Team Around The Client Magazine - Edition 1 - June 2020

EDITION 1 | JUNE 2020

ROYDS WITHY KING’S NEW COMPENSATION PROTECTION UNIT

NAVIGATING THE LEGAL MINEFIELD FOLLOWING A BRAIN INJURY

Find out more about our Compensation Protection Team and how we approach working with our clients.

Find out more about how our team helps to setup trusts and deputyships for clients with and without capacity.

MEET OUR COMPENSATION PROTECTION TEAM

TRACY NORRIS-EVANS

MARIA MEEK

Partner & Head of Compensation Protection | 07717 358 058 tracy.norrisevans@roydswithyking.com

Partner & Head of Compensation Protection, Bath | 07881 244 254 maria.meek@roydswithyking.com

KERSTIN SCHEEL

EDWARD VIDNES

Partner | 07827 920 973 kerstin.scheel@roydswithyking.com

Partner | 01225 730 270 edward.vidnes@roydswithyking.com

PARDEEP BIRING

SARA ISENBERG

Senior Associate | 07901 060 860 pardeep.biring@roydswithyking.com

Associate | 07776 318 188 sara.isenberg@roydswithyking.com

BETH EVANS

CAMERON FINDLEY-SMITH

Paralegal | 01225 352 872 beth.evans@roydswithyking.com

Paralegal | 01865 268 610 cameron.findley-smith@ roydswithyking.com

NAVIGATING THE LEGAL MINEFIELD FOLLOWING A BRAIN INJURY P8

CONTENTS

4

NEWS

6

FAMILY ADVICE

8

INJURY ADVICE

12

BUILDING YOUR SUPPORT TEAM

16

CHARITY SPOTLIGHT

EMILIE GOUZIEN

BETHANY LOCKE

Paralegal | 01225 352 919 emilie.gouzien@roydswithyking.com

Paralegal | 01865 264 009 bethany.locke@roydswithyking.com

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SPECIALISTS IN THEIR FIELD

GUEST WRITERS

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YOUR COMPENSATION STUART BRAZINGTON

SIMON ELLIMAN

Head of Brain Injury | 07788 413 356 stuart.brazington@roydswithyking.com

Head of Clinical Negligence | 07818 451 354 simon.elliman@roydswithyking.com

FOREWORD No-one could have anticipated the pandemic we presently face and the need for the Government, in turn, to drastically infringe on our civil liberties in an effort to preserve precious lives. The demand for lockdown has restricted everyone’s freedom of movement, access to basic amenities, and deprived them of familial and social relationships. However, perhaps for once it has forced those of us who are able-bodied and well of mind to appreciate that these constraints have already been suffered in one form or another by those who don’t enjoy the same privileges. It has also brought into sharp focus that imposing further restrictive demands on those with disabilities causes extreme hardship and exposes further their vulnerability, depending as they do on others for even their most basic needs.

The aim of the Mental Capacity Act 2005 is to protect and empower people who may lack the mental capacity to make their own decisions about their care and treatment; it’s there to ensure that there is no deprivation of liberty (even in lockdown!).

This ethos is a long-standing one, identified as far back as the Declaration of Independence of 1776 “…all men are created equal and independent, that from that equal creation they derive rights inherent and inalienable, among which are the preservation of life, and liberty, and the pursuit of happiness”. I don’t think there has ever been a heavier burden on the duties of a deputy to ensure these core moral principles are fulfilled.

KERSTIN SCHEEL Partner Royds Withy King

With all this in mind, the launch of our new Compensation Protection Unit in May 2020 takes on a whole new importance.

The Unit’s central mantra is “Team Around The Client”; this team comprises not only the deputy, but also case managers, therapists, IFAs, architects and litigation solicitors, amongst others. For any programme of support to work a collective focus around the exacting goals to meet our clients’ needs is adopted by the team.

It is our interdisciplinary approach which leads to successful outcomes and hopefully a much improved quality of life for our clients, and their families: we hope our magazine reflects this.

There has never been a more important time to work collectively and collaboratively. This crisis will hopefully continue to bring out the best in people. The nation is united in gratitude for the endless dedication and work of its NHS, social care, domestic care and care home staff and I for one am certainly humbled by it.

NEWS

RECENT SUCCESSFUL CLAIMS

“Earlier delivery would have avoided the full impact of the infection in an already vulnerable premature baby and made a material contribution to the cause of the claimant’s severe brain injury. Damages were recovered in full.”

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Here you can read two recent case studies about successful claims settled by our medical negligence experts: CLAIM SETTLED IN EARLY 2020 FOR YOUNG BOY WITH CEREBRAL PALSY Kerstin Scheel in our Bath Birth Injury team represented a young boy in Bristol who received £23,000,000 (capitalised value of the claim) in damages following the negligent management of his mother’s antenatal advice as to mode of delivery.

The mother had encountered shoulder dystocia during the birth of her first child, however she was not informed of the nature of this complication, instead simply understanding it to have been a generally “difficult birth”.

As such, no advice was given to seek medical advice on the mode of delivery in any future pregnancy. The mother became pregnant again and was noted to be carrying a

“The mother had encountered shoulder dystocia during the birth of her first child, however she was not informed of the nature of this complication, instead simply understanding it to have been a generally “difficult birth”

large baby and referred for obstetric management, at the same hospital where her first child was born.

Unfortunately the obstetrician failed to review the notes from the first pregnancy and no discussion was had regarding the option of an elective caesarean section to avoid not insignificant risks of the same complication re-occurring.

A YOUNG GIRL IN WALES IS AWARDED SUBSTANTIAL DAMAGES IN EARLY 2020 Kerstin Scheel in our Bath Birth Injury team represented a young girl from Wales, whose mother received negligent medical care during her pregnancy. The mother had a complicated obstetric medical history and carried a high risk of premature birth. Unfortunately, 32 weeks into the pregnancy she developed a significant infection and presented to hospital with reduced fetal movement. Despite knowing of the maternal infection there was a significant delay in undertaking a caesarean section, during which time the infection spread into the uterus and the unborn baby. Earlier delivery would have avoided the full impact of the infection in an already vulnerable premature baby and made a material contribution to the cause of the claimant’s severe brain injury. Damages were recovered in full.

The little girl suffered a catastrophic brain injury which will very sadly result in a much reduced life expectancy. Her mother is a single parent requiring a huge amount of support to care for her daughter, who cannot communicate, cannot sit unaided, is doubly incontinent and PEG fed. She receives devoted care from her mother and older siblings.

During the birth of the claimant a very difficult shoulder dystocia did indeed occur; the medical staff were unable to release the impacted anterior shoulder for 20 minutes during which time the claimant suffered a severe period of acute hypoxic injury and also a severe injury to his brachial plexus nerves.

The claimant was subsequently diagnosed with cerebral palsy and Erb’s palsy. His injuries were severe; he cannot walk more than a few metres unaided, he is doubly incontinent, he cannot feed himself, he cannot verbally communicate and has little to no use of his right arm. He requires 24-hour care and will require two carers from puberty onwards.

He received a lump sum award with an annual periodical payment order to cover the costs of care and case management for the remainder of his life.

His life expectancy was not significantly reduced.

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FAMILY ADVICE

AHEAD TOGETHER 2019: SUPPORTING FAMILIES Rob Kuschel, Case Manager and brother to a brain injury survivor, talks through his family's experience of brain injury.

“Dr Giles Yeates spoke

In September 2019, a sold-out conference at Rhodes

about using couples

House, Oxford brought together family members of

therapy to rehabilitate love after brain injury, whilst

brain injury survivors and recognised experts in the field to share their deeply emotional stories, learning and wisdom, in understanding family needs after this most catastrophic of injuries. The initial vision of

Dr Mark Holloway provided

Dr Audrey Daisley, developed in collaboration with

top tips for fostering good

Tracy Norris-Evans and the team at Royds Withy King,

relationships with families of brain injury survivors.�

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resulted in a conference programme that covered clinical practice, applied academic research and the medico-legal experience.

With the latest clinical and evidence-based research, combined with the personal accounts of family members, this conference provided a unique perspective on how professionals can work more harmoniously with families to achieve improved outcomes. Dr Daisley canvassed the audience for greater support for families to help them build resilience and strategies for the tough times they would inevitably face. This is a call to action with authenticity since the Oxford Centre of Enablement, where she is clinical lead, aims to offer a “gold standard” service for families including joint goal setting, reflective practice groups for front line staff and involvement in research. Dr Giles Yeates spoke about using couples therapy to rehabilitate love after brain injury, whilst Dr Mark Holloway provided top tips for fostering good relationships with families of brain injury survivors. Keynote international speaker, Professor Jeff Kreutzer, delivered a forensic review of the literature on divorce and relationships concluding that well-informed people do better while advocating for a focus on education and stress management.

“Variously described as a “standout” conference and “the best brain injury conference ever” it will be a hard act to follow, but follow it we will in our quest to be activists for change.”

But it was the powerful personal stories of family members that stood out and are most likely to be the catalyst for change; especially the account of the youngest speaker, nine-yearold Cerys Hughes who bravely spoke about the adverse impact of her father’s catastrophic brain injury on her young life.

Variously described as a “stand-out” conference and “the best brain injury conference ever” it will be a hard act to follow, but follow it we will in our quest to be activists for change. We were working hard to scope out the Ahead Together 2021 programme when the pandemic hit: in the hope that this will be a short setback we plan to announce the second Ahead Together Conference shortly again focusing on the family experience.

Above, top to bottom: Cerys Hughes tells her experience of having a parent with a brain injury; Tracy Norris-Evans (left), partner and head of our Compensation Protection Unit, and Dr Audrey Daisley, Consultant Clinical Neuropsychologist, who were inspired to run the event following their own experience working with families who live with brain injury.

TRACY NORRIS-EVANS Head of Compensation Protection Royds Withy King

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INJURY ADVICE

NAVIGATING THE LEGAL MINEFIELD FOLLOWING A BRAIN INJURY With the latest clinical and academic research, and the personal accounts of relatives at the Ahead Together conference, we were provided with a unique perspective on how professionals and families can work more effectively together towards improved outcomes.

Common themes running through the family stories included the anguish of the early days, of thoughts about whether it might have been better if their relative had not survived, and the consequential feelings of guilt and shame; speakers also alluded to damaging interactions with professionals particularly referencing careless language which had a powerful and enduring emotional impact.

The motivation behind the conference was to inspire activists for change, to generate new ways of families and professionals moving forward, ahead together. Lawyers, whether it be litigators or professional deputies/trustees, typically engaged in the early years following the injury, have a responsibility to influence the landscape for people with acquired brain injury by giving them a voice 8

and championing their rights and those of their families.

HOW WE APPROACH CASES WHERE THE CLIENT LACKS CAPACITY TO LITIGATE THEMSELVES In terms of the legal journey, the first matter to determine is whether the injured person has the capacity to litigate. If incapacitous then the first decision the family needs to make is who should be appointed the Litigation Friend to stand in the shoes of the client.

Being appointed a Litigation Friend comes with a heavy responsibility in terms of decision-making, particularly with regards to risk, costs and acceptance of the final award: this can be daunting for any family member who accepts this role. Unfortunately this process often comes at a time when the family is coming to terms with the extent of the injury and absorbing the longterm impact of a life-changing disability. However, there is an imperative for the litigator to work promptly in accordance with the 2015 Rehabilitation Code,

which promotes collaborative use of rehabilitation and early intervention, the aim being to bring about the best possible outcome for the client.

Co-ordination of medical and therapeutic input can also be reassuring for the client and family at a time when overstretched state services struggle to provide optimum support. Where liability is undisputed, the lawyer should seek an early (large) interim payment to fund case management, a care regime, to review accommodation, to challenge the Education Health Care Plan if the client is a child, or, if appropriate, activate vocational rehabilitation, and therapeutic intervention to include where appropriate therapy for the family or therapeutic couples intervention (which should be included as a head of loss).

An application to the Court of Protection to appoint a professional deputy should then be made, once it is evident that an interim payment will be agreed/ approved by the Court. If settlement is likely to be more than £500,000, a professional deputy should be appointed as the Court of Protection requires a professional appointment where the compensation is significant. If the interim payment is less than £500,000 though, it is important to do a costs/ benefit analysis as to whether a professional deputy is affordable, if not a lay deputy should be appointed.

An application to the Court of Protection to appoint a deputy can take up to six months, so plan this well in advance: in the meantime the litigator should seek a direction from the Court, pursuant to Civil Procedure Rule 21, Practice Direction 8.1(2), to enable the litigator to make decisions about spending from the interim fund.

WHEN THE CLIENT DOES HAVE CAPACITY TO LITIGATE If the client has capacity then they can litigate themselves, but caution needs to be exercised if the client has borderline or fluctuating capacity.

The same approach should be taken with a capacitous client as you would with an incapacitous individual; early rehabilitation, seeking a significant interim payment and applying the interim payment to meet the client’s needs are crucial.

PI TRUST With a client who has capacity, if a significant interim payment has been agreed/approved by the Court, it is essential to advise the client of the merits of setting up a personal injury (PI) trust.

Deputyships

PI trust

• Lifetime costs of a professional deputy are recoverable in the injury claim.

• Lifetime costs of a professional trustee are not currently recoverable in the injury claim – no precedent but there is case law to support recovery of the cost of setting up the trust.

Except the costs of a professional trustee acting for a minor are recoverable up to 18.

• A deputy is responsible for all client’s assets, income and benefits.

• A financial deputy cannot make true health and welfare decisions – does in reality if has a financial implication.

• May need a health and welfare deputy if required.

• No testamentary capacity so application for a statutory will – only if varies from Intestacy Rules.

• Marriage/divorce – can client consent? Consider a pre/post nuptial agreement if client can make the decision.

• Trustee is responsible solely for the damages settled in the PI trust; so no control over earnings or benefits. Ensure there is an appointee for benefits.

• Trustee cannot make health and welfare decisions – consider Lasting Powers of Attorney for: (1) property and financial affairs, and (2) health and welfare.

• Testamentary capacity – make a will.

• Marriage – client can enter into a pre/post nuptial agreement.

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A PI trust is a formal structure to hold and manage damages from a personal injury which requires a formal trust deed, typically a bare trust with two or more trustees. Trustees have a fiduciary duty to the (beneficiary) client.

• an act done, or decision made, under the Act for or on behalf of a person who lacks capacity must be done, or made, in his best interests;

The client will need support and advice to identify appropriate lay trustees (preferably family members).

If the compensation is going to be significant then a professional trustee (or trust corporation) should be appointed, working alongside joint lay trustees.

• before the act is done, or the decision is made, regard must be had to whether the purpose for which it is needed can be as effectively achieved in a way that is less restrictive of the person’s rights and freedom of action.

THE LEGAL TESTS FOR INCAPACITY

The test for establishing whether a client lacks capacity is based upon the balance of probabilities and not beyond all reasonable doubt.

The test for incapacity appears at section 2 of the Mental Capacity Act 2005 (MCA). A person lacks capacity in relation to a matter if, at the material time, they are unable to make a decision about it for themselves because of an impairment or disturbance in the functioning of the mind or brain.

Section 1 of the MCA identifies five main principles in determining capacity. It is stated in the Act that: • a person must be assumed to have capacity unless it is established that he lacks capacity;

a decision merely because he makes an unwise decision;

There is a presumption of capacity in all areas of life, until the Court determines otherwise. Capacity is time and function specific: a person can have capacity to marry and gamble, but for example not to litigate and manage their own affairs. The intention behind the MCA is to empower and protect incapacitated persons. The “best interests” test must therefore be at the forefront of the deputy’s mind and the deputy

• a person is not to be treated as unable to make that decision unless all practicable steps to help him to do so have been taken without success;

As you can ascertain from the

• a person is not to be treated as unable to make

details given here, empathy and trust are pivotal to a longterm (life-long) relationship with clients and their families.

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sum and periodical payments. For the periodical payment to be made, proof of life has to be provided on an annual basis. It can be particularly difficult for relatives to grasp that each year the lawyer has to prove that their loved one is still alive!

EFFECTIVE COMMUNICATION WITH A CLIENT

must not trespass into decision-making that the client can make themselves – such a decision would be invalid.

HOW A PI TRUST/DEPUTYSHIP WORKS IN PRACTICE The Government recognises the special situation of individuals who have suffered a personal injury, and so any damages either paid into a PI trust or subject to a deputyship (both capital and income) are disregarded when the injured individual is assessed for state benefits or statutory funding.

Clients have variable life expectancies dependent on the extent of the brain injury, so it is encumbent on the professional to ensure that damages are structured in a way that access to means tested benefits and statutory funding is preserved; they may become a necessary source of income to supplement depleting resources.

The purpose of damages is to put the client back in the position they would have been in if the injury had never happened. The compensation is also intended to last the client’s lifetime and, as such, the last pound of compensation is to be expended as the client draws his/her final breath. Accordingly, inheritance tax planning is not appropriate. Whilst it would be impossible for the professional deputy/trustee to administer the funds to last until the final day of life, with collective experience and by working closely with an expert independent financial advisor undertaking modelling and financial surveillance, it is possible to adjust spending and to identify other income streams to prolong the funds.

It is the right of all individuals to have their established family life respected, and to maintain family relationships. For a litigator/professional trustee/ deputy to work effectively, communication with the client and their family should be regular and collaborative. Indeed, where a deputy is appointed, the Deputy Standards 2015 require the deputy to liaise with the extended family, case manager and support worker(s) to record the client’s feelings, wishes, beliefs and interests, both past and present.

The deputy must take all practical steps to enable the client to make their own decisions. This is all the more important as clients who have a trustee/ deputy will potentially have a lifelong relationship with a professional unless the deputyship/trust is determined. Even if the client regains capacity such that the deputyship is discharged, they should be advised to settle what is left of the compensation award into a personal injury trust.

The appointment of a professional deputy/trustee enables family members to keep their close, familial relationship with the injured individual by removing the burden of financial management and decisionmaking. So, as you can ascertain from the details given here, empathy and trust are pivotal to a long-term (life-long) relationship with clients and their families.

TRACY NORRIS-EVANS Head of Compensation Protection Royds Withy King

Typically awards are structured by a hybrid of lump 11

BUILDING YOUR SUPPORT TEAM

SMOOTHING THE ROLLERCOASTER – THE ROLES SUPPORT GROUPS CAN PLAY IN SUPPORTING THOSE WITH BRAIN INJURIES AND THEIR FAMILIES

“Often the most valuable

In over 29 years of practising as a solicitor, and

support groups are

having represented clients from all walks of life, it

those formed by parents

has never failed to amaze me how little is known by the general public about the effects of brain injury.

of children with brain

Our team at Royds Withy King is privileged to work

injuries, spouses whose

with this special group of people whose lives have

partner has a brain injury, or relatives of a brain-injured person.”

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sadly been touched by brain injury, whether it be to a husband, wife, partner, child, family relative or friend. One thing is certain, severe brain injury does not discriminate. It can affect anyone.

In 2017, there were over 348,000 acquired brain injuries in the UK. It is estimated that there are over one million people living in the UK with a long-term brain injury and its devastating effects. Whether the brain injury has been caused by a road traffic accident, a fall, a stroke or criminal assault, the range of outcomes for survivors is broad.

Severe physical disability can result, as can severe cognitive and memory problems. Put simply, the ability to live one’s life as one did previously changed the day the brain injury happened.

TRADITIONAL SUPPORT MECHANISMS The introduction of Major Trauma Centres in the UK has had a dramatic effect in improving both survival rates and the emergency treatment received within a very short space of the trauma being diagnosed. The UK Major Trauma Centres (MTC) are respected world wide for both the knowledge, skills and care that they provide. The MTCs have been deliberately developed to cover the UK from a geographical perspective. Inevitably this means that there are areas of the country where the nearest MTC is a considerable distance away. Given austerity and the underfunded community support, this often leaves families with little or no support outside of the immediate MTC catchment area.

There is another common reason why acquired brain injury does not receive the support from the state that one might expect.

Brain injury can often be a “hidden disability”.

History is littered with people who have become famous or infamous for things they said or did and which has occurred because of their brain injury, despite it not being widely known a brain injury had been suffered. We know there are many effects following brain injury, some of which can be subtle and some less so. When someone makes a good physical recovery, it does not necessarily follow that all is well. Changes in personality, decision-making, behaviour, judgement and disinhibition/inhibition creates a huge strain for those who are left to care and support.

Given there are estimated to be over one million people living with the long-term effects of brain injury, support groups spring up to fill the void.

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PATHWAYS POST DISCHARGE Following a brain injury, and hospital support from a Major Trauma Centre and DGH, it is common to hear stories of families having to become involved with the Department of Work and Pensions, Social Services, Local Education Authorities, and the bureaucracy that inevitably accompanies all attempts to secure the benefits offered by these services. The bureaucracy is often difficult if not impossible for many to navigate.

SUPPORT GROUPS – A PROBLEM SHARED Often the most valuable support groups are those formed by parents of children with brain injuries, spouses whose partner has a brain injury, or relatives of a brain-injured person. One of the key drivers for the support groups is the fact that everyone attending has one thing in common, and that is they are doing their very best to support someone with a brain injury.

Living with a brain-injured person is often a relentless pressure. Respite is difficult to find.

The charitable sector will often provide some support whether it be in the home or at a centre designed to support those with brain injury. Our increasingly stretched NHS community support is forever under pressure and underfunded.

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Many charities, including Headway, the brain injury charity, offer telephone support as well as faceto-face support. Brain injury often leads to social isolation. Having a support group of people who are either living with brain injury or supporting someone with a brain injury enables a social aspect to return to lives that have been denied the socialisation and friendships so many of us enjoy regularly, and take for granted. Carers who are able to talk through the issues they are facing with fellow carers in similar situations find this incredibly therapeutic and supportive. This does not need to involve any professional input or structured guidance. In many cases, simply finding the time to sit down and offload

can achieve the same benefit as many sessions with professionals. Knowing that you are not alone, that there are others who are struggling to support people they care for builds resilience, social connection, and inevitably leads to a sharing of knowledge and ideas that can only benefit us all.

STUART BRAZINGTON Partner, Personal Injury team Royds Withy King

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CHARITY SPOTLIGHT

HOW WE’RE SUPPORTING A CAUDA EQUINA CHARITY TO HELP ISOLATED SUFFERERS AND RAISE AWARENESS

“We’re pleased to support them on their journey, and

As part of a team that works closely with those who live with cauda equina syndrome - an injury to the nerves at the base of the spine - I often

help them raise awareness of

come across support groups and charities who

this debilitating condition. And

condition. One such charity and support network

as part of this, there are two ahead of the curve initiatives that we hope everyone who

work hard to help those who suffer with the is the Cauda Equina Syndrome Association (CESA). As part of their panel, myself and my team work closely with this particular non-profit and have begun to understand their main aims, the foremost of which is to become a household

reads this magazine will keep

name and ensure everyone, including healthcare

an eye out for.”

cauda equina syndrome.

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professionals, is more aware of the ‘red flags’ of

“2020 has been a challenging time for many, but we’re hoping that we can help CESA continue to achieve their goal of raising awareness of the condition, developing their reach across the UK.”

We had already started to deliver guided meditation for pain management at our residential workshops and this comment inspired me to combine podcasts with meditation. What better way to deliver pain management courses to those who are stuck at home – especially now!”

However, this isn’t the only initiative that Claire and CESA have up their collective sleeve. We’re happy to say that we are also aiming - amongst other firms to support CESA as they launch their inaugural CES Awareness Day later this year.

2020 has been a challenging time for many, but we’re hoping that we can help CESA continue to achieve their goal of raising awareness of the condition, developing their reach across the UK, and most importantly helping more people who live with cauda equina every day.

We’re pleased to support them on their journey, and help them raise awareness of this debilitating condition. And as part of this, there are two ahead of the curve initiatives that we hope everyone who reads this magazine will keep an eye out for.

The first of these is their upcoming pain management podcast, which we are looking forward to supporting as a winner of our Ahead of the Curve magazine’s Leading Edge competition. In an excerpt from her upcoming article on the podcast, founder Claire Thornber writes about how the podcast came about: “A common theme for most people though is relentless neuropathic pain. This gnawing, constant pain often increases at night, and many are subjected to countless nights of poor sleep interrupted by intense burning and cramps.

Sleep interrupted by pain in turn causes chronic fatigue during the day, making everyday tasks almost impossible for some.

SIMON ELLIMAN During one of the Cauda Equina Syndrome Association (CESA)’s support group meetings we were discussing this issue and a new member highlighted a way they had discovered to cope with these lonely, long nights: listening to podcasts.

Partner and head of Medical Negligence Royds Withy King

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SPECIALISTS IN THEIR FIELD

CHILDREN WITH CEREBRAL PALSY: MULTIDISCIPLINARY THERAPY PROGRAMMES

Children with cerebral palsy come with a huge variety of clinical presentations and needs, dependent on their level of disability,

“No one therapist is the same, they all come with varying degrees of clinical expertise and will have differing knowledge and skills.�

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age at the time of engagement of the legal/ case management process and other factors.

This can also be said for a variety of catastrophic injury clients, whether that be a head injury, spinal injury, amputees or multifactored pathologies premorbid and post injury. But what all these clients often have in common is the need for a specialist, experienced therapy team to be around them, to support any initial recovery, and also to enable them to live an independent, fulfilling and active lifestyle as possible. One where they can still have the ability to dream, aspire and achieve.

The other important, vital element, particularly where children are involved, is the family dynamic around them and how their support networks are structured both at home and in their educational environment.

Often with cerebral palsy cases, statutory services can/will be involved from very early on, with some therapists already working with a family, particularly once they have started into the educational system.

However, the financial and time restraints from statutory services can mean vast limitations in the equipment available, therapy time and often delays in achieving set goals. Resourcing basic equipment or working on activities of daily living or communication can be slow, causing delays in progression and the child’s ability to be more independent.

This is where the role of the litigation process and the appointment of a case manager can pay dividends.

It is vital that a child has the right support from a specialist team, at the right time in their lives to optimise their function and longer-term outcomes.

Sourcing a specialist team can, however, be easier said than done. Within each therapy profession are subspecialties, all of whom will have differing levels of experience and knowledge relevant to your client’s case. For example, a speech and language therapist who specialises in paediatrics may work more with mainstream children with speech impediments or delayed speech, whereas others will specialise in augmentative and alternative communication technologies for children or adults with minimal communication skills. The same specialities apply within the occupational and physiotherapy worlds – no one therapist is the same, they all come with varying degrees of clinical expertise and will have differing knowledge and skills. This is why it is vital to get the right therapist, with the right experience, in place who will work well with the clients, their families and each other as a larger multidisciplinary team.

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Quite an extensive period of time can be taken up looking for the right therapists, who not only have the degree of experience and expertise needed, are relatively local to the client to keep travel costs down but who also have the availability to take on a client in both the short and long term, as it is important for clients and families to have continuity with who they are working with.

Once the team are in place, it is then so important that the parents of the child are engaged and happy to work with them. The therapists will only be there to provide face-to-face therapeutic intervention for certain periods and it is key that parents are on board and want to be involved in supporting their children throughout their ongoing therapeutic management. This can involve using certain pieces of equipment that have been provided or recommended,

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Ultimately, a well-established, experienced, cohesive multidisciplinary team, who are all working towards the same goals and are striving to achieve the best outcome for our clients is what we are all trying to achieve.

being willing to be trained and aware of any ongoing therapeutic intervention that support workers may need to support the clients with and communicating back to the therapists and case manager when there is a problem.

Close monitoring of the therapy goals, costings and equipment needs by the case manager working with the team is vital. Regular multidisciplinary team meetings can enable therapists to all get together, discuss the client in depth, aid communication and ensure they are all aware of each other’s goals and plans. Often there can be a crossover in therapists’ roles, such as in posture and seating needs, standing frames etc., so it can work well with the two therapists working together, combining assessment and treatments in order to get the best long-term outcome for their client.

Ultimately, a well-established, experienced, cohesive multidisciplinary team, who are all working towards the same goals and are striving to achieve the best outcome for our clients is what we are all trying to achieve.

HANNAH PROCTOR Case Manager Cooci Associates

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YOUR COMPENSATION

INTRODUCING OUR NEW COMPENSATION PROTECTION UNIT

We are delighted to announce the launch of the new Royds Withy King Compensation Protection Unit (CPU).

WHAT WE DO When an individual suffers a life-changing injury as a consequence of negligence, and receives a large compensation award, they need an expert team to administer the funds to meet their complex needs.

Our Compensation Protection Team has over 50 years’ experience between them of managing and safeguarding clients’ compensation. We don’t do this in isolation - we create a Team Around the Client in partnership with the family and professionals, including the therapists, case manager and Independent Financial Advisor. The (vulnerable) client remains at the heart of this multidisciplinary team, whose aim it is to administer the compensation so that it optimises the client’s quality of life for his or her lifetime and empowers them to lead as independent a life as possible.

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SAFEGUARDING THE COMPENSATION If the individual has capacity to manage their financial affairs, they can establish a personal injury (PI) trust with the appointment of a professional trustee and lay trustees. If appropriate, the individual can also be appointed a trustee despite being the beneficiary.

These are typically bare trusts. If the individual is incapacitous, then they come within the jurisdiction of the Court of Protection and require the appointment of a professional deputy. In both scenarios, the client is safeguarded by a vehicle which protects them from the demands of unscrupulous individuals/companies and enables them to secure other income streams in the form of means tested benefits and statutory funding.

MEET THE TEAM We have three discrete teams operating out of our offices in Bath, Oxford and London but we represent clients all over England and Wales as well as abroad. The national team is led by Tracy Norris-Evans, supported

by Maria Meek who heads up the Bath CPU team. Over

and above our specialist knowledge of deputyships and PI trusts, we also have expertise in personal injury litigation and comprehensive experience of constructing Schedules of Special Damages and Future Losses which helps inform decision-making when it comes to spending the funds, budgeting and forecasting for future needs. We work closely with litigators, both within the firm and externally, during the life of claims to manage interim payments and provide expert reports for the Court on the lifetime costs of deputyships.

WITHY KING TRUSTEES LIMITED - TRUST CORPORATION Responding to our clients’ concerns about succession if the deputy retires or is ill, and to ensure continuity and consistency of decision-making, we established a trust corporation nine years ago named Withy King Trustees limited (WKTL). The trust corporation is run by directors who are all experienced in this area and are like-minded individuals. The mechanics of the trust corporation are such that, whilst WKTL is appointed the professional deputy or trustee, a named director will be the custodian and has the personal relationship with the client and family. The sharing of knowledge and experience between the directors and teams is pivotal to operating best practice for the benefit of the client. A particular advantage of WKTL is that if a director is on holiday or unwell, another director is immediately available to execute decisions for the client, ensuring speed of response so as to prevent any unnecessary delays.

“The sharing of knowledge and experience between the directors and teams is pivotal to operating best practice for the benefit of the client.”

THE PERSONAL PROFESSIONAL RELATIONSHIP The team is passionate about improving the quality of life of our clients through the management of the compensation. This goal can only be achieved by gaining an intimate understanding of the client, their pre and post-accident personality, needs, ambitions, interests, responsibilities and relationships. We aim to be accessible at all times which we achieve through working in a distinct team with the client.

LIFELONG LEGAL COMPANION Our aim as a trusted advisor is to become a lifelong legal companion to the client and their family.

Indeed some of our longest running PI trusts were established over two decades ago. Our combined experience means that we have encountered most of the vicissitudes of life and that expertise has never been more in demand than in the current coronavirus crisis. Our vulnerable clients are not just facing the threat of Covid-19 in respect of their precarious health but the pandemic is creating unprecedented volatility in the stock markets with an adverse impact on investment portfolios. This is not private wealth but damages awarded to clients (who typically cannot work and are dependent on support for every aspect of their daily living) to fund their often challenging needs until their death.

The CPU has been able to respond swiftly to the crisis, enabling clients to self-isolate and to protect their funds, having already appointed specialist independent financial advisors.

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IFA st o i S pe n Building y cia ou rs up t settlement Pos leg a nd employm a y e ur y a mil dvi Fa

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Family advice Supporting you, your parents, your partner, your siblings, your children.

Injury and employment advice Legal advice for your injury claim.

Post settlement legal advice As a professional deputy or trustee making financial decisions to enhance your quality of life.

Building your support team Working with professionals, especially case managers, to build and manage your support team to meet your care, therapeutic, medical and educational needs.

Specialist in their field Liaising with specialist neurologists, neuropsychologists, paediatricians, physiotherapists, occupational and speech and language therapists, architects and construction experts to optimise your independence.

Working closely with IFAs to invest your compensation As your lifelong legal companion working with financial experts to manage your investments to last your lifetime.