by push button or remote control. Integrated douching and drying deliver hygienic and thorough cleaning. The user is left feeling fresh and dry without any need to wipe... or be wiped! Asana also offers unrivalled personalisation: the concealed cistern can be built into the wall, or hidden behind a choice of sleek back panels in a choice of finishes; operation can be via the integrated push buttons on the edge of the pan, remote control, or, if being used as a conventional WC, via a choice of smart flush devices.
I FEEL MUCH CLEANER
“My carers have to do everything for me. I wanted some privacy back,” Kyle explained. “My injuries don’t mean I can’t have living space that looks good! The architect designing the alterations to my home told me about Closomat: I had a look on the website and saw the Asana. “It looks much better than anything else like it on the market. Also, in my opinion, it washes and dries more effectively too. I feel much cleaner.” Kyle (27) has specified his Asana with a solid white back panel, and chrome finish Oyster flush pad. “I am having to have major alterations done to live at home, including widened doors, a lift between floors, and ramps. Having spent almost a year in hospital, it is important to me that my home doesn’t look like an
institution. The Closomat is one way I can still have a home that is functional but stylish.” Asana is the latest evolution of smart toilets from the UK’s brand leader, Closomat. Founded almost 60 years ago, the company was the first to introduce the concept of toilets that washed and dried the user, to the UK. Its Palma Vita floor-mounted unit is now the biggest selling WC of its type, and the only one developed specifically for disabled and elderly people. Closomat is also the only shower toilet manufacturer that has UK-based sales and aftercare support, complete with its own dedicated team of service engineers. It is also unique in offering a selection of service and maintenance packages, to give peace of mind for the long-term future, enabling its units to deliver ultimate hygiene and cleanliness for decades. ■
Tel: 0161 969 1199 Email: info@clos-o-mat.com www.facebook.com/clos-o-mat @closomatuk
www.clos-o-mat.com
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PREMIUM RANGE WHEELCHAIR ACCESSIBLE VEHICLES Lewis Reed (WAV) Ltd is the leading UK vehicle supplier specialising in the conversion of vehicles to aid the mobility of wheelchair users. About our converted vehicles: Our range include the Mercedes-Benz V-Class & Vito, the Volkswagen Caravelle & Transporter, and also the award winning SEAT Alhambra. Available with up to 7 passenger seats plus wheelchair position. Side and rear access available.
For more information call us FREE* on 0800 or email priority@lewisreedgroup.co.uk
247 1001
*Calls from UK landlines are free of charge, calls from mobile networks may incur additional charges. Please check with your telephone provider for details
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www.lewisreedgroup.co.uk
LEWIS REED HELPS GREG SUMNER EDUCATE YOUNGSTERS ON THE DANGERS OF DRINK DRIVING Six years ago, 28-year-old Greg Sumner was involved in a serious car accident in which two people (including the driver who had been drinking) died, leaving Greg paralysed from the neck down. Greg recently took delivery of his third wheelchair accessible vehicle (WAV) – a Mercedes Benz V-Class from leading UK WAV manufacturer Lewis Reed. Having a vehicle is vital to Greg and his carers, otherwise they have to rely on trains or buses. Over the last 6 years Greg has gradually rebuilt his life after the life changing events of that night and he now travels around schools and colleges giving talks about the dangers of drink driving and this would be impossible without his wheelchair accessible vehicle (WAV) from Lewis Reed.
“I was determined that something positive would come out of what happened to me and I decided if I could stop just one person from either drink driving or getting in a car being driven by someone who had been drinking that would be a start” commented Greg. In addition to his two young children, Greg has friends and family all over the UK and having a WAV means he can visit them.
“The independence I get from my vehicle is hard to put into words. From my first conversation with Chris at Lewis Reed, everyone there has been incredibly helpful, from bringing vehicles from their HQ on the Wirral down to my home here in Bristol, to ensuring the vehicle met all my requirements they could not do enough to help. I would not hesitate in recommending Lewis Reed to anyone looking to purchase a WAV” concluded Greg. To find out more about the full range of vehicle conversations available from Lewis Reed, call us free* on 0800 247 1001.
*Calls from UK landlines are free of charge, calls from mobile networks may incur additional charges. Please check with your telephone provider for details
www.lewisreedgroup.co.uk B&SI 77
Future proof your home with our complete independent living solutions
independent living at affordable prices Maintain independence in the home Accessible bathrooms, kitchens, accessories and more Over 40 years experience British manufacturer Beautiful products designed for your home
Multi-User Bathrooms | Grab Rails | Daily Living Products | Accessible Showering Wetrooms | Wall and Floor Solutions | Access Solutions | Multi-User Kitchens
0845 605 1345 78 B&SI
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info@nichollsandclarke.com
Why
Manage Posture ?
Why is postural management so critical for wheelchair users? Lucy Weech is the Clinical Director leading the Wheel of Health team based throughout the UK and Ireland. The team consists of 17 Clinical Associates who all have extensive post graduate experience in the postural management of complex clients. Presentations range from physical disability following trauma to those with profound and multiple learning difficulties. These clients frequently present either during the litigation process or post settlement. All Clinical Associates manage a highly complex caseload of children and adults. Within this role, clincians complete 24-hour postural management assessments (including medico-legal reports); assessment, prescription and provision of specialist equipment; assessment for provision of wheelchair accessible vehicles; personal care and manual handling assessments.
To contact:E: info@wheelofhealth.co.uk T: +44 (0) 23 8076 8583 M: +44 (0) 78300 72700 W: www.wheelofhealth.co.uk
Posture is often seen as static, with the posture presented at assessment identified as being the clients permanent posture, likely to stay that way. But consider how our own posture changes as we age, and our lifestyle changes. How much more so, then, will the postural requirements of wheelchair users change under the influence of rehabilitation, variable and changeable muscle tone, spasticity patterns, behavioural changes and so forth. A wheelchair users very independence can hinge on effective postural management within the wheelchair. Postural management can and does influence:• Systemic function (i.e the effect of posture on all the bodily systems including the cardiovascular system, respiratory system and digestive system) • Ease of propulsion in a manual wheelchair. • Ease of access to driving controls in a powered wheelchair. • Management of the interface between the wheelchair and other equipment of daily living. •Access to and completion of all activities of daily living inclusive of personal care, work/ education and leisure activities. • Access to communication and other assistive technology devices such as environmental controls. How does a postural management specialist/ expert evaluate a client’s needs when assessing? The first step in an assessment process is to carefully evaluate the client’s physical presentation taking account of deformity, altered muscle tone, spasticity patterns, impaired sensation,
effects of trauma and so forth. These findings should be clinically recorded to give a baseline to subsequent problem solving. It is important to evaluate how much correction is achievable for that which is obviously seen. For example, where there is a pelvic asymmetry that is correctable, then any seating solution should seek to correct it. If it is not correctable, then a posture management solution should seek to accommodate it, to reduce the risk of the deformity becoming worse.
“outwards” in the selection of clinically appropriate products. Therefore, posture management products interface into wheelchairs which then interface into vehicles. We are then able to select a suitable vehicle to fit the wheelchair, rather than trying, usually unsuccessfully, to find a clinically appropriate wheelchair to fit the already purchased vehicle. Retrospective adaptations to previously purchased wheelchair accessible vehicles can cost tens of thousands of pounds.
How do the findings of that evaluation influence the selection of the most appropriate equipment?
How can you ensure that equipment selected meets both the needs of the present as well as being able to futureproof ongoing clinical needs?
Having completed postural analysis and recorded clinical findings in detail, the professional clinician’s responsibility lies in the selection of equipment that is clinically appropriate and addresses issues identified during the assessment process. Features of wheelchairs and posture management equipment informs this process. The professional is therefore responsible for ensuring that they have a good grasp of the features of the equipment and how they affect posture. It is rare to find a single product that will effectively manage client’s postural needs but rather a range of products used together to reach an effective clinical solution. We consider it of the utmost importance to actively work in direct collaboration with the client, their carers and stakeholders and take a multidisciplinary and holistic approach. Which comes first; the wheelchair or the vehicle, and why? It is of paramount importance to “work from the inside, out”. That is to say, that during the process, it is imperative to start with the client and their presenting postural needs, then work
Wheel of Health “Opening doors to maximise independence...”
Competent clinicians need to work with equally competent technical teams and mutual collaboration is of the utmost importance. Equipment suppliers have variable strengths and for wheelchair users who have a full-time dependency on all their equipment require both clinical and technical input that can address those complex needs. Additionally, it is true to say that the clinician needs to be able to crystal ball gaze as much as is possible with regard to the presenting condition (be that positive rehabilitative progress or degenerative progression). Our ethos is to work in direct collaboration with competent equipment suppliers who can provide, maintain and assist in the adjustment of equipment to meet the ongoing clinical changes of our clients. Do you have a client in mind, (or are you the client) that would benefit from a postural management assessment? Please contact myself or Wheel of Health HQ to discuss further.
UK & IRELAND Specialists in Wheelchair, Seating & 24hr Posture Management Solutions... » Specialist wheechair, seating and 24hr posture management clinical practice. » Specialist provider of wheelchair, posture management and allied equipment solutions for adults and children with complex needs. » Highly specialist and skilled professionals with specialist postgraduate training and expertise.
CONTACT US Office: +44 (0) 23 8076 8583 Mobile: 078300 72700
Email: info@wheelofhealth.co.uk Web: www.wheelofhealth.co.uk 79
61 Washway Road | Sale | Cheshire | M33 7SS
t: +44 (0)161 876 0016 e: info@uksmd.com
THE LEADING INDEPENDENT PROVIDER OF MEDICAL & DIAGNOSTIC PROCEDURES TO THE MEDICO-LEGAL PROFESSION
www.uksmd.com
WITH FAST-TRACK NATIONWIDE ACCESS TO UK HOSPITALS & PRACTICES SPECIALISING IN: DIAGNOSTICS • CONSULTATIONS • SURGERY • REHABILITATION
RECOVERY & REHABILITATION
UKS Medical Diagnostics are the leading independent provider of medical and diagnostic procedures to the medico-legal profession.
FAST-TRACK NATIONWIDE ACCESS TO UK HOSPITALS
UKS
Medical Diagnostics were formed in 2003 and have become one of the leading providers of private medical treatment to the personal injury sector working with Medical Agencies and Case Management companies, Insurers and other associated companies – varying from some of the largest in the country to some of the smaller new companies in the industry. UKS are passionate about the industry and have supported companies through transitional periods and growth, the key to our success is our bespoke service meeting all requirements of our clients.
WHAT WE DO
UKS provide a wide range of treatments nationally for example, MRI Scans, X-Rays and CT to more complex procedures such as consultations, injections and surgeries and aftercare such as Physiotherapy and CBT. Patients are treated at over 400 sites across the UK and all patients are treated privately at a hospital local to them, receiving the best treatment. Due to UKSs economies of scale we can provide these services at a competitive price to clients but just as important it saves time; UKS take away all the hassle
and problems clients come across trying to arrange treatment for a patient. Relationships with hospitals and consultants have been established over many years and through constant contact it allows UKS to provide a slick, speedy service, this in turn allows clients to concentrate on their core business, knowing their patients are been provided the best of care.
UKS AND YOU
Our clients are given full access to our secure online portal where you can view and access documents from your patient’s files in real-time 24 hours a day. Our highly experienced case handlers are available to you to assist and manage the procedures, as well as manage the expectations of the patient. We also provide free estimates for further procedures that may be required, enabling you to agree or manage the case funding. ■
Tel +44 (0)161 876 0016 Email: info@uksmd.com Overview
www.uksmd.com
UKS Medical Diagnostics were formed in 2003 and have become one of the leading providers of private medical treatment to the personal injury sector working with Medical Agencies and Case Management companies, Insurers and other associated companies varying from some of the largest in the country to some of the smaller new companies in the industry. UKS are passionate about the industry and have supported companies through transitional periods and growth, the key to our success is our bespoke service meeting all requirements of our clients.
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Dr Linda Monaci Consultant Clinical Neuropsychologist Medico-legal assessments for suspected or known brain injury and/or brain dysfunction in Personal Injury and Medical Negligence claims • Acquired brain injury
• Post-concussion syndrome
• Stroke
• Anoxia
• Epilepsy
• Dementia
• Alcohol and drug abuse
• Neuropsychiatric conditions
• Mental capacity assessments Medico-legal services: Instructions from Claimants, Defendants and as a Single Joint Expert. Appointments usually within 2 to 4 weeks, and reports produced in a further 2 to 4 weeks. Assessments can also be carried out in Italian. Dr Monaci has a good knowledge of the Swedish language and has experience of working through interpreters. Clinical services: neurorehabilitation services are also available Dr Monaci has completed the Cardiff University Bond Solon Expert Witness Certificates (Civil and Criminal Law). Contact: linda@monaciconsultancy.com for an initial enquiry. Main consulting rooms (nationwide locations):
Several locations in the UK are available. Domiciliary visits can be arranged when clinically appropriate Ten Harley Street London W1G 9PF Tel. 020 8942 3148
Borough Chambers Keats House 24-26 St Thomas London SE1 9RS
Aston Clinic 26 Kingston Road Surrey KT3 3LS Tel. 020 8942 3148
Correspondence address: Aston Clinic, 26 Kingston Road, Surrey KT3 3LS Tel. 020 8942 3148
Mental Capacity Simplified TSF provide an antidote to the stress and complexities of mental capacity assessments
The right outcome The rights of the individual The right to excellence in mental capacity assessments To discuss a case or make a referral contact us on 0333 577 7020 or info@tsfconsultants.co.uk
Housing Occupational Therapy www.designforindependence.co.uk
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FINANCIAL & LEGAL
Vicky Gould, is a specialist Occupational Therapist, with experience in neurology, brain injury including cognitive dysfunction & orthopaedics.
Sadia Hussain is a Speech and Language Therapist, experienced in adult neurological and ENT conditions. Sadia is bilingual in Urdu.
Cath Sweby is a Clinical Specialist Physiotherapist with major trauma, neuroscience and spinal cord injury experience.
Dr Caz Lyall, an
experienced Consultant Occupational Therapist specialising in complex neurology, specifically TBI, stroke & PTSD.
MEET THE EXPERTS Here we introduce a sample of Somek and Associates brain and spinal injury experts
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or over 20 years Somek and Associates has been delivering quantum reports (care, occupational therapy, physiotherapy and speech and language therapy) in personal injury and clinical negligence litigation. The experts are based across the UK, and a number specialise in brain and spinal cord injuries. All experts continue to undertake clinical practice either in a statutory or independent setting and many are also case managers, ensuring their recommendations and opinions are current and robust.
To discuss specific case needs and obtain the full CVs of the above experts, and any others, contact Elise Warner, Clinical Business Manager, Somek and Associates: â–
Tel: 01494 792711 Email: admin@somek.com
www.somek.com
Accommodation Experts
Park House | Parkway | Holmes Chapel | Cheshire | CW4 7BA | T: 01477 544499 | F: 01477 544433 www.stevendocker.co.uk
Steven Docker Mag Ad 176 x 120.indd 1
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FUNDING SOLUTIONS AN ESSENTIAL FOR GREATER FINANCIAL FLEXIBILITY
A report recently commissioned by the watchdog NHS Improvement revealed that for every £3 the NHS spends on spinal surgery, £1 is paid out in litigation.
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hese figures through to the larger make it practices with sales in excess startling of £50 million. Our Costs obvious that Advance and High Cost Case clinical negligence and funding products can prove personal injury lawyers are particularly useful needed more than ever to for PI firms. ensure those impacted by High Cost Case funding these types of mistakes allows lawyers to focus on are properly compensated. their case and client, rather However, another issue, than the cash flow. This besides the surprising volume product releases a of cases related to spinal proportion of the law firm’s injury, is the amount of time accrued WIP on a case these cases can take to where there is an admission conclude, with many settled of liability, providing ongoing at the last minute. This does funding until the case is not create the best environment for law firms concluded and ready to bill. operating in this space, which must contend with This removes the cash flow pressures of running a stretched litigation timescales, whilst balancing their high value case with a low, interest-only solution and cash flow. Once a case has been decided and the bill puts the firm on the strategic front foot. For a case issued, a negotiation about costs then that’s been won, the VFS Costs Advance High Cost facility immediately releases the cash takes place which extends the time significantly between billing and payment. Case funding tied up in ongoing cost negotiations. What we don’t want to see is a firm This gives firms the time, and the allows lawyers financial muscle, to negotiate a better ever tempted to undermine the profitability of a case and taking an early settlement and avoid compromise. to focus on settlement due to cash flow troubles. A growing number of law firms have their client Issues with cash flow and a long period discovered how an improved cash before payment can also make it hard for firms to flow means stronger negotiating, better settlements plan for the future. on costs and greater bottom line profitability – don’t be left behind and give yourself the financial space to focus on the case, not cash flow, with these EMBRACING FUNDING SOLUTIONS Thankfully, savvy firms operating in the PI and Clin Neg funding solutions. ■ market are increasingly considering a number of financial instruments to ensure a more robust and predictable cash flow. VFS Legal Funding is a finance company with one focus; providing funding solutions to the legal sector Email: enquiries@vfslegal.com and demand is growing - in just seven years we have www.vfslegal.com provided around £100m to 60 law firms; from the small
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FINANCIAL & LEGAL
THE BENEFITS...
...of lawyers outsourcing medical record collation.
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edical records in brain and spinal injury cases are often voluminous and complex. Before medical experts can be instructed the records need to be collated into type/chronological order, indexed, paginated, scanned and reviewed to identify any crucial missing records. This is a time-consuming process which many law firms don’t have the capacity to complete in-house. This work can be easily outsourced to an external medico-legal provider, such as DMR Collation. The benefits of outsourcing this work are high: ● The outsourced services are recoverable on an agency basis which means that law firms can bill profit costs for the work undertaken by the medico-legal provider on their behalf, rather than recover these fees as a disbursement. ● The services are a recognised disbursement in the industry, qualifying for disbursement funding schemes and funded by ATE insurance. ● The work creates a fully indexed, paginated and navigational set of records which can be used by all parties to the action.
● Most providers offer digital scanning of the records which assists with paperless working and dramatically reduces photocopying and admin costs when providing records to the medical experts. ● Redaction of the records to remove client and third-party information can be completed at the same time as collation. ● Chronologies can be tailored to the client’s specific requirements and include entries relevant to the issue of limitation, breach of duty, causation, contributory negligence and quantum. ● Accompanying memorandums highlight a summary/ timeline of events, relevant points of note, and the identification of missing, privileged and potentially discrediting records. To find out more about DMR Collation’s full range of services, please visit their website. ■
www.dmrcollation.co.uk.
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insurer can provide some welcome infrastructure of the legal market, its stability for law firms, insurers and their been expected that– PHIL firms willRUSE also look – PHILcustomers. RUSE One backed by a strong to simplify processes, look at value added The The world world todaytoday can be described can be described as volatile 1and as uncertain volatile and best uncertain ofas this will at th credit ratingatisthe fundamental services and innovate in technology . times. times. 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PI and clinical negligence market. through the courts. Flexibility through is the cour another factor that should be another factor th letsTECHNOLOGY solicitors TECHNOLOGY offer a better service – INNOVATION AND INNOVATION AND What seems critical now,the is maintaining considered when selecting considered right when legalopportunity. expenses insurer. One legal that gives expenses in This brings both Thisthreat brings both opportunity. threat and they’ll have more time toandspend with anoption industryto top focused on enhancing the up cover on the After option thethe to top Law firms could Law use firms advanced could use advanced (ATE) insurance will help Event to (ATE) insura technology and technology artificial intelligence and artificialEvent intelligence their customers. integrity thetooflegal sector.maintain a level o maintain aoflevel confidence to enhance the to enhance service they provide the service to they provide
2019 2019 OUTLOOK OUTLOOK
PHIL RUSE,PHIL RUSE, HEAD OF HEAD SALESOF AND SALES AND DISTRIBUTION, DISTRIBUTION, ALLIANZ ALLIANZ LEGAL LEGAL PROTECTION PROTECTION
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PHIL RUSE: “Treating customers fairly in our insurance provisions remains IRN research paper (2018) UK personal injury market Solicitors Regulation Authority (2018) Technology and legal services PHIL PHIL RUSE: “Treating “Treating customerscustomers fairly fairly a matter ofRUSE: underlying importance. ” Solicitors Regulation Authority (2018) Technology and legal services 1 2 3
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FINANCIAL & LEGAL
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PUTTING YOUR CUSTOMERS
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Call 0370 243 4340 allianzlegalprotection.co.uk @allianzuklegal Allianz Legal Protection is a trading name of Allianz Insurance plc. Registered in England number 84638. Registered office: 57 Ladymead, Guildford, Surrey GU1 1DB, United Kingdom. Allianz Insurance plc is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. Financial Services Register number 121849. Allianz Legal Protection trading address: 2530 The Quadrant, Aztec West, Almondsbury, Bristol BS32 4AW. ACPERLEG128_1_03.19
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COSTS LAW AND LITIGATION FUNDING IS CONSTANTLY EVOLVING AND BECOMING INCREASINGLY COMPLICATED. There is downward pressure from the Government and some parts of the Judiciary to reduce legal costs. It is therefore more important than ever that legal costs on successful cases are properly recovered to ensure that: 1 Claimant lawyers are paid properly for the valuable work that they do; and 2 Any shortfalls charged to Claimants are at the lowest level possible. Brain and spinal injury claims represent some of the most demanding and complex work in the legal system. The damages are large, which often results in contested litigation and high legal costs.
Claimant law firms are fantastic at caring about their clients and recovering the maximum damages possible, but the same care and attention to their legal costs is often overlooked. This can result in some firms not receiving the appropriate level of payment for the excellent work that they do. At Clarion, we give the right care and attention because our specialist team love legal costs! We are routinely instructed to deal with high value personal injury work and regularly recover in excess of 80% of claims for costs. We concentrate on the costs law, enabling lawyers to focus on the law. Give us a call today on 0113 336 3334 for more information regarding our services.
HOW CLARION CAN SUPPORT YOU: • Bills of Costs, Statements of Costs and Costs Budgets • Negotiation • Advocacy • Fast turnaround • Potential for on site working • Costs law work conducted within a SRA regulated law firm • Team of 17 people • Competitive charges • Free on site legal costs training • Client seminar programme • Monthly newsletters 88
FINANCIAL & LEGAL
A PROVEN RECORD
Parklane Plowden is the North Eastern leading Personal Injury and Clinical Negligence barristers’ chambers. Located in Leeds and Newcastle and have the largest team of specialist barristers described as “outstanding and by far the best in the North of England”*. supporting companies working in this sector, including: IFAs, Costs Companies, medical specialists, software companies and financiers. Chambers is at the heart of the injury claims profession. As one client puts it - “I consider Parklane Plowden Chambers to be in a league of their own when it comes to the broad and loyal relationships that they have with law firms and other industry providers working in this field. They are a hugely respected and trusted Set whose contribution to the industry extends way beyond the courtroom.” ■
Email: clerks@parklaneplowden.co.uk
parklaneplowden.co.uk
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*Chambers & Partners
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hambers is home to over 50 barristers, many of whom are widely regarded as pre-eminent in their field. They provide strong regional coverage and attract national recognition for their expertise. Chambers is also home to the majority of ranked legal directory barristers for the region. The team undertake a wide range of personal injury, clinical negligence, civil fraud and fatal accidents work – offering considerable experience and a proven track record for advice and advocacy work. The are experienced in handling cases involving injuries of the utmost severity – regularly appear in the Chambers is known for its commercial approach and commitment to client care. This extends to not just the relationships developed with the solicitors that instruct them, but also those directly involved in the litigation. Hardworking, committed and strong adversaries, the team has a reputation for getting results. Chambers relationships don’t just lie with those who instruct them, but also the network of
SERIOUS INJURY TEAM
Expertise & Excellence in all aspects of serious injury litigation: – Acquired brain injury – Spinal cord injury – Amputation – Pain disorders – Fatal accidents
For more information please contact: Tel: 0845 241 7006 Email: MT@no5.com Birmingham London Bristol Leicester
No5.com/seriousinjury 90
No5 Barristers’ Chambers provides services on an equal opportunities basis
FINANCIAL & LEGAL
STRENGTH IN DEPTH
The Serious Injury Team at No5 Barristers’ Chambers prides itself on its strength in depth, with experienced counsel at all levels offering an exceptional understanding of complex clinical, causation and quantum issues.
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e are regularly instructed in cases involving issues around capacity, provisional damages, PPOs and statutory funding. Members work nationally and internationally, for both claimants and defendants, with leading provincial and London solicitors and national defendant insurer firms. We are regularly involved in training for Headway, CBIT and the SIA and others upon litigating catastrophic injury claims. Most importantly, we pride ourselves on being accessible and responsive, working closely with those who instruct us to provide a proactive and strategic approach in order to secure outstanding results. Members are noted for their empathy and approachability. We are keenly aware of the need to see a claimant as an individual, not just as another ‘case’ and of the concept of facilitation i.e. by care and support, mobility aids and equipment, to support aspiration and maximise quality of life. Full details of the team visit our website: www. no5.com/expertise/serious-injury BRAIN INJURIES Our experience covers a range of brain injuries, including accidents at work and RTAs, from significant structural brain damage to more subtle brain injuries and post-concussional syndrome, cases of hypoxic brain injury, brain haemorrhage and delay in diagnosis of brain tumours. Case examples include: l TBI involving a Libyan national on holiday in the UK with international expert evidence/an immigration case run in parallel. Settlement for a lump sum of £3.625m gross and a complex PPO of £250,000 pa for care/case management in the UK, £175,000 in Egypt, £125,000 in Libya and £110,000 in Tunisia, depending upon future residency. Given
the claimant’s life expectancy, the lump sum equivalent (pre-Discount Rate review) was 12m+. l A reported catastrophic injury/RTA case involving the road safety responsibilities of an eight-year-old child and his mother. l An RTA involving an American citizen on holiday in the UK who suffered a severe brain injury. Liability was an issue and the case involved complex quantification of a 24-hour care regime and Court of Protection costs in the US. Settled for £3m. SPINAL INJURIES As well as spinal injuries arising from trauma, our work includes clinical/surgical mismanagement and spinal cord injury, including cauda equina, hip replacement, spinal and epidural anaesthesia and surgery. An example is a claim made for delay in diagnosing cauda equina syndrome following the claimant’s attendance at A&E, leaving her doubly incontinent and significantly disabled and as a result, unable to look after her children. The case settled at an RTM shortly before trial for a lump sum of £1m and PPOs of £75,000 to age 48 and £57,335 thereafter. ■
Contact the Serious Injury clerking team: Telephone: 0845 241 7006 Email: MT@no5.com No5.com 91
‘These highly respected Chambers have become totally focused and expert at what they do’ Chambers and Partners
Setting the bar for service, standards and success, with our clients in mind Specialist barristers for Civil and Public law across England and Wales covering: ■ Personal Injuries & Clinical Negligence ■ Catastrophic Injury
The Mews, 38 Cathedral Road, Cardiff, CF11 9LL DX No. 50750 Cardiff2 Telephone: 0845 0713 007 Fax: 0845 0713 008 Andrea.mclean@civitaslaw.com
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For further information please contact our Senior Clerk Andrea Mclean Andrea.mclean@civitaslaw.com Or visit www.civitaslaw.com
FINANCIAL & LEGAL
CIVIL AND PUBLIC LAW BARRISTERS
Civitas Law’s award-winning set of lawyers are ranked as a Top Tier set in The Legal 500 and Leading Set in Chambers UK Bar Guide.
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e are recognised by the Bar and clients, for excellence and strength in depth in advisory work, drafting, mediation and advocacy. Established in 2008, our ethos is based on our progressive principles – to be at the heart of the evolution of legal services and society and to provide clear legal advice, easily understood by our lay clients. At Civitas Law we aim to eliminate traditional barriers between barristers and solicitors. Our outstanding set of barristers is matched by excellent front of house facilities, for use for conferences, meetings, tele and video conferencing, dispute resolution matters and events/seminars. Civitas Law is fully accessible with free visitor parking.
annum. Experience in complex SCI cases where a risk of syrinx has been identified and in claims for adapted accommodation including new build property. We’ll look at cold cases where claims have already been rejected by Lawyers. Nicholas David Jones Year of call: 1987 Nick has a great deal of experience of catastrophic injury claims which involve spinal cord injury and brain damage. Well versed in dealing with claims involving 24 hour care regimes, substantial accommodation needs and periodic payment orders. ■
OUR OUTSTANDING SET INCLUDES:
Bryan Thomas Year of call: 1978 Bryan has PPO experience at levels over £200,000 per
For more information call 0845 0713 007
‘These highly respected Chambers have become totally focused and expert at what they do’
Truly independent, specialist advice for Settin damages awards servic Chambers and Partners
and su our cl
Our highly regarded Personal Injury & Court of Protection Team offers more than 25 years’ of experience in dealing with the specific financial aspects of personal injury and clinical negligence claims, pre- and post-settlement, as well as advising individuals on general financial matters.
Specialist law across
For more information call us on 0207 065 1747 or email personalinjury@chasedevere.co.uk
■ Persona Clinical
■ Catastro The Mews,
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A specialist set with members, including 14 Queen's Counsel, Old Square Chambers provides advocacy, adviceadvice and drafting of theof the A specialist set 80 with 80 members, including 14 Queen's Counsel, Old Square Chambers provides advocacy, and drafting highest quality, at trial level. level. Our exceptional clerking team team are also and provide friendly and professional highest quality, at and trial appellate and appellate Our exceptional clerking are recognised also recognised and provide friendly and professional support. support.
Old Square Chambers has proven expertise, at all at levels of seniority, encompassing the full of Personal InjuryInjury matters. Our Our Old Square Chambers has proven expertise, all levels of seniority, encompassing thespectrum full spectrum of Personal matters. members are particularly recognised for their experience in high and complex claims, frequently actingacting for both claimants and and members are particularly recognised for their experience in value high value and complex claims, frequently for both claimants defendants in cases involving catastrophic and fatal and traumatic brain,brain, spinalspinal and life-altering injuries. We also an an defendants in cases involving catastrophic and accidents, fatal accidents, and traumatic and life-altering injuries. We have also have outstanding reputation in theinareas of Clinical Negligence, HealthHealth and Safety prosecutions and Product Liability. outstanding reputation the areas of Clinical Negligence, and Safety prosecutions and Product Liability. Our clients choose Old Square Chambers because of ouroffirst because of ourofexperience and knowledge, and because we we Our clients choose Old Square Chambers because ourclass first reputation, class reputation, because our experience and knowledge, and because listen.listen. We put at the of allof we tirelessly for your interests and to the best We our put clients our clients at heart the heart all do. we We do. will We fight will fight tirelessly for your interests andachieve to achieve the best results. results. For more information, pleaseplease call one ourofclerks on 0207 269 0300 or email clerks@oldsquare.co.uk For more information, callofone our clerks on 0207 269 0300 or email clerks@oldsquare.co.uk LONDON LONDON 10-11 10-11 Bedford Row Row Bedford London London WC1R WC1R 4BU 4BU
T +44 T(0)+44 20 (0) 7269 200300 7269 0300 F +44 F(0)+44 117(0) 927 3478 117 927 3478
DX 1046 Lane Lane DXChancery 1046 Chancery
BRISTOL BRISTOL 9 Queen SquareSquare 9 Queen BristolBristol BS1 4JE BS1 4JE
T +44 T(0)+44 117(0) 930 5100 117 930 5100 F +44 F(0)+44 117(0) 927 3478 117 927 3478 DX 78229 BristolBristol 1 DX 78229 1
LEADING EXPERTS
Personal injury specialists acting for a multitude of clients in all forms of personal injury.
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specialist set with 80 members, including 14 Queen's Counsel, Old Square Chambers provides advocacy, advice and drafting of the highest quality, at trial and appellate level. Our exceptional clerking team are also recognised and provide friendly and professional support. Our team of personal injury specialists act for a multitude of clients in all forms of personal injury – from high value, complex catastrophic injury claims to disputes in the small claims court - enabling us to service a wide range of advocacy and advisory work nationwide. Our team's experience in other associated areas, such as clinical negligence, costs work, product liability and professional regulatory disputes, allows us to provide a fully comprehensive service, giving our clients the option of maintaining continuity throughout the entire course of personal injury cases. We work across the UK to get the compensation our clients and families need to help rebuild their 94
lives and cope with life-changing injuries with expert rehabilitation, medical care and support. Our barristers are leading experts in personal injury and clinical negligence. Our clients are victims of catastrophic injuries, including brain and spinal injuries, childbirth injuries, cerebral palsy, amputations, chronic pain conditions and psychiatric disorders. Our clients choose Old Square Chambers because of our first class reputation, because of our experience and knowledge, and because we listen. We put our clients at the heart of all we do. We will fight tirelessly for your interests and to achieve the best results. â–
For more information, please call one of our clerks on 0207 269 0300 or email clerks@oldsquare.co.uk
FINANCIAL & LEGAL
A VOICE FOR THE INJURED & BEREAVED The Association of Personal Injury Lawyers is a not-for-profit campaign organisation set up almost 30 years ago to provide a voice for wrongfully injured people and bereaved families. In the intervening years it has grown from just a handful of lawyers to a membership of around 3,400 individuals.
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efore APIL was established in 1990, expected to be able to demonstrate substantial standards among lawyers representing experience in these fields. A lawyer with spinal cord injured people left some room for accreditation, for example, is likely to have conducted at improvement. Injured people were least ten spinal cord injury cases, of which at least five constantly struggling to claim redress from those will be for people who have tetraplegia. In the years who had injured them – usually other before gaining specialist accreditation, the One of the lawyer will have dedicated around half his motorists, or employers who had the means to mount robust legal defences reasons the or her training to spinal cord injury issues. paid for by their compulsory These lawyers will also be likely to organisation take an active part in spinal cord injury insurance premiums. The injured person on the other side was at a was formed groups such as the Spinal Injuries serious disadvantage. or ASPIRE. A lawyer who is was to provide Association One of the reasons the organisation accredited as a brain injury specialist will high quality meet similar criteria, and his case was formed was to provide high quality training for APIL members so they could experience will probably include at least training provide the best service possible for three cases which involved helping injured people. people who were unable to make their own Being a member of APIL is not, though, a badge of decisions. The brain injury specialist is also likely to merit. Efforts to address that began twenty years play an active part in brain injury groups such as the ago, with a special scheme to provide accreditation Acquired Brain Injury Forum or Headway. for APIL members. This accreditation is available to solicitors and barristers at different levels to reflect BEST WAY TO THE RIGHT LAWYER Specialist lawyers can be identified by the logos they their expertise and experience as they progress in their careers. Accreditation is not awarded lightly, nor are entitled to use, and APIL also has a long-established relationship with Citizens Advice, to ensure people who are all APIL members accredited. They have to earn it turn to them for help are pointed in the right direction by jumping through some very high hoops. That in terms of finding the right lawyers. includes completing 16 hours of accredited personal In the 20th anniversary of the launch of the injury training every year, and revalidating their accreditation scheme, APIL is still working to improve accreditation every five years. and extend its network of accredited lawyer members. This, after all, is the best way to ensure ABLE TO DEMONSTRATE SUBSTANTIAL EXPERIENCE injured people know they are going to the right lawyer, with the right level of experience and But more needed to be done. A person with a serious expertise to handle their cases. ■ brain or spinal injury may well live near an APIL member who is accredited at the highest level but that isn’t much help if the solicitor does not have the specialist skills needed to represent people with these injuries. This is why APIL members who are accredited at the highest tiers of the general scheme are also able to apply for accreditation in seven specific fields of expertise, including brain injury and spinal cord injury. Although the underlying procedures are often Tel 0115 943 5400 common to all personal injury cases, lawyers seeking www.apil.org.uk specialist spinal cord or brain injury accreditation are
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Lawyers Specialising in Brain and Head Injuries Understanding, Knowledge, Experience
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e are one of the UK’s leading specialist legal firms dealing with brain and head injuries. Our personal injury team understands that a major trauma injury will require early, specialist, intensive and expertly delivered rehabilitation to help with your recovery. It also requires someone to help fight for the compensation you deserve as well as support you throughout the entire rehabilitation and claims process, which is where our team of specialist lawyers will help. Our major trauma team, led by Riffat Yaqub and Anne Sanders, work with case managers, care providers and support groups to help you get the medical care and rehabilitation you may need to help you recuperate. Our ethos for over forty years has always been to fight for what’s right and get the best possible results for our clients and their families. Our team of specialist personal injury solicitors have an enviable track record of getting the results for clients with brain and head injuries. We were recently awarded London Firm of the Year 2019 for our personal injury and clinical negligence work by The Legal 500.
Riffat Yaqub
Anne Sanders
For expert legal advice request a FREE initial telephone consultation by calling 0808 239 5575 Call us 24 hours a day Email: hja@hja.net Web: www.hja.net We are authorised and regulated by the Solicitors Regulation Authority (No 651238).
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Suffering a catastrophic brain or spinal injury is devastating and life changing not only for the injured patient but also for their family and friends. It’s difficult to know where to turn for help.
FINANCIAL & LEGAL
FIGHTING FOR WHAT’S RIGHT H ere at Hodge Jones & Allen Solicitors we have been handling personal injury claims for over 40 years, putting the injured person at the heart of everything we do. Our team of solicitors have a real depth and diversity of knowledge, offering personal support, guidance and a helping hand throughout the claims process. We understand the challenges and uncertainties you’re likely to face following such an injury and our aim is to guide you through the legal process, not only to obtain the financial security you deserve for the future, but also to access early rehabilitation through treatment, therapies, care and support.
SPECIALIST BRAIN AND SPINAL INJURY SOLICITORS
Rehabilitation and care is our primary focus and our clients choose Hodge Jones & Allen because we’re in tune with their needs. We recognise every injury is different and every individual is different, so, the treatment and recommendations will be tailored to you and your symptoms. We have a proven track record of high value settlements, but also access to top quality rehabilitation experts. We work with medical professionals and with the insurers (of the person who injured you), to ensure an early rehabilitation package is put in place, as well as an early compensation payment, also known as an interim payment. Both are essential ingredients to getting your life back on track.
At Hodge Jones & Allen we feel privileged to be part of your journey to make a real difference to what can be a daunting and lonely experience. Our personal injury solicitors deal with a wide range of catastrophic and life changing injuries such as:l Acquired and traumatic brain Injuries l Spinal cord injuries and amputations l Complex and multiple fractures l Chronic pain and complex regional pain syndrome l Fatal accidents and nerve damage l Psychological injuries such as PTSD and depression We also have a specialist Court of Protection team who deal with brain injured patients, the elderly with dementia and people with learning disabilities – using their expertise to manage the affairs for individuals lacking the capacity to make decisions for themselves. Most of our cases are dealt with on a No Win No Fee arrangement so there is no financial risk to you. We’re here to help. ■
Tel 0808 239 5575 @hodgejonesallen @hodgejonesallen
www.hja.net
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When people suffer serious injuries, they need specialist support. That’s why we’re here. Our Serious Personal Injury team are experts in helping victims and their families deal with the effects of a devastating accident, so they can get the most out of life.
Our Solicitors have a proven track record of dealing with brain and spinal injuries. Meet our brain and spinal injury specialists:
Rose Gibson Partner
Matthew Clayton Partner
Caroline Fox Associate Solicitor
rose.gibson @simpsonmillar.co.uk
matthew.clayton @simpsonmillar.co.uk
caroline.fox @simpsonmillar.co.uk
We can offer:
▶ Free initial consultation at home, hospital, or one of our offices ▶ A No Win, No Fee service ▶ Housing and living advice and assistance ▶ Early rehabilitation assessment ▶ Legal expense funding ▶ Expert financial and welfare benefit advice ▶ Senior Solicitors working solely on serious injury claims To find out how we can help, call 0808 239 1602 www.simpsonmillar.co.uk Simpson Millar LLP is authorised and regulated by the Solicitors Regulation Authority
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FINANCIAL & LEGAL
BRAIN-INJURED BIKER HOPEFUL FOR FUTURE AFTER SIMPSON MILLAR INTERVENTION
Our client was injured in a road traffic collision on August 17th 2016 when he was riding his motorcycle along Edlington Road in Doncaster.
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car turned right across the right direction. His claim is his path and he suffered some way off settlement and a severe catastrophic we continue to focus on his brain injury, which ongoing rehabilitation and resulted in him losing consciousness increasing his mobility. for several months. As our client is 6 ft 7, this The NHS felt that his future outcome has presented us with some would most likely be that he would challenges. Because his mobility need to live in a residential brain injury has increased, so too has his life unit for the rest of his life, as he was expectancy, as well as the future unable to communicate or move other value of his claim. The more that he Rose Gibson, Partner, Serious than to clench his thumb to say ‘yes’ or can move, the less likely it is that he Injury Solicitor ‘no’, and he appeared to be ‘locked in’ . will be prone to chest infections, The family were given pneumonia, and other very little hope for his secondary complications. Desperate for decisive future. However, they got in He is now looking action to be taken, they asked forward to living a much touch with us at Simpson Millar, and we went to visit if there was anything else that more independent life them. Desperate for his family could ever we could do, so we sought an than decisive action to be taken, have dreamed of, purely opinion from a specialist they asked if there was because the private input anything else that we could into his rehabilitation neuro-physiotherapist do, so we sought a private seized the window of opinion from a specialist neuro-physiotherapist. opportunity to maximise this stage of his recovery. With their initial input (on a credit basis initially and Our client is now looking forward to returning to subsequently recovered as part of his compensation his hobbies of fishing, keeping chickens and spending package), our client began to increase his movements, time with his friends and family. ■ demonstrate an ability to understand what was being said to him, and hugged his mother for the first time.
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LIFE EXPECTANCY HAS INCREASED Eighteen months after the accident, he started speaking again, and two years post-accident, he started to walk with assistance. He now mobilises with an electric wheelchair and we have just purchased a house for him. The house needs adaptations and he will need a vehicle too. This will take time, but we are moving in
Call us on 0808 239 1602
www.simpsonmillar.co.uk 99
Call Girlings Personal Injury Claims Solicitors on 01227 828 299 for a FREE no-obligation chat about your accident or medical negligence claim.
BRAIN INJURY CLAIM?
KENT’S NO WIN, NO FEE BRAIN INJURY SPECIALISTS Apart from seeking compensation for you, we can also discuss arranging any private medical treatment you may require from neurologists, neuro-psychologists, occupational therapists, physiotherapists, etc. as we appreciate that making a good recovery is the main priority. 100 B&SI
01227 828 299 www.girlingspersonalinjury.co.uk personal@girlingspersonalinjury.co.uk
FINANCIAL & LEGAL
IN PRAISE OF COOPERATION
The benefits of a team-approach to rehabilitation: By Jonathan Pidduck, Managing Director of Girlings Personal Injury Claims Ltd.
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resident Franklin D Roosevelt damages payable. once said: “Competition has I am presently working on brain injury claims where Jonathon been shown to be useful up to we have an excellent working relationship with the Pidduck a certain point and no further, Defendants’ Solicitors. This has included rehabilitation but cooperation, which is the thing we must strive ‘signposting’ meetings, keeping them fully in the loop in for today, begins where competition leaves off”. terms of case management and keeping them fully As a Claimant Solicitor, it will come as a surprise to updated in relation to treatment. In return, they have no-one to hear that my basic objective in dealing with a funded the treatment which my clients have required personal injury claim is very different to that of the to help maximise their recovery. Defendant’s solicitor; my aim is to recover as much I have been told by one Defendant firm of a claim damages for my client as I possibly can, a serious brain injury where the Both involving whereas my opponent will try to keep the Claimant’s Solicitor refused an offer to fund parties rehabilitation altogether, presumably because award as low as he/she is able (or indeed to avoid payment altogether). should be he wanted to “keep his cards close to his There are some areas where we share a chest!” On the other hand, I have had cases seeking to where Defendants have refused to fund common objective; both parties should be seeking to resolve the claim within a resolve the rehabilitation under the Code and the reasonable time-frame and without interim payment route has had to be claim unnecessary friction. I invariably find that pursued instead (the claimants’ condition where I have a good working relationship with my deteriorating in the meantime). opposite number, the claim will be concluded faster This is not to say, of course, that there should be no (and at lower cost) than in those cases (thankfully few scrutiny of any proposals which one party makes to and far between) where the Defendant engages in a the other concerning rehabilitation, but if both parties point-scoring exercise. Despite this, our basic objectives can work in tandem to assist the Case Manager in (maximising and minimising damages respectively) driving the rehabilitation process then there really are remain diametrically opposed. no losers. Franklin D Roosevelt would be proud! ■ The exception to this should be in the field of rehabilitation. It is clearly in the Claimant’s best interests to make as quick a recovery as possible, and much more often than not this will be more important to him/her than the compensation itself. Likewise, it is Tel:01227 828299 in the Defendant’s best interests to ensure as complete www.girlingspersonalinjury.co.uk a recovery as possible is made in order to minimise the
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WHEN YOU NEED US The Clinical Negligence Specialists: Brain & Spinal Injuries Cerebral Palsy & Child Brain Injury Fatal Claims Diagnosis Errors & Delays Orthopaedic Claims Cancer Claims
www.hay-kilner.co.uk 0191 232 8345
LEGAL EXPERTS– HERE TO HELP YOU If you have suffered a brain or spinal injury, we can help you claim the compensation you deserve and secure the future you need. WHO ARE WE? At Hay and Kilner Law Firm we understand the impact that suffering a serious injury can have on your life and on the lives of people around you. We have one of the leading teams in the North East of England, dedicated to helping the seriously injured re-build their lives. Our friendly team of solicitors have years of experience in providing specialist support to clients throughout the country, following a brain or spinal injury. We will fight hard to ensure that you obtain the compensation you are entitled to and to ensure your future financial security. We are experienced trial lawyers and have won multimillion pounds in settlements on behalf of our clients.
WHAT DO WE DO? We act on behalf of seriously injured clients who have suffered life-changing injuries. We understand that bringing a claim can be stressful and do our best to explain things in a clear, friendly and approachable manner. We offer support and straightforward advice to ensure that your claim runs as smoothly as possible, without bringing any further stress on you. We take time to listen to, and understand, your concerns and those of your family and to reassure you that we will be there to help every step of the way. Whilst we recognise the importance of maximising the recovery of financial compensation, we also understand the need to facilitate access to early rehabilitation so that you can get the most out of life.
We work alongside trusted and highly experienced teams of medical professionals, therapists, care experts and rehabilitation services to ensure the very best support and after care is provided to you. All members of our team are professionally qualified and experienced in dealing with the complex and sensitive issues which can arise in such life-changing claims.
WHAT CAN WE OFFER? We are always happy to take the time to meet with clients who are considering a claim, to explain the steps involved and what you can expect throughout the process. We will discuss with you the funding options available and, subject to assessment, are able to offer no win, no fee agreements. We can visit you at home or in hospital. We can also help you with other legal advice you may need, for instance wills, powers of attorney, Court of Protection and house-buying. Our relationship with you does not end when your claim settles. For many of our clients we remain involved in assisting you with your financial and practical needs throughout your lifetime.
We are very happy to offer a free initial consultation, so if you are considering making a claim, please contact our Clinical Negligence Team on 0191 232 8345 or email clare.thompson@hay-Kilner.co.uk.
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right people, right skills, right technology Specialist brain and spinal injury lawyers Helping you access rehabilitation and care Welfare benefits advice Home/hospital visits at a time that suits you Clients across the UK Specialist motorcycle team NO WIN NO FEE
www.carpentersgroup.co.uk
seek to ensure that your rehabilitation Our team of serious injury lawyers is one of the largest in requirements are identified and met early on and are delivered in an environment that best suits the UK. Our Lawyers are members of the Headway your needs. We will seek an early interim payment UK approved Solicitor Panel, the UK Acquired Brain Injury Forum, the Association of Personal Injury Lawyers from the Defendant where appropriate to fund Carol Hopwood, Head of Serious Injury at Carpenters Group, talks you through and Motor Accident Solicitors Society. Our lawyers are rehabilitation. We can also assist with welfare how our team can help those suffering with a serious injury. benefits advice. also trustees and volunteers for local branches of look “normal”. We can work with your family, Life after a brain or spinal injuryRoad can be very and different Headway as well as supporting Peace Brake friends and employer if needed to help them to and you will have many better understand through our connections with questions about the Headway. journeywhat is different the Road Safety Charity. “Everyone’s future will hold. Our role is to but our significant experience in this work the will Brain and Spinal Rehabilitation, Support and ensure thattype you of receive best rehabilitation and support Reaching your Full Potential ensure that your rehabilitation specific to youryour needs so youiscan maximise recovery, reach your full potential and have financial The rehabilitation process is unique to you. Our and goalsYour to ensure outcomeandforyou you.willWebe at focus is always on maximising your recovery and security. needsthe arebest our priority the centre of the entire process. getting you back to being the best you. We will understand the impact that life-changing injuries will seek to ensure that your rehabilitation Our team of serious injury lawyers is one of the largest in requirements are identified and met early on and have upon and your family physically, emotionally are delivered in an environment that best suits the UK. Ouryou Lawyers are members of the Headway your needs. We will seek an early interim payment UK approved Solicitor Panel, the UK Acquired Brain and financially andAssociation the practicalof Personal worries that youLawyers and from the Defendant where appropriate to fund Injury Forum, the Injury rehabilitation. We can also assist with welfare and Motor Accident Solicitors Society. Our lawyers are withbranches you to identify your family willandface. We will work benefits advice. also trustees volunteers for local of Headway as well as supporting Road Peace and Brake andRoad deal with those worries”. Safety Charity. “Everyone’s journey is different the
Carpenters Group Serious Injury Team
but our significant experience in this type of work will ensure that your rehabilitation is specific to your needs and goals to ensure the best outcome for you. We understand the impact that life-changing injuries will have upon you and your family physically, emotionally and financially and the practical worries that you and your family will face. We will work with you to identify and deal with those worries”.
“The Invisible Injury” There are many different effects of a brain injury. Some are temporary, some are permanent. Some are obvious and some are not. It is often referred to as “the invisible “The Invisible Injury” There are many different effects of a brain injury. Some injury” because often there are no obvious external are temporary, some are permanent. Some are obvious and some are not. It is often referred to as “the invisible indications that a person has a brain injury and this injury” because often there are no obvious external indications that apeople personto has a brain injury and this makes it hard for understand because you makes it hard for people to understand because you
working collaboratively to rebuild lives working collaboratively Hopwood toCarol rebuild lives
Head of Serious Injury Team Carol Hopwood EmailHead - cmh@carpentersgroup.co.uk of Serious Injury Team Email - cmh@carpentersgroup.co.uk Call Call -- 0344 0344 249 249 3942 3942 B&SI 105
AWARD-WINNING PERSONAL INJURY & MEDICAL NEGLIGENCE SOLICITORS
“Fieldfisher provides ‘a level of service that is 10/10 in all aspects’. The team of ‘excellent litigators’ handles all types of high-value claims both in the UK and abroad and combines ‘a highly compassionate and client-oriented approach with the resources and the hard-driving attitude of a City firm’.” Legal 500
SPEAK WITH ONE OF OUR EXPERTS
Call 0800 358 3848 Email: personalinjury@fieldfisher.com 106 B&SI
Web: fieldfisher.com/personalinjury
throughout England and Wales, whilst al early rehabilitation to help our clients ma FINANCIAL & LEGAL ADVERTISEMENT FEATURE possible recovery. Advertisement feature The team has recently successfully ac Hugh James - Leading Brain and Spinal Cord Injury aSolicitors Jones*, who suffered severe brain and funding care and rehabilitation, we Hugh James provides a bespoke, partner led, in privately injury when, as a pedestrian sowalking h holistic approach to litigation involving life changing had to act quickly for Mr Jones. We quickly issued was hit by made a carawhich hadapplication mounted the successful injuries. With more than 40 years’ experience, court proceedings, Mr Jones required urgent a substantial interim and rehabilitation soon after our multidisciplinary team has an outstanding Hugh James provides a bespoke, partner-led,forholistic approach topayment, litigation. residential rehabilitation washis arranged success rate in pursuing complex brain and spinal privatethe clock care following tragicforincide ith more years’ experience, for Mr Jones. We quickly issuedwe court him.quickly On discharge from rehabilitation arranged cord injury claims. Wethan have40recovered hundreds act multidisciplinary teamfor hasclients an proceedings, made a successful application forus avehicle Mr Jones’ family and instructed because for adapted accommodation an adapted of millions of our pounds in compensation outstanding success ratealso in securing substantial interim payment, and soon after private to be purchased for Mr Jones. throughout England and Wales, whilst aware of the reputation of Hugh James a pursuing complex brainmake and spinal rehabilitation was arranged for him. On early rehabilitation to help our clients the best residential We also arranged him specialising and his familyintoassisting be national lawforfirm cord injury claims. discharge from rehabilitation we arranged for adapted possible recovery. supported by a specialist case manager who cohad sustained life changing We have recovered hundreds of millions of pounds accommodation and an adapted vehicle to beinjuries. The team has recently successfully acted for Mr ordinated the bespoke private care package and in compensation for clients throughout England and purchased for Mr Jones. rehabilitation. Jones*, who suffered a severe brain and spinal cord ongoing The defendant’s were We also arranged for him andinsurers his family to be reluctan Wales, whilst also securing early rehabilitation to help our
LEADING BRAIN & SPINAL CORD INJURY SOLICITORS
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injury when, as a pedestrian walking his dog, he clients make the best possible recovery. was hit by a car which had mounted the pavement. The team has recently successfully acted for Mr Mr Jones required urgent rehabilitation and around Jones*, who suffered a severe brain and spinal cord the clock care following his tragic incident. injury when, as a pedestrian walking his dog, he was hit Mra Jones’ family instructedthe uspavement. because Mr they were by car which had mounted Jones aware of the reputation of Hugh James as a leading required urgent rehabilitation and around the clock national law firm specialising care following his tragic incident.in assisting those who had sustained life changing Mr Jones’ family instructed usinjuries. because they were The insurers wereJames reluctant to engage awaredefendant’s of the reputation of Hugh as a leading
The team by at Hugh James will alwayswho go above supported a specialist case manager co- and beyond, to secure quality care and support ordinated the bespoke private care package and in the shortestrehabilitation. possible time. ongoing ToThe speak member ofwill ouralways specialist teamand today, teamtoataHugh James go above please call 0808 163 5074. beyond, to secure quality care and support in the shortest possible time.changed to protect the privacy of *his name has been To speak to a member of our specialist team today, individual. please call 0808 163 5074. ■ *His name has been changed to protect the privacy of the individual.
national law firm specialising in assisting those who had sustained life changing injuries. The defendant’s insurers were reluctant to engage in privately funding care and rehabilitation, so we had to
HELPING YOU GET BACK TO LIVING L HELPING YOU GET BACK TO LIVING LIFE Life changing brain and spinal cord injuries can have an impact on your relationships, career, ability to provide for your family and your general quality of life. Our team of specialist solicitors provides expert advice and services to ensure that you receive the highest possible level of compensation, care, treatment and rehabilitation following a life changing injury.
Contact us hughjames.com | 0808 163 5074 Hugh James is authorised and regulated by the Solicitors Regulation Authority (SRA Number:303202) and is authorised and regulated by the Financial Conduct Authority.
Life changing brain and spinal cord injuries an impact on your relationships, career, abi provide for your family and your general qu
Our team of specialist solicitors provides ex and services to ensure that you receive the possible level of compensation, care, treatm rehabilitation following a life changing injury
Contact us hughjames.com | 0808 163 5074
Hugh James is authorised and regulated by the Solicitors Regulation Au Number:303202) and is authorised and regulated by the Financial Cond
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Expertise in Brain and Spinal Injury The importance of early diagnosis Specialist care in neurological and neurosurgery units helps to ensure that those who have suffered traumatic brain or spinal injury have the best possible chance of effective treatment and a good recovery. Those who have suffered these devastating injuries may be taken immediately to a suitable unit or find that they are transferred there after being stabilised. The reality is that life changing injuries do not only occur as a result of serious accidents. A devastating brain injury can occur as a consequence of an aneurysm or because an underlying condition has gone undiagnosed. A spinal cord injury can occur as a result of a simple fall, particularly in those with some degree of pre-existing vulnerability.
compromise may not be recognized until permanent damage has occurred. The consequences of these missed diagnoses can be devastating. Individuals who could have been effectively treated may find that they are now in need of round-the-clock care. The CNCI team have experience at dealing with claims arising from brain and spinal-cord injury where a significant factor in the severity of the injury was a clinical failing. We act for clients across England and Wales and work closely with independent medical experts.
“We listen, we understand. we help.�
Sadly, serious conditions are not always recognized in primary care or even at local hospitals. Patients who are displaying early symptoms of subarachnoid haemorrhage or sinus thrombosis may find that their symptoms are mistaken for less serious conditions. Similarly, cervical myelopathy and cord
If you have concerns about medical advice or treatment in respect of a brain or spinal cord injury then call or e-mail us today for a confidential discussion.
www.cnci.co.uk enquiries@cnci.co.uk 0845 601 4499
Clinical Negligence and Catastrophic Injury Solicitors
Advising with empathy and experience CNCI have specialist knowledge of the particular issues associated with a range of the most serious medical negligence injuries including those affecting the brain and spine. We also act for clients who have suffered life changing injuries at work, leisure or on the road. Our compassionate, professional advice and assistance helps support individuals and families who are suffering from the trauma of catastrophic injury. Call to speak in confidence to one of our advisors today.
We listen, we understand, we help.
0845 601 4499 www.cnci.co.uk
CNCI is a specialist service provided by Harrowells Limited which is authorised and regulated by the Solicitors Regulation Authority.
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FINANCIAL & LEGAL
SPECIALIST MEDICAL KNOWLEDGE
Morrisons Solicitors is a Surrey and South-West London based law firm, who act exclusively for claimants, many of whom have suffered catastrophic injury; including brain and spinal injury.
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number of our team have specialist medical knowledge and despite the complexity of the cases, we understand how stressful and traumatic a life changing injury can be for our clients. Our team deal with claims compassionately, but robustly, working to achieve the best possible outcome for our Clients; which means securing interim payments as needed so that any required care and rehabilitation can be put in place. As the claim progresses, we put you in touch with the appropriate experts/agencies who can also assist you. We maximise the damages for our clients, and
have been known to take on very risky cases and succeed against defendants. We are confident in our abilities and if you believe we can assist you then please do get in touch. â–
Tel: 01737 854500
www.morrlaw.com
PERSONAL PERSONAL INJURY INJURY && CLINICALCLINICAL NEGLIGENCE NEGLIGENCE
at life Dealing throws with everything at you. that life throws at you.
g smoothly, Just when lifesomething seems to be going can along smoothly, something can own. happen At Morrisons that turns your world we upside will support down. At Morrisons we will support sensitve you through approach, the claims process to help with a you sensitve approach, to help you . restore a little balance back in your life.
morrlaw.com 01737 854 546
01737 854 546
on | Redhill Woking | Oxted| |Camberley Wimbledon | Teddington | Woking | Camberley
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Protect yourself and your clients Providing specialist advice and calculations to safeguard your clients’ future financial security.
PROUDLY DELIVERING EXPERT ADVICE FOR OVER 30 YEARS. We are passionate about maximising life enhancing outomes for our clients
Our consultants have advised many of the UK’s leading law firms and barristers on settlements and investments for their clients. Using a specialist IFA will help you feel better informed to maximise damages and
“I have been involved with Frenkel Topping in
make the right investment choices. We can provide you with the confidence that the
several major clinical
financial position of your clients have been properly assessed so that they receive
negligence cases. Their
the maximum amount of damages they are entitled to. We deliver a variety of expert reports to meet the needs of our clients.
reports are carefully researched and clearly
To talk to one of our consultants, contact us on
presented, so the client
0161 886 8000
is fully informed on the
or email us at enquiries@frenkeltopping.co.uk EXPERT WITNESS
PERIODICAL PAYMENTS
COURT OF PROTECTION
WELFARE BENEFITS
PENSION LOSS
SPECIALIST FREE TRAINING
best options available to them.”
Clare Jones Associate, Zest Legal
Frenkel Topping Limited is authorised and regulated by the Financial Conduct Authority No: 145186. Registered in England No: 02312427
Specialist Court of Protection Solicitors At Hyphen Law, we have an expert team of specialists in Deputyships and Personal Injury Trusts who fully understand the needs of vulnerable people. Helping children and adults with brain and other life-changing injuries is a key focus for us. We advise and assist on: •
All aspects of Court of Protection property and affairs work
•
Support for family members or friends who are deputies, including joint Deputyships
•
Applications to the Court of Protection including statutory wills
•
The creation and management of Personal Injury Trusts
•
Securing and administering state-funded care
•
Planning for the possibility of future incapacity
•
Private client services including: tax planning, wills and probate
Call: 0845 160 1111 Email: info@hyphenlaw.co.uk Visit: www.hyphenlaw.co.uk EXPERT HELP WHEN IT’S NEEDED MOST
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Expert help when it’s needed most Hyphen Law has an expert team of dedicated Court of Protection solicitors providing a wide range of specialist professional Deputyship services. What is the Court of Protection? The Court of Protection helps vulnerable people who are unable to make certain decisions due to a lack of mental capacity. This may be due to a brain injury from a serious accident, medical negligence, illness or old age.
What is a Deputy? A Deputy assists with decision-making for someone who lacks capacity. A ‘lay Deputy’ is often a family member or friend. A ‘professional Deputy’ is an employed individual, often a lawyer, who has expertise in legal issues affecting the vulnerable and has experience managing the financial affairs of others.
Why consider a professional Deputy? The financial affairs of vulnerable individuals can be complex, particularly when they involve large compensation awards. A professional Deputy can bring the additional skills that are needed in these cases and the court may require the appointment of a professional where there are significant funds to manage.
What does a professional Deputy do? Professional Deputies have a wide-ranging role. This can include: buying, selling or adapting property, making investments, employing carers, keeping tax affairs up-to-date, claiming state benefits and other statutory funding, paying bills, monitoring cash flow, applying to the court for a statutory will and, in the case of ongoing litigation, working closely with personal injury solicitors and much more.
I can see the benefits of a professional Deputy but what if I’d still rather do it myself? Hyphen Law offers a complete support service for those who prefer to take on the role of Deputy themselves. We provide practical information and expertise to ensure you comply with legal, financial and reporting obligations. We also offer joint Deputyships for families wishing to retain some control while benefitting from our specialist expertise.
How can Hyphen Law help us? We have many years of experience dealing with the Court of Protection. We understand everyone’s needs vary enormously and whatever the circumstances, we tailor our services and always put our clients’ best interests first. Our Deputyship services make a huge difference to people’s lives, safeguarding finances and protecting their future. We also help set up and administer Personal Injury Trusts.
To find out how we can help you or a loved one, call us on: 0845 160 1111 or email: info@hyphenlaw.co.uk EXPERT HELP WHEN IT’S NEEDED MOST
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Thoughtful, well-considered, open and honest Mr H, Warwickshire
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As specialist Independent Financial Advisers, Nestor can help you get the most out of your personal injury settlement, helping you get the most out of life. We provide postsettlement investment and welfare benefits advice, personal injury trust and periodical payment and pension loss reports for personal injury claimants and their families. Controlled House, Waterfold Business Park, Rochdale Road, Bury, Lancashire BL9 7BR DX 20511 Bury
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0161 763 4800 0161 763 4809 info@nestor.co.uk @NestorIFA nestor.co.uk
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.
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PERIODICAL PAYMENTS At Nestor, we have many years’ experience advising on Periodical Payments. Settlements involving Periodical Payments are far from straightforward, and we offer an expert witness service to assist in this complex area of law and financial planning.
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e have built a strong reputation acting for both claimants and defendants in high-value claims. Our level of knowledge in such cases is second to none and we have invested in systems that allow us to provide up-to-date advice on whether Periodical Payments are appropriate.
OUR EXPERT WITNESS PERIODICAL PAYMENT SERVICE INCLUDES: ● Periodical Payments versus lump sum analysis ● Format of the award ● Appropriate indexation ● Case conference attendance ● Advice on settlement strategies and negotiations ● Expert evidence at trial
PERSONAL INJURY TRUSTS
Many Personal Injury claimants are in receipt of welfare benefits, or may become entitled to state support over the course of their lifetime. If claimants do not receive appropriate advice about the use of Personal Injury Trusts, their benefits may be affected upon receipt of a damages award. We can advise in plain, straightforward terms how best to manage payments and how to set up a structure that protects the best interests of claimants. Legal advisers have a duty to inform claimants of the option to set up a Trust in order to protect entitlement to means-tested state benefits. We can assist by providing a free written assessment for all clients, and then, if a Trust is viable, arrange a suitably worded Trust Deed, establish a Trustee bank account and deal with the local Benefits Agency, both now and in years to come. Moving forward, we can also offer cash and investment advice to suit the client’s needs.
WELFARE BENEFITS ADVICE
Personal Injury can have profound and often devastating effects, not just on the injured party, but also on their family, friends and work. The impacts of the aftermath of an injury can be complex, and may include medical needs, litigation, rehabilitation and financial affairs. Families often find themselves under financial pressure as a result of Personal Injury and have to navigate the complex welfare benefits system. ● We can smooth the process of dealing with multiple benefits from several agencies. ● We offer a benefits health check service to make sure that clients are receiving all the payments to which
they are entitled. ● We offer assistance with claiming the correct benefits and managing application processes. ● We provide representation at appeals and tribunal hearings and assist in overturning unjust decisions by applying expert knowledge of welfare benefit law. We will stand by clients from the very beginning of the process and be there at every stage as required. We aim to ensure the best results possible, with peace of mind and confidence in our skills and experience.
LOSS OF EARNINGS
Claims for loss of earnings in Personal Injury cases can be complex and challenging, particularly when they involve the self-employed, family businesses or employments with variable components such as bonuses or commission. To help with negotiations and settlement of cases, we provide thorough calculations and reports from the financial evidence. We aim to provide this as clearly as possible and at any stage of the claim process. We have considerable experience and expertise in advising on evidence and disclosure, providing alternative calculations for different scenarios, letters or reports for disclosure, advising in conference and giving expert evidence.
LOSS OF PENSION
Depending on the age of the claimant or their employment, pension calculations may be an important part of the losses to be quantified. There has been, and continues to be, many changes to state and private pensions, including changes to the way pensions based on final salary are calculated, lifetime allowances and the rising state pension retirement age. Again, to help with negotiations and settlement, we provide thorough calculations and reports from the financial evidence, set out as clearly as possible. We have considerable experience and expertise in all types of pensions. At Nestor, we are aware of budgeting requirements and the need to control costs. We are happy to discuss cases and review papers in order to provide a fee estimate before we are instructed. ■
Tel: 0161 763 4800 Email: info@nestor.co.uk
Periodical Payments
At Nestor, we have many years’ experience advising on Periodical Payments. Settlements involving Periodical Payments are far from straightforward, and we offer an expert witness service to assist in this complex area of law and financial planning. We have built a strong reputation acting for both claimants and defendants in high value claims. Our level of knowledge in such cases is second to none and we have invested in systems that allow us to provide up-todate advice on whether Periodical Payments are appropriate.
www.nestor.co.uk
Our expert witness Periodical Payment service includes: • Periodical Payments versus lump sum analysis • Format of the award • Appropriate indexation
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Court of Protection Specialist Solicitors We have extensive experience of working with injured or disabled people with matters concerning the Court of Protection. We are uniquely placed to assist you in this specialist area as we are not part of a litigation firm and are independent.
Why Wrigleys?
Our team of specialists deal with various matters that arise following catastrophic injury, such as: • Court of Protection applications • professional deputyship • professional trustee • property purchases and adaptations • issues concerning community care • statutory wills and liaison with the CICA • direct employment
• We have one of the largest trust and Court of Protection administration teams of any national • We are well known and respected nationally in this law firm; this team includes tax specialists, trust area of expertise and work with you to achieve the specialists and legal experts. best outcomes for you. • We believe a strong, long-standing professional • We have experience in driving negotiations with the working relationship is key and we pride CICA meaning we are often able to redraft clauses of ourselves in that we care. We build relationships the trust deed with your interests in mind. that last a lifetime.
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FINANCIAL & LEGAL
CAN A DEPUTY WITHHOLD KNOWLEDGE OF THE AMOUNT
OF A PERSONAL INJURY SETTLEMENT?
Here we examine a case where this very question needed to be answered.
A
t age 26 ‘Chris’ ordered the following was involved in declarations: a catastrophic 1) that Chris lacked capacity road traffic to decide whether he accident from which he should know the amount of acquired a traumatic brain the settlement award; injury. This injury was 2) that it was in his best expected to be lifelong and interests not to know the meant that Chris would amount of the award; and likely need support for the 3) that it would be unlawful rest of his life; his life for any person to convey expectancy was that information to him. unaffected. Critically an The Court made it clear agreed reduction in that this decision was damages for contributory specific to Chris. negligence amplified the WRIGLEYS’ need for the final award to COMMENT be carefully managed, to cover the costs of ongoing care and support. Deputies will usually feel that ‘P’ should know the Chris’ Deputy sought an order from the Court of amount of their personal injury award, so as to ‘permit Protection preventing any person who had knowledge and encourage the person to participate’ in any of the final award from disclosing the amount of that decision-making process and therefore be compliant award to Chris. The Deputy’s motivation was to prevent with the Mental Capacity Act 2005. However, the him from “obsessively” trying to spend funds required Deputy may also believe that such knowledge will have for his long-term care. a significant negative impact on P’s mental health. If The judge took account of Chris’ previous they try to withhold that knowledge on This comments to his solicitor and to the court their own (on the assumption that the that knowledge of the settlement figure injury was deputyship order allows would cause him stress and that he would them to), this could lead expected to a material breakdown “probably end up spending it”. The judge also reviewed evidence from the Deputy as in their relationship with to be well as Chris’ mother, case manager and P and make their job lifelong treating neuropsychologist. The common much harder. observation from that evidence was that whilst at Knowing that, where necessary, times Chris had a degree of understanding of the a decision can be sought from demand the cost of care had on the personal injury the Court of Protection will fund, he would not apply that understanding to his give Deputies in that position everyday decision-making. some comfort. ■ Chris’ neuropsychologist felt the knowledge of the settlement amount increased his vulnerability to his own impulses and in relation to his peers; this had been noted by his mother who stated that it was unlikely that “he would be able to keep the size of the fund to Please contact Jane Netting himself if he knew”. Tel:0114 267 5588 Email:jane.netting@wrigleys.co.uk Taking into account this evidence, the Court
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Helping you get on with life after serious injury We provide professional deputyship services allowing you to concentrate on giving loving care rather than dealing with financial and legal matters. The Court of Protection team at Slater Heelis are specialist lawyers, dedicated to managing the property and financial affairs of people who sadly lack the ability to deal with those matters due to a serious brain or spinal injury. Our solicitors can provide you with clear honest advice on: • • • •
Deputyship & Court of Protection applications Professional deputyship services Contested deputyship applications Specific applications to the Court of Protection
Speak with our specialist brain & spinal injury solicitor, Chris Partington TEP & Panel Deputy chris.partington@slaterheelis.co.uk 0161 672 1242 /slaterheelis
@slaterheelislaw
slaterheelis.co.uk
FINANCIAL & LEGAL
PROTECTING FAMILIES
Chris Partington is a Professional Deputy and Professional Attorney acting for mentally incapacitated individuals.
C
hris specialises in advising clients on the best way of protecting their families and their loved one’s assets, assisting with Court of Protection applications and giving guidance on Lasting Powers of Attorney. Due to the sensitive and potentially stressful nature of this type of work, he has developed a particularly sensitive approach, recognising that many clients need friendly support and reassurance in addition to uncomplicated advice on the legal issues.
unprepared for the unexpected changes in a loved one’s injury and recovery. Another mistake people make is that they fail to prepare for an individual’s personality change, especially after a brain injury. This can be particularly hard for families and those close to the loved one to deal with.
Chris Partington TEP, Partner and Head of Private Client at Slater Heelis LLP.
Who are you and what do you do? I’m partner at one of the North West’s largest law firms What areas can you help families with? Slater Heelis LLP. My team and I are experts in Court of I help families particularly with the financial aspects Protection, wills and probate issues. following a brain or spinal injury, such as taking care of We have two panel deputies here at Slater Heelis; the financial award or protecting their assets. myself and my colleague Katharine Peterson. We are I also strongly believe that emotional support is as two out of only 72 in England & Wales appointed by valuable and necessary as legal advice, and will always the Office of the Public Guardian to take on some of give guidance and advice. the most challenging cases, often involving family conflict or financial abuse. What are the three most important Remember things a family should do following Katharine and I have lots of experience in acting for vulnerable clients who lack that there is a a brain injury? complete mental capacity to protect The most important, and possibly the lot of help out ● themselves and their assets. We have hardest thing to do under such a stressful there from situation, is not to panic. It’s important to particular expertise in acting for clients who have sustained a severe brain injury, ranging charities and remain as calm as possible to ensure you’re in age from small children to the elderly, able to make decisions rationally for your solicitors victims of clinical negligence or assault, and loved one. Also it’s useful to remember those injured in traffic accidents or at work. that there is a lot of help out there from charities and solicitors, so you will never have to be uncertain or lost Tell us more about your personal experience and during such a difficult time. how it affected the work you do? ● Second of all, don’t rush through decisions for your Unfortunately, last year a close family member was loved one and before you act make sure you get involved in a serious motorcycle accident and professional legal advice first. This way you are ensuring suffered a brain injury. I experienced first-hand the you are getting the best help your loved one needs. emotional impact a life-changing injury can have on a ● And lastly, it’s vital to look after yourself as often loved one and their families. This, along with my families neglect themselves during such a distressing thirteen years’ experience in Court of Protection, situation. Needless to say, a brain or spinal injury of a wills and probate, means I treat each case with family member can be very emotional and it’s individual attention, both legally and emotionally. important to make sure you take care of yourself emotionally to process the situation healthily. ■ What are the most common mistakes people make following a brain injury? One of the most common mistakes people make is that they rush into making changes in a loved one’s lifestyle before knowing the full prognosis of their injury. Often Tel: 0161 672 1242 family members and those close to the victim don’t Email: chris.partington@slaterheelis.co.uk fully comprehend or plan for the full outcome of a slaterheelis.co.uk brain or spinal injury, which can mean they are
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Paul Bleasdale QC
One of the go-to silks for high-value personal injury and disease cases. He gets to grips with the issues quickly and always adopts a pragmatic approach. (Chambers UK 2019) Telephone: 0845 241 7006 Email: MT@no5.com
No5.com
BUSH & CO
Jonathan Jones QC A real specialist with a keen eye for detail - the most approachable QC in the country. (Chambers UK 2019)
Telephone: 0845 241 7006 Email: MT@no5.com
No5.com
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Jane Netting Partner
Chris Bright QC
He has a great ability to process a lot of information quickly and explain it in a straightforward and effective manner. (Chambers UK 2019) Telephone: 0845 241 7006 Email: MT@no5.com
No5.com
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We know that injured people have a number of inter-connecting issues to deal with which often go beyond the purely “ legal� aspects. We can help.
t: 0114 267 5621 e: jane.netting@wrigleys.co.uk w: www.wrigleys.co.uk
PERSONAL PROFILES
We are a team of Neurological Physiotherapists and Occupational Therapists. Led by Susan Pattison, we specialise in Acquired Brain Injury and Spinal Cord Injury in local regions such as Greater Manchester/Lancashire, Cheshire, and South and West Yorkshire. +44 (0) 161 764 3799 info@sptherapyservices.co.uk www.sptherapyservices.co.uk @SPTherapySvcs @SPTherapySvcs
AWARD-WINNING PERSONAL INJURY & MEDICAL NEGLIGENCE SOLICITORS
SPEAK WITH ONE OF OUR EXPERTS
Call 0800 358 3848 personalinjury@fieldfisher.com fieldfisher.com/personalinjury
VFS LEGAL FUNDING R E L E A S I N G C A S H F L OW
Norman Kenvyn Founder & CEO
VFS can provide immediate funding against your issued bill of costs or when you have a case with admitted liability. +44 (0) 20 3747 9333 +44 (0) 7748 963 965 enquiries@vfslegal.com vfslegal.com
We are a unique Multi-Disciplinary Team offering Neuro physiotherapy, occupational therapy, psychology, speech and language therapy and other associated adjunct therapies. We provide expert witness reports, Immediate needs assessments and rehabilitation for individuals who suffer from neurological conditions.
VFS LEG
E: enquiries@nppneurogroup.com T: 0800 917 3330 W: www.nppneurogroup.com
RELEASING CA
Riffat Yaqub Serious and Catastrophic Personal Injury Specialist
020 7874 8300 hja@hja.net www.hja.net
Advisors in all areas of Clinical Negligence, including: Brain & Spinal Injuries Cerebral Palsy & Child Brain Injury Fatal Claims Diagnosis Errors & Delays Orthopaedic Claims Cancer Claims Clare Thompson Head of Clinical Negligence E: clare.thompson@hay-kilner.co.uk T: 0191 232 8345
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BRAIN & SPINAL INJURY
CONTACT INFORMATION
Support groups, charities and other useful contacts and organisations across the UK. Brain Injury is BIG (B.I.G.)
Registered charity for carers of people with severe brain injuries with online discussion forum and telephone helpline. www.braininjuryisbig.org.uk
Brain Injury Rehabilitation Trust (BIRT) BIRT is a division of The Disabilities Trust, a leading charity that provides services to people with physical and learning disabilities, autism and brain injury. The Brain Injury Rehabilitation Trust (BIRT) aims to provide the best quality neurobehavioural rehabilitation for people with complex and challenging needs after brain injury. www.thedtgroup.org/braininjury
Brain Injury Hub
Online support centre for the families of children affected by acquired brain injury created by The Children’s Trust. www.braininjuryhub.co.uk
Brain & Spine Foundation
Provides support and quality information to people affected by brain and spine conditions, in order to reduce anxiety and help inform their choices. A free helpline is staffed by neuroscience nurses to answer questions about all neurological conditions and offer information and support on any medical or related social and emotional issues. Helpline Number 0808 808 1000 www.brainandspine.org.uk
Carers UK
An excellent source of information, advice and support, this charity is at the forefront of campaigning for carers. www.carersuk.org
The Children’s Trust
A national charity, The Children’s Trust provides care, education, therapy and rehabilitation to children with acquired brain injury, multiple disabilities and complex health needs. It runs the UK’s largest paediatric brain injury rehabilitation centre at Tadworth (Surrey), and services include nationwide support in the community for children and young people with acquired brain injury. www.thechildrenstrust.org.uk
Child Brain Injury Trust (CBIT)
A leading charity providing non-medical services and support, including a telephone helpline, for families. CBIT also provides training for health and social care professionals working with families. Helpline Number 0303 303 2248. www.childbraininjurytrust.org.uk
Headway
A national brain injury charity that promotes understanding of all aspects of brain injury and provides information, support and services to brain injured people, their families and carers. Headway also operates a regional network of branches and support groups. www.headway.org.uk
The United Kingdom Acquired Brain Injury Forum (UKABIF)
The United Kingdom Acquired Brain Injury Forum (UKABIF) is a membership organisation and charity which aims to promote the understanding of all aspects of acquired brain injury. There are also regional groups throughout the UK and UKABIF works with these groups to set common aims, encourage sharing of information and practice and co-ordinate group work. www.ukabif.org.uk
Spinal Injuries Association (SIA)
Spinal Injuries Association (SIA) are a charity that provides information and support to spinal cord injured people, their families and health care professionals. www.spinal.co.uk 122
USEFUL CONTACTS Association of Personal Injury Lawyers (APIL)
Association of Personal Injury Lawyers (APIL) is an independent, not for profit organisation providing accreditation to lawyers specialising in the area of personal injury law. Website includes a directory of accredited solicitors. www.apil.org.uk
British Association of Brain Injury Case Managers (BABICM)
British Association of Brain Injury Case Managers (BABICM) is a professional association that was established in 1996 to promote the development of case management in the field of acquired brain injury. www.babicm.org
Law Society
Law Society is the professional association that represents and governs solicitors for the jurisdiction of England and Wales. It provides services and support to practising and training solicitors, as well as serving as a sounding board for law reform. www.lawsociety.org.uk
The Case Management Society UK (CMSUK)
The Backup Trust
The Backup Trust provides support services for people of all ages with spinal cord injury. Services include wheelchair skills training, activity courses, mentoring and support to get back to work or school after an injury. www.backuptrust.org.uk
Aspire
Aspire works with people with a spinal cord injury to create opportunity, choice and independence. They aim to support people to lead a fulfilled and independent life from the moment of their injury throughout their life. They are also committed to research in the field of technology to find cost effective solutions to improve the quality of disabled people’s lives. www.aspire.org.uk
The Case Management Society UK (CMSUK) is a non-profit association of Case Managers, committed to the delivery of quality case management through standards of best practice while promoting the individual and collective development of case management throughout the United Kingdom. www.cmsuk.org
The Neurological Alliance
The Neurological Alliance is a wide range of neurological charities which have come together to make life better for people in the UK with a neurological condition. Their aim is to raise awareness of neurological conditions and their impact; inform and influence policy makers about the needs of people with neurological conditions; secure the highest standards of service and improved care for people with neurological conditions; promote research and the dissemination of information about neurological conditions. www.neural.org.uk 123
has a concussion or other type of THANK YOUbrain injury? acquired
A SPECIAL ‘THANK-YOU’
If yes, we’re on hand to provide the support they may need.
We are The Children’s Trust, the UK’s leading charity or children with brain injury. We work with children and young people aged 0-18 from across the UK with acquired brain injury, neurodisabilities and complex health needs delivering rehabilitation, education and community services through highly-skilled teams.
TO ALL OUR CONTRIBUTORS
upporting children and young people with acquired
Our Injury Community Service provides rainBrain injury in the community goal-orientated rehabilitation delivered in the child’s environment.
Delivered by specialists from a range of clinical backgrounds, we work with the child and their family focusing on the needs which result from an acquired brain injury. These may be social, emotional, cognitive, communicative and behavioural needs.
Our ultimate goal is to maximise the child/young person’s participation in their everyday life.
For children and young people with an acquired brain njury, including those with a concussion, we provide a ange of support centred around the child or young person, including clinical screening, advice and onward eferral completely free-of-charge. Subject to funding we also offer community-based neurorehabilitation skills packages delivered by our multidisciplinary team.
This service provides the initial support needed when a child is discharged from hospital to home and can also be accessed after an initial injury or illness which, in some cases, can be many years later. This may be because the effects of the injury may not be obvious for some time.
We provide: • clinical screening, advice and onward referral completely free-of-charge • advice, support and rehabilitation delivered at home, in school, or a combination of both • a dedicated multidisciplinary team supporting children from across the UK • assessment and rehabilitation packages for children with on-going needs* • a long-term register to help monitor support needs at key stages.
Making a referral is simple, get in touch today. 01737 365 864 thechildrenstrust.org.uk/bics bics@thechildrenstrust.org.uk
ubject to funding. egistered Charity No. 288018. TCT_422 V1 February 2019.
CT_432 Brain and Spinal Injury Handbook 2019 Brain Full Page V0.1.indd 1 01/03/2019 16:25:45 Disclaimer: & Spinal Injury Handbook is published annually (once per annum) by Seven Star Media Ltd. No part of Brain & Spinal Injury
Handbook may be reproduced, stored in a retrieval system or transmitted to any form without permission. Views expressed in the publication are not necessarily those of Seven Star Media Ltd, and are included to provide advice only. No content is a substitute for professional medical advice. During printing, images may be subject to a 15% variation. © Copyright of content belongs to individual contributors with the publication copyright belonging to Seven Star Media. All rights reserved. Please either keep this magazine for future reference, pass it on for somebody else to read, or recycle it.
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Caring for you, caring for your family A serious injury to your brain or spinal cord can have life-changing consequences for you and for your loved ones. Whether your injury is the result of a road traffic accident, an accident at work, negligent surgery, a criminal assault, a birth injury, inappropriate medical treatment or a trip or fall, we understand the challenges you face. We’ve been helping clients to achieve financial security and access the best possible medical care and rehabilitation in order to rebuild their lives for over 30 years. To find out how we can help you, contact a member of our serious injury team.
Talk to us in confidence +44(0)20 7650 1200 seriousinjury@leighday.co.uk www.leighday.co.uk @LeighDay_Law
‘“They really give their heart and souls to their clients. They are meticulous, compassionate, very diligent and extremely committed to getting the best result for their client.” Chambers and Partners 2019 B&SI 125
When it comes to litigation costs – don’t settle for less Release up to 80% of the net bill Increase your profitability Quick and simple, with certainty of cash flow Liability admitted cases also considered
For further information please call 020 3747 9333 or email enquiries@vfslegal.com or visit vfslegal.com