Brain & Spinal Injury Handbook- 20/21 by Seven Star Media

B&SI Brain & Spinal Injury Handbook

THE IMPORTANCE OF EARLY INTERVENTION Ask the expert - Lucy Weech.

FINANCIAL & LEGAL Winning the case and winning the costs.

HIGHER-LEVEL LANGUAGE NEEDS ... of Children with acquired brain injury.

MUSIC THERAPISTS ON EXPERT PANELS Can it expedite client recovery effectively?

2020 /2021

EDITION

Together WE CAN HELP

Specialist Brain Injury, Spinal Injury and Medical Negligence Lawyers Access to top quality healthcare, giving you the best recovery service National UK coverage, Home and Hospital visits available Free initial case review No win, No fee agreements available

Sternberg Reed is authorised and regulated by the Solicitors Regulation Authority. Our Solicitors Regulation Authority Number is: 63650 and you may access their rules at www.sra.org.uk/solicitors/handbook/code/content.page | Online consumers' dispute resolution VAT Registration Number: 283 9422 33

B&SI WELCOME Dear Reader, Welcome to the 2020/2021 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, weâ&#x20AC;&#x2122;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 3

B&SI CONTENTS RECOVERY & REHABILITAION AND LONG-TERM SUPPORT 6 T he APPG on ABI driving awareness in Westminster 9 Specialised complex neurological care and rehabilitation 11 A new approach to ABI rehabilitation 13 Neuro physiotherapy in a state-of-the-art centre 15 Putting the patient first 17 Hydrotherapy as standard at askham 19 Part of the family 20 H igher-level language needs of Children with ABI 25 Reach your potential 26 M usic therapists on expert panels can expedite client recovery cost effectively 29 Benchmarking independent neurological occupational therapy services 31 Inspiring recovery, together! 33 Dedicated rehabilitation 35 The truly personal touch 36 The Importance of early intervention and diagnosis of paediatric acquired brain injury 39 Personalised, goal-driven neurological rehabilitation 40 A hazardous relationship 43 The ultimate goal 44 Twenty-five not out… BABICM 47 Owning goals 48 Spinal Injuries Association – supporting everyone affected by SCI 4

2020 /2021

EDITION

51 T he experience, skills & knowledge 53 Struggling to find trained, rehabilitation assistants who have something special? 54 Accreditation for case managers – background and progress to date 57 Quality of care for quality of life 59 Complete Care… complex care at home 60 Complex care made simple! 63 Born through a vision of nurse led bespoke care provision 65 Tailor-made to support our clients 67 Enjoy life outdoors 69 Powerchair perfection from precision rehab 70 Ask the expert - Lucy Weech 75 Brotherwood case study - The Collins family 77 How appropriate living aids can tackle spinal injury 79 How dynamic movement orthoses are helping change lives

FINANCIAL & LEGAL 80 Renowned & respected medico-legal consultancy 81 We are a team of care experts with a focus on delivering concise and robust reports 82 Mental capacity – why is it so important? 83 Accommodation experts 86 W inning the case and winning the costs – how to avoid the technical traps

89 W orking with deputies and their clients 91 Increase your financial muscle 93 Injury doesn’t discriminate! 95 Periodical payments 97 How should capacity to use social media be assessed? 99 Strength in depth 100 Leading experts 101 A proven record

103 Civil and public law barristers 105 Managing finances following a brain injury 107 Safeguarding measures to prevent brain injury at birth 109 Brain & Spinal Cord Injury: Fighting for what is right 111 Adding insult to injury 113 S ubtle brain injury - do not miss the signs 114 Specialist knowledge

115 E arly notification scheme for birth injuries 119 Together we can help

REFERENCE 116 Professional profiles 120 Brain and spinal injury contact information 122 Special thanks to our contributors

Executive Editor Lee Gatland Art Director Adrian Brown Sales Team Claire Hollingdale & Joanne Lewis 01959 543 659 sales@sevenstarmedia.co.uk All other enquiries contact@sevenstarmedia.co.uk

The APPG on ABI

DRIVING AWARENESS IN WESTMINSTER

The All-Party Parliamentary Group on Acquired Brain Injury (APPG on ABI) has been driving change for people with ABI since it was established in 2017.

he APPG on ABI is a voice for those who are not always heard in Westminster and beyond, raising important issues across health, social care and welfare, and seeking improvements in support and services for people directly affected by ABI, and for their families and carers. The United Kingdom Acquired Brain Injury Forum (UKABIF) provides the secretariat for the APPG on ABI.

In October 2018, the APPG on ABI published a report ‘Acquired Brain Injury and Neurorehabilitation – Time for Change’ which called for immediate action to address the issues surrounding neurorehabilitation. The report was the result of a series of meetings with experts about the issues surrounding the provision of neurorehabilitation services for children, young people and adults with ABI in the UK; focussing on education, criminal justice, sportrelated concussion and the welfare benefits system.

Key neurorehabilitation recommendations in Acquired Brain Injury and Neurorehabilitation – Time for Change

l Rehabilitation Prescriptions should be available to all individuals with an ABI on discharge from acute care, held by the individual with copies made available to the general practitioner 6

l A national review of neurorehabilitation is required to ensure service provision is adequate and consistent throughout the UK l The Government should collate reliable statistics for the number of individuals presenting at Accident and Emergency Departments with ABI, and record the numbers that require and receive neurorehabilitation. l There should be a significant increase in neurorehabilitation beds and neurorehabilitation professionals so that every trauma centre has a consultant in rehabilitation medicine, and individuals with an ABI have access to neurorehabilitation l Cooperation between key government departments (i.e. the Department of Health and Social Care and the Department for Work and Pensions) is required to review funding for in-patient and community neurorehabilitation services The Government produced a response to the APPG on ABI ‘Time for Change’ report, and it was subsequently discussed in a Backbench debate in the Commons Chamber last year. The debate was led by MPs Chris Bryant (Chair of APPG on ABI), Sir John Hayes and Liz Twist, with a wide range of issues discussed about the lack of neurorehabilitation services. This was followed by a well-attended Lobbying Reception at the Speaker’s House, during Brain Injury Week, attended by people with ABI and

ACQUIRED BRAIN INJURY would generate net savings in excess of £500 million per year in longer-term care costs.

The impact of ABI on children and young people, particularly in relation to their return to education has also been aired in Westminster with concerns expressed regarding the lack of neurorehabilitation services in the UK for children. When Major Trauma Centres (MTC) were established in England the neurorehabilitation services were not integrated into the care pathways or additional services established for children. As an MP representing Rhondda, Chris Bryant has been keen to highlight that when the new major trauma centre opens in South Wales, it should have a fully functioning neurorehabilitation centre alongside it.

A TASK FORCE TO DISCUSS THE ISSUES

Although the immediate response in Westminster has been that ABI and neurorehabilitation is a health topic, the APPG on ABI is focussed on raising awareness that it actually concerns many government departments including the Ministry of Defence, the Department for Work and Pensions, the Ministry of Housing, Aquired Communities and Local Government, the Department brain for Education, the Ministry of Justice, and the Home injury Office. ABI and neurorehabilitation affects so many key facts different government departments; it is timely to establish a task force to discuss the The impact of issues and identify solutions in the short and long-term. It is crucial that ABI on children, their families from all over the UK, to changes are made and the particularly in discuss issues with their MPs. recommendations in ‘Time for Change’ Chris Bryant secured another ABI are implemented. Following a debate relation to their debate in July during which he discussed earlier this year, Chris Bryant, MP said: return to education, “A government task force is required the publication of the report ‘National Clinical Audit of Specialist Rehabilitation has also been aired as a matter of urgency. The APPG on for Patients with Complex Needs ABI in tends to unite all the in Westminster following Major Injury’ (NCASRI), which departments involved in order to identifies important shortfalls in existing service drive change for brain injury survivors”. UKABIF is provision and provides some potential solutions. extremely grateful to Chris Bryant and the members NCASRI is a major national clinical audit, commissioned of the APPG on ABI for their hard work and support. ■ by the Healthcare Quality Improvement Partnership as part of the National Clinical Audit and Patient Outcomes Programme, and was funded by NHS England and the Welsh Government. The NCASRI report found that in a group of 1381 individuals assessed as requiring specialist rehabilitation, only 40% received it. Those who did receive specialist UKABIF aims to promote better understanding rehabilitation did well, with 94% becoming more of all aspects of ABI; to educate, inform and independent in their activities of daily living, which in provide networking opportunities for turn reduced the costs of ongoing care by an average professionals, service providers, planners and of £536 per week. Over their lifetime, the average net policy makers and to campaign for better services life-time savings from neurorehabilitation amounted to in the UK. UKABIF is a membership organisation just over £500,000 per patient, and the total savings and charity, established in 1998 by a coalition of generated from this study group was £582 million. The organisations working in the field of ABI. cost of meeting the current shortfall of 330 rehabilitation

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beds was estimated at just £53 million per year, which

www.ukabif.org.uk

Specialised Complex Neurological Rehabilitation & Care

Pathways

The spectrum of Elysium Neurological services across the UK covers the following five pathways for inpatient, residential care and respite stays for men and women over the age of 18.

Neurorehabilitation

Neurobehavioural

Assessment, rehabilitation, flexible packages for ABI or neurological conditions

Specialised behavioural programmes including people who may be detained under the Mental Act 1983 (amended 2007)

Complex Physical Conditions – as a result of a

Neuroprogressive Conditions

neurological problem Including disorders of consciousness, spinal injury, tracheostomy care, ventilation and complex stroke

Including Huntington’s Disease, Motor Neurone Disease, Multiple Sclerosis and Parkinson’s Disease

Complex Dementias Including Frontotemporal, Pick’s, Lewy Body, Korsakoff, young-onset or vascular

Care centres

Hospitals

Adderley Green Stoke-on-Trent, Staffordshire

Stanley House Bosbury, Herefordshire

St Neots Neurological Centre St Neots, Cambridgeshire

Badby Park Daventry, Northamptonshire

The Bridge Middlesbrough, North Yorkshire

The Avalon Centre Swindon, Wiltshire

Get in touch 24hr Referrals and enquiries T: 0800 218 2398

E: referrals@elysiumhealthcare.co.uk

RECOVERY & REHABILITATION

Specialised Complex

NEUROLOGICAL CARE AND REHABILITATION Neurological care & rehabilitation centres & hospitals providing extensive clinical facilities.

lysium Neurological, a division of Elysium Healthcare, provides rehabilitation and long-term complex care for men and women with acquired brain injuries (ABI or TBI), spinal cord injuries and neuroprogressive conditions such as Huntington’s, Motor Neurone Disease and complex dementias. With the addition in 2020 of The Avalon Centre in Swindon, a neurobehavioural rehabilitation hospital service, we will have a full spectrum of neurological provision across the UK. Our specialised neurological care and rehabilitation centres or hospitals provide extensive clinical facilities which cater for the specific needs of men and women aged over 18 years. We offer five clinical pathways covering neurorehabilitation, neurobehavioural rehabilitation, neuroprogressive disorders or dementias and complex physical conditions.

PERSONALISED GOAL SETTING

All our services employ very experienced, full multidisciplinary teams and work in either inter or transdisciplinary clinical models with personalised goal setting and outcome measures key features for all pathways. For some, the expected outcomes are linked to their rehabilitation and recovery journey, for others it may be more about symptom management and quality of life. At every site, family and friends are at the heart of the placements we offer people. When someone is admitted to a service, we establish who is important to the person and we make sure that those important relationships are maintained and nurtured. This forms a very important element of a person’s care and rehabilitation.

We employ a team of Partnership Development Managers who, alongside the Referrals Manager, work to ensure that the person commissioning a service has a named person who they can contact for information or feedback at the referral to admission stage and beyond if needed. This team are the interface between the commissioners and the services and have a wealth of prior clinical and operational experience. They are a single point of communication and provide a solution focussed approach at an early stage. Being part of a larger organisation brings a wealth of benefits for services, the people we care for and support and our staff. We provide a broad network of support with numerous resources to help us provide the best possible service quality in all locations. Our staff are well looked after with support from dedicated Wellbeing teams as well as a wide range of benefits and services to them both inside and outside work. Training and development are high on our agenda as we want all our staff to know they have the right skills to work with the people in their care. ■

For further information about Elysium Neurological Services please contact: Tel: 0800 218 2398 Email: referrals@elysiumhealthcare.co.uk

www.elysiumhealthcare.co.uk/ neurological/

Inspired neurorehabilitation in the beautiful Lake District Calvert Reconnections is the UK’s first intensive Acquired Brain Injury (ABI) rehabilitation centre focused on outdoor activities.

We offer: • A unique combination of interdisciplinary clinical therapies with physical outdoor activity led by highly-experienced clinicians and practitioners • Transitional, residential rehabilitation – from two weeks to six months • A maximum of 10 places at any one time

Now taking referrals To find out more visit: calvertreconnections.org.uk call: 017687 85381 or email: info@calvertreconnections.org.uk 00

RECOVERY & REHABILITATION

A new approach to ABI

REHABILITATION

Calvert Reconnections , the UK’s first intensive ABI rehabilitation centre focused on outdoor activities has opened its doors.

alvert Reconnections is the UK’s first ABI rehabilitation centre combining traditional interdisciplinary clinical therapies with physical outdoor activity. The new centre, run by the Lake District Calvert Trust, provides ground-breaking, world-class ABI rehabilitation programmes tailored to support individuals in their recovery. The 10-bed wheelchair accessible residential facility is a beautifully adapted grade II listed building, in the heart of the Lake District in Keswick. There is growing evidence that physical and outdoor activity promotes neuroplasticity post-brain injury whilst also improving mental health, outlook and wellbeing. At Calvert Reconnections, we actively seek to incorporate a wide range of outdoor activities into our rehabilitation programmes, ranging from gentle activities such as fishing, bird watching or a nature walk to higher adventure activities including canoeing, rockclimbing and abseiling. This is closely assessed and graded to the person’s interests and functional abilities. We have a homely residential facility with 24-hour support on site. We also welcome family and support staff, particularly whilst participants are settling into their new environment and in preparation for transition back home. Our team includes qualified activity instructors, rehab coaches, an occupational therapist, physiotherapist, clinical psychologist and a nurse.

WHAT THE EXPERTS SAY

“The Calvert Reconnections concept is brilliant. I am sure there will be many people with brain and other neurological injuries who will benefit from this centre. It is unique in the UK and a much-needed service which I am sure will succeed and be much in demand.” Professor Mike Barnes “Calvert Reconnections is the most exciting development in brain injury management in the last

20 years. The centre offers a ground-breaking, world-class brain injury rehabilitation programme.” Bill Braithwaite QC

WHAT ABI PARTICIPANTS SAY

“I used to say ‘I live to fight another day’. When I come here I say ‘I live to enjoy another day’ because after all, without hope, there can be no recovery.” John Gaimster, ABI survivor and Calvert Reconnections advocate

DID YOU KNOW?

A registered charity, for over 40 years, the Lake District Calvert Trust has been welcoming guests with disabilities to our dedicated centre, so that they can enjoy the benefits of outdoor activities in a safe and accessible, yet challenging environment. ■

Tel: 017687 85381

www.calvertreconnections.org.uk 11

Rebuilding lives and creating brighter futures Now in a fantastic, new state-of-the-art centre

Call us on 01372 841 111 or email neurorehab@qef.org.uk www.qef.org.uk 12

queen elizabethâ&#x20AC;&#x2122;s foundation for disabled people

RECOVERY & REHABILITATION

Neuro physiotherapy in a STATE-OF-THE-ART CENTRE

Emma is lead physiotherapist at QEF’s Neuro Rehabilitation Service (NRS). She leads a team that provide expert support for adults with physical, cognitive and/or communication disabilities as a result of an acquired brain injury following stroke, traumatic injury or neurological illness.

have been working at QEF for 13 years, progressing from a band 6 EMMA physiotherapist to the lead physiotherapist for neuro rehabilitation. My role includes talking to clients and their families to assess the clients’ abilities and producing neuro rehabilitation programmes specific to their needs. These are developed alongside other physiotherapists, occupational therapists, speech and language therapists and clinical psychologists, as part of our multidisciplinary team. I’m heavily involved in working with all the specialist therapy teams at QEF to continually develop exercise plans and walking practices, so that clients can continue their progress with our care team and their families to really excel their recovery. Some of our clients return after they’ve left QEF’s residential service for further physiotherapy and they go into our outpatient service, which allows us to continue helping them through their journey.

Helping them achieve their goals is a key part of my role, as recognising and tapping into these personal motivations is a great way to support their recovery. We’ve recently moved into a state-of-the-art Care and Rehabilitation Centre (CRC) near Leatherhead. This is a £15millon, purpose-built centre that was designed to reflect the needs of QEF’s service users. Our multi-disciplinary therapy teams have all moved to this new centre, so we are able to provide the same great quality service in a fantastic, purpose-built building. The therapy gym is twice the size with 2 hoists and the multiple therapy rooms are more spacious, meaning our teams can work together much more effectively. Every client has an en-suite bedroom, with overhead hoists and tracking systems into their bathrooms. This makes it much easier for people to be moved safely. Each person also has accessible technology in their rooms, offering greater control over their personal space; such as changing room temperature, opening the blinds or turning the TV on if they choose. ■

THE MOST DEVASTATING TIME

Read more about QEF’s Care and Rehabilitation Centre at: www.qef.org.uk/about-us/qef-blog/CRC

My role is extremely rewarding as I’m able to see the difference we make every day through each client’s progress, during the most devastating time of their lives. QEF becomes a part of their journey of recovery. Some clients come in unable to walk and when they leave they are able to walk again - the improvements can be as life changing as that. Sometimes clients set themselves very specific goals at the beginning of their journey, which they’re very determined to hit. For example, they may want to be able to walk 100 yards or be able to play a sport again.

Call us on 01372 841 111 or email neurorehab@qef.org.uk

www.qef.org.uk

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. Consultations for medico-legal services are available world-wide including London, New Malden, Reigate, Guildford, Leatherhead Southampton and Portsmouth. Assessments in care homes and in individuals' home may also be possible when based on clinical needs; worldwide consultations are also available. Clinical services are available in central London and Surrey.

Correspondence address: The Aston Clinic, 26 Kingston Road, Surrey KT3 3LS Tel. 020 8942 3148

The Royal Buckinghamshire Hospital is a centre for high-intensity rehabilitation and complex nursing care in Aylesbury. Providing a state of the art facility in a historical, landmark building in the centre of Aylesbury, staffed by specialists, the service is well equipped to support patients with their recovery and rehabilitation.

BEST IN CLASS TREATMENT

OUR PATHWAYS HIGH INTENSITY SPINAL AND NEURO REHABILITATION COMPLEX AND HIGH DEPENDENCY NURSING CARE SLOW STREAM REHABILITATION STEP FORWARD FACILITIES OUTPAITIENT SERVICES STROKE REHABILITATION

PUTTING THE PATIENT FIRST

USE RBH#B&SI TO RECEIVE A REWARD enquiries@royalbucks.co.uk www.royalbucks.co.uk

The Royal Buckinghamshire Hospital Buckingham Road, Aylesbury Buckinghamshire HP19 9AB Tel: +44 (0) 1296 678 800

Search for us on

A WHOLE SOLUTION IN ONE LOCATION

RECOVERY & REHABILITATION

Putting the

PATIENT FIRST

The Royal Buckinghamshire Hospital is a specialist hospital recognised worldwide for its work (expertise) in the areas of high-intensity rehabilitation and complex nursing care.

ince 1994 The Royal Buckinghamshire Hospital (Royal Bucks) has dedicated itself to helping patients recover from spinal, brain, and neurological injuries so that they can resume their lives. The Royal Bucks was the first purpose built civilian hospital in England, with a building design influenced by Florence Nightingale, the heroine and pioneer of modern nursing. The treatment that defines The Royal Bucks is at the heart of its rehabilitation and care. With an array of committed and highly trained specialists, the hospital strives to provide high quality transitional care to patients with a variety of highly complex injuries and conditions.

PATIENT SUCCESS STORIES: MR R

Earlier this year, Mr R was involved in a road traffic incident which resulted in an L3 fracture - and as a result, suffered from impaired sensation and muscle power in both legs. After the accident, he underwent a spinal fixation at a major trauma centre in London. He then transferred to his local NHS trust for 3 weeks in an acute ward, and afterwards to the community hospital for further rehabilitation. Prior to discharge, Mr R contacted the Royal Bucks Hospital and attended a multidisciplinary assessment, seeking specialised rehabilitation input. The team discussed their findings with him and developed a plan to admit him for intensive rehabilitation after his discharge from the community hospital. Mr R started the programme 12 weeks after his injury. His goals were to be able to drive, walk without crutches, and to return to work. He arrived in a wheelchair, moving up to 50 metres with bilateral ankle support and crutches. His walking pattern, besides being very unstable, was also very much reliant on his upper limb strength. His rehabilitation programme was structured so he would have daily strengthening sessions to help him walk unaided. His walking pattern and gait were improved through treadmill use and aquatic therapy, as well as indoor and outdoor walking practice. With the

intensity of input he started showing rapid improvement in leg strength, which demanded constant adaptation and review of exercises and aids to support his foot drop. By the time of discharge, Mr R had made significant improvement in walking quality and was accessing the community on foot. He left Royal Bucks using only a foot drop support on the right foot, and a walking pole on the left side - walking with a safe and nearly symmetrical pattern. He went home by himself using the train - and was due to attend a festival at the weekend with his friends as soon as he got home. Mr R was able to resume his favourite leisure activities, and safely and actively participate in all aspects of his personal and working life. â&#x2013;

Tel: +44 (0) 1296 678 800 Email: enquiries@royalbucks.co.uk

www.royalbucks.co.uk

Achieve your rehabilitation goals sooner with hydrotherapy Every person that comes to Askham Village Community for rehabilitation will benefit from our full Multi-Disciplinary approach which includes hydrotherapy (also known as aquatic physiotherapy) as part of our core provision. Call us now for more information – our goal is to help you reach your goals quickly! Benefits of aquatic physiotherapy • • • • • • • •

Patient C: wheelchair transfer

Patient C was unable to weight bear or actively move legs on dry land. On arrival at Askham he was being hoisted into his wheelchair. Following a stretching programme on dry-land and multiple sessions each week in the hydrotherapy pool he is now transferring with a sliding board – using upper limbs to propel himself across to his wheelchair.

Phone: 01354 740269 Email: info@askhamvillagecommunity.com Website: www.askhamvillagecommunity.com 00

Pain relief and reduction of muscle spasm Ease of movement, joint range and flexibility Improved strength and endurance Enhanced relaxation Improved balance, coordination and posture Improved cardiovascular fitness Enhanced feeling of well-being Reduction of oedema and improved circulation

Patient W: taking steps

With major orthopaedic injuries following a RTC, patient W was unable to weight-bear on dry land for 8-months. Transferred to Askham and was in the pool first week of admission. Two sessions a week led to increased range of movement in both legs. Within a month of being admitted was step transferring with rollator frame.

RECOVERY & REHABILITATION

HYDROTHERAPY

as standard at Askham At Askham, we believe it is our job to do everything we can to help you meet your goals. As such, we ensure that hydrotherapy is considered for all our residents.

he benefits of receiving therapy input while in a purpose built and heated pool are clear and we have seen evidence of this within our patient population. This is also why we are training up more therapists and rehab assistants in aquatic therapy so that more rehabilitation patients can benefit. Pain relief and reduction of muscle spasm The warmth of the water helps suppress the sympathetic nervous system and stimulates the skin sensory nerve endings. There is also a reduced effect of gravity due to the properties of the water. Reduced muscle tone may also have an effect on reducing discomfort. Ease of movement, joint range and flexibility The support of buoyancy in the water reduces the effect of gravity. This allows for exercises to be completed easier than on dry land.

The Metacentric effect can be further challenged with assistance or resistance given to the different movements. Improved cardiovascular fitness Exercises in the pool are often used where dry land exercises cannot be achieved, providing an opportunity to push levels safely. This is due to the hydrostatic pressure gradient providing assistance to the circulation. The properties of the water also help provide resistance to movement which has a positive effect on our cardiovascular system.

Enhanced feeling of wellbeing Due to all the properties of the water, it allows for people to exercise who cannot on dry land. This is discussed as ability versus We are training often disability. It can allow for people to be even more therapists more independent whilst enjoying the and rehab assistants freedom it may provide. It can also allow for social interaction that often in aquatic therapy isn’t available in other settings.

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so more patients

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Improved strength and endurance Reduction of oedema and improved can benefit circulation The properties of the water are used to The hydrostatic pressure gradient enhances blood and work muscles in different planes and in a way that often cannot be achieved on dry land. Such exudate fluid circulation which has a positive effect on properties include the viscosity, weight and density of oedema. Reducing swelling can ease the ability to the water, force of buoyancy. Also using the water to move more freely. produce resistance, such as a negative pressure from turbulence and a drag effect. We welcome any therapists or patients who would like to know more about how aquatic therapy can Enhanced relaxation help you or someone you know. Our Clinical Lead, There is a hypnotic effect of water and due to the Sara Neaves (sara.neaves@askhamvillagecommunity. temperature being thermo-neutral it has a positive com), is available any time for a discussion. ■ effect on reducing pain. Using the properties of the water, such as the support of buoyancy and the reduced effect of gravity, it allows people to relax. This is often not possible on dry land. For more information about types of Improved balance, coordination and posture outcome-based rehabilitation, care and lifestyle These very important variants can be challenged that Askham Village Community provides, further and safer within the water. This is due to the call 01354 740269 person being unencumbered, with the support of or email info@askhamvillagecommunity.com. buoyancy and weight-bearing in various positions. www.askhamvillagecommunity.com 17

SPECIALISED NEUROLOGICAL 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.

Hawthorns Care Centre at a glance:

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.

– Care for those recovering from traumatic or non-traumatic brain or spinal injury.

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.

– Active rehabilitation packages.

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.

– Long-term and respite placements.

– Tailored therapy programmes. – Higher dependency floor for those with complex neurological, respiratory care and rehabilitation requirements.

For more information on the types of complex neurological services we care for please visit our website or call 0191

4487 239

www.barchestermentalhealth.com/Hawthorns Hawthorns Care Centre, O'Neill Drive, North Blunts, Peterlee, SR8 5UP 18

RECOVERY & REHABILITATION

Part of the FAMILY

Richardson Care celebrated its 30th anniversary in 2019, so what’s behind its success?

irstly, Richardson Care provides specialist In addition, staff are empowered to be innovative in residential care and rehabilitation for their approach to meet the needs of each individual. adults with acquired brain injury and Service users can choose to take part in a wide range separately for adults with learning disabilities. of therapeutic activities, such as music, crafts, Secondly, it remains an independent family business. hydrotherapy, trampolining, theatre visits and day Since 1989, its inclusive family trips. These activities help to Service users can choose to reduce anxiety, improve environment has been crucial to the well-being and positive take part in a wide range of communication, self-esteem and well-being, which are vital in the outcomes experienced by service therapeutic activities complex process of recovering users. By feeling comfortable in from a brain injury. Richardson Care has a portfolio of their surroundings, they engage more with their six specialist homes in Northampton and offers a rehabilitation programmes and are better able to develop daily living skills to be more independent. Placing range of services including short-term rehabilitation, someone in a real ‘home from home’ also provides long-term rehabilitation and a home for life. ■ reassurance and comfort for their family members. Thirdly, Richardson Care provides holistic personcentred care and places as much emphasis on psychological well-being as on physical recovery. Social inclusion and community participation are a big part of life in a Richardson Care home, and there are plenty Call Richardson Care on 01604 791071 of communal spaces. This means that service users can to arrange a visit or email choose who to socialise with and when to spend time admissions@richardsoncares.co.uk on their own. www.richardsoncares.co.uk

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Respect & Restore Specialist residential care and rehabilitation for adults with acquired brain injuries. • Portfolio of services to meet a variety of needs • Innovative person-centred care • Unique ‘family’ environment • Focus on social integration • 30-year proven track record The Richardson Partnership for Care is now Richardson Care still proud to be an independent family business.

Call us on 01604 791071 to arrange a visit or email admissions@richardsoncares.co.uk

www.richardsoncares.co.uk The Richardson Mews, Kingsland Gardens, Northampton NN2 7PW

HIGHER-LEVEL LANGUAGE NEEDS OF CHILDREN with acquired brain injury By Isobel Hatfield and Dr Karen Cundy of The Children’s Trust.

cquired brain injury (ABI) is the most common cause of injury in childhood and affects 18 in every 100,000 children in England (NHS England, 2013). This includes both traumatic brain injury (e.g. road traffic accident) and non-traumatic brain injury (e.g. tumour, stroke, infection). As the brain continues to develop until the late 20s, the impact of an ABI is considered to be a developing condition, rather than confined to the single physical injury. The children and young people that are supported by the Brain 2020), ‘hidden disability’ refers to Injury Community Service at The a range of difficulties that aren’t Children’s Trust, have often made necessarily visible on the outside. a good physical recovery These may include underlying following their ABI and have difficulties in areas such as returned to their previously attention and concentration, attended school. planning and organising, problem However, these children will solving, understanding and using likely experience inferential Everyday tasks language, memory, something described as a such as homework and emotional ‘hidden disability’. changes. assignmentsand daily In terms of their As discussed in Katy James’s scheduling are likely language, these previous article may to be more revealing children (Acquired brain present with injury, a hidden of challenges faced seemingly intact disability – Brain & functional than scores on Spinal Injury expressive and standardised tests Handbook 2019receptive language

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skills. However, they commonly experience ‘higher-level’ language difficulties, which is an umbrella term under which there may be deficits in areas such as: word finding, sequencing, narrative skills, understanding figurative or ambiguous language and making inferences or predictions. In addition to formal assessments, higher-level language skills can be picked up and assessed through observations across settings, the use of checklists as well as informal functional tasks. For example, a community assessment in a supermarket can reveal much about a child’s ability to sequence, understand

RECOVERY & REHABILITATION complex language and infer. Ciccia et al. (2009) suggest that everyday tasks such as homework assignments, peer conversations and daily scheduling are likely to be more revealing of challenges faced than scores on standardised tests. Higher-level cognitive and communication difficulties can have a devastating impact and are often ongoing and long-term (Anderson et al. 2004, Shakalai et al. 2014). As children and young people develop, they are expected to communicate in a range of increasingly complex academic, social and vocational contexts.

DEFICITS IN LANGUAGE ABILITIES CAN HAVE A SIGNIFICANT IMPACT

They are learning to regulate their own behaviour, negotiate and to use language to achieve complex goals (Ciccia et al, 2009). Deficits in higher-level language abilities can therefore potentially have a significant impact on their participation in all areas of their lives, such as school/college, home, going out with friends, participating in clubs and leisure pursuits and planning for the future. Language impairment, particularly in higher-level language skills, may misleadingly present as educational and social difficulties (Jordan & Ashton, 1996). For example, the 10 year old who is being ‘disruptive’ in the classroom may actually be experiencing difficulties understanding the ambiguous or figurative language used by the teacher, which results in the behaviour seen. Similarly, the 14 year old who is having difficulties making and maintaining friends, may be experiencing underlying difficulties inferring meaning from other’s intentions, resulting in the relationship breakdown. ▲

CONTINUED OVER

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on-going needs* This service provides the initial support needed when a • a long-term register to RECOVERY child&isREHABILITATION discharged from hospital to home and can also help monitor support needs be accessed after an initial injury or illness which, in some at●key stages. by Isobel cases, the canright be many years later. Much This may besupport becausefor the Without level of of the the Co-written effects of thewith injury obvious some time.who support, children ABImay are atnot be children andfor young people Hatfield, Speech and Language risk of increased mental health access the Brain Injury difficulties, reduced education Community Service will involve and employment education, training Children with and advocating for opportunities, antisocial behaviour are at risk of their hidden 01737 365ABI 864 and involvement in difficulties, increased mental including their the criminal thechildrenstrust.org.uk/bics justice system (Hoofien et health difficulties higher-level bics@thechildrenstrust.org.uk al. 2001, Williams et language. This al. 2015). It is therefore essential involves working closely with that*subject thosetoinvolved home and school, as well as with funding. in supporting Registered Charity No.an 288018. TCT_422 V1 February 2019. these children, have awareness speech and language therapy and and understanding of hidden occupational therapy colleagues higher-level language needs. in the community. ■ TCT_432 Brain and Spinal Injury Handbook 2019 Full Page V0.1.indd 1

Therapist, Brain Injury Community Service, The Children’s Trust, and Dr Karen Cundy, Speech and Language Therapist, The Children’s Trust.

Making a referral is simple, get in touch today.

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Tel: 01737 365 864

thechildrenstrust.org.uk/bics 01/03/2019 16:25:45

Support and Rehabilitation Delivered at home, in school, or a combination of both The Children’s Trust Brain Injury Community Service provides specialist goal-orientated neurorehabilitation delivered in the child’s environment, at home, in school, or a combination of both. With members of The Children’s Trust Community Service team based in four of the UK’s major hospitals, and a dedicated multidisciplinary team based at their national specialist centre in Surrey, the service supports children from right across the UK. To find out more about the service, get in touch with the team by: Calling 01737 365 864 or visit www.thechildrenstrust.org.uk/bics TCT_806 01/20 | Charity registration number: 288018.

Private placements available

The Children’s Trust is the UK’s leading charity for children with brain injury. We provide rehabilitation and specialist education to children and young people aged 0–19 with brain injury, neurodisabilities and complex health needs. Located just south of London and set in 24-acres of beautiful woodland, our national specialist centre is the UK’s largest paediatric residential rehabilitation centre of its kind. With our children and family services rated ‘Outstanding’ by CQC and our school rated ‘Good’ with ‘excellent management and leadership’ by Ofsted, we are currently accepting placements (including private patients) across all areas of our service. Our key services include: • brain injury rehabilitation • step-down medical and nursing care from hospital to home • specialist assessment and clinical support in the community • special education at The Children’s Trust School (residential and non-residential) • short breaks, camps and clubs • online information and support via www.braininjuryhub.co.uk.

To find out more and for a list of our open days and conferences, visit: thechildrenstrust.org.uk. 01737 365 080 placements@ thechildrenstrust.org.uk @childrens_trust /childrenstrust

The Children’s Trust, Tadworth Court, Tadworth, Surrey KT20 5RU. Registered charity number 288018. TCT_748 02/20

Brain injury and stroke rehabilitation

349k

people are admitted to hospital with an acquired brain injury each year Headway UK

Exemplar offers a truly supportive rehabilitation environment which focuses on restoring a person’s independence and developing functional skills.” Helen Baxendale Clinical Director Exemplar Health Care

Brain injuries and strokes can affect anyone, at any time in their life. Whatever the symptoms, Exemplar provides the support and rehabilitation that makes a difference to a person’s quality of life. People living with acquired and traumatic brain injury, stroke and spinal injury can experience a broad range of complex physical, sensory, cognitive, psychological, emotional, behavioural and social difficulties. We support individuals with traumatic (TBI) and acquired brain injury (ABI). Our highly specialist services can accommodate individuals with brain and spinal injuries who require tracheostomy management and ventilated care. Individuals living with the life-changing effect of a stroke are supported by Exemplar’s specialist teams who work with a person to increase their functional abilities including movement, speech and emotional needs. Where possible, our specialist teams use assistive technology, including communication aids and environmental controls, to increase a person’s independence.

A positive approach to rehabilitation At Exemplar, we take a positive approach to care and rehabilitation, which focuses on restoring independence. We work in partnership with our own multi-disciplinary teams and community occupational therapists, speech and language therapists, physiotherapists, psychiatrists and psychologists to ensure service users can achieve their goals.

01709 565777 | referrals@exemplarhc.com | www.exemplarhc.com

RECOVERY & REHABILITATION

Reach your POTENTIAL S A dedicated, specialist residential and day rehabilitation facility.

like no other care facility you will have visited. TEPS Rehabilitation is a purpose built, state Four bedrooms form our transitional living unit and of the art facility set in South Yorkshire, we also have one independent/supported living serving clients from the UK and overseas. apartment. Together, they enable us to provide the We deliver intensive 7 day rehabilitation for people complete rehabilitation pathway as well as recovering from neurological conditions, spinal cord independent living trials. injuries, traumatic brain injuries, orthopaedic and We offer individualised rehabilitation packages, complex trauma injuries, enabling them to reach their including the only residential amputee full potential. Having only opened in Our mission is to rehab programme in the UK. We are 2017, STEPS has won multiple awards for our neurological and complex achieve the highest able to care for people with complex nursing needs including those with trauma rehabilitation. levels of recovery tracheostomies. We provide both residential and day We accept referrals from clients, clinicians, solicitors rehabilitation packages. and case managers. Please see our online referral form Our mission is to achieve the highest levels of on our website. We would be happy to discuss any recovery by providing intensive therapy, delivered by questions you have about possible referrals. ■ a carefully chosen, specialist team of professionals, working in real partnership with individuals and their families along the journey to recovery. STEPS has 23 ensuite bedrooms, therapy gym, hydrotherapy pool, skills kitchens, games room, music room, café/dining space and gardens in a Tel:is0114 258 7769 STEPS a dedicated, specialist residential and non-clinical, comfortable and homely environment www.stepsrehabilitation.co.uk day rehabilitation facility. We treat neurological

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conditions, stroke, spinal cord injury, acquired brain injury, orthopaedic and other complex trauma injuries. Also providing specialist, residential amputee and orthotic rehabilitation programmes. Complex nursing care & specialist therapy team: • physiotherapy • occupational therapy • speech and language therapy • psychology • neurologic music therapy

STEPS is a dedicated, specialist residential and day rehabilitation facility. We treat neurological conditions, stroke, spinal cord injury, acquired brain injury, orthopaedic and other complex trauma injuries. Also providing specialist, residential amputee and orthotic rehabilitation programmes.

vestibular rehabilitation / residential amputee programme spasticity management / functional electrical stimulation (FES) acupuncture / pain management programme independent living trials / in house hydrotherapy pool

Alex enquiries: 0114

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

MUSIC THERAPISTS ON EXPERT PANELS can expedite client recovery cost effectively

Daniel Thomas

By Daniel Thomas, joint managing director, Chroma.

ccording to official Government statistics, ensure treatment instructions are clear and a third of all people aged 65 or over fall unambiguous in areas where they have relevant once a year, with this figure rising to half knowledge or direct experience, and which lie within for people who are 80 or above. the limits of their professional competence. And with the UK’s population set to increase to 74 As treatment needs to be accurate from the million people by 2039, treatment for people falling is beginning, therapists, especially music therapists likely to become a bigger problem for the emergency shouldn’t be an afterthought and should be involved services. There are around 255,000 fall-related from the beginning of the process in order to help emergency hospital admissions in England among assess the clients’ condition and ensure they are getting patients aged 65 and over each year. It is estimated that the right treatment immediately, rather than becoming fragility fractures cost the UK around £4.4 billion, of involved once the case is concluded. There is a plethora which 25% is for social care. In around 5% of cases, a fall of scientific evidence that demonstrates that music leads to fracture and therapist involvement in a hospitalisation, which is costly multi-disciplinary team can for health services and the expedite clients’ rehabilitation. wider economy. Therapies like physiotherapy Rehabilitation for patients will or speech therapy serve to be necessary in order to help evoke movement, improve prevent a fall recurrence. And, it muscular strength and is becoming increasingly evident improve speech. Neurologic that music therapists need to be Music Therapy (NMT) has a integral in the rehabilitation place among these therapies. plan. This has not been the case NMT works by connecting in the past. Being part of expert music and movement, allowing panels help ensure the right the brain and body to learn Being part of expert panels and re-teach functions that treatment plan is determined and undertaken immediately help ensure the right treatment have become impaired. and effectively. It allows people to become plan is undertaken When it comes to hearings in more aware of themselves, their court, tribunal or committee or other situations that actions and the overall coordination of movement, require expert witnesses music therapists are able to helping identify emotion by using musical aspects, offer an impartial expert opinion, based on experience tones, and rhythms to communicate with the different in the relevant field and are able to help decide on a receptors in the brain. Co-ordination of movement in treatment plan. An expert witness differs from a the case of preventing falls is the key here and witness of fact. A witness of fact has usually already demonstrates how NMT would be an ideal seen the patient for clinical purposes, whereas an rehabilitation technique following a fall. expert witness is usually first approached by a solicitor As a result of music processors being present all over or claims handler when a patient initiates legal the brain and despite the damaged area, musical proceedings. neurons are used to gain access to the non-damaged Music therapists who act as expert witnesses can parts. It can stimulate and develop new aspects such as

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RECOVERY & REHABILITATION implemented from the beginning of treatment otherwise recovery outcomes may not surpass preconceived ideas, demonstrating just why therapists should be present at each expert panel. If recovery outcomes such as those outlined above can be achieved for those living with a severe brain injury, imagine the possibilities for balance, coordination and strength gains for those elderly patients injured from a fall. Music therapy remains a cost-effective, imperative measure to help prevent fall recurrence as well as help reduce the cost felt by health care services and the wider community. Music walking or communicating, taking away the focus from learning directly. It allows the body and functions of the therapy has been found to improve walking stride and cadence, which is a skill these patients can implement brain to respond to music and re-learn behaviours that into their everyday lives. were lost, helping individuals gain back control of their By appointing a therapist as an expert witness on all life. One particular case involving a middle-aged man fall-related cases, treatment can and will be effective in who suffered a severe brain injury following a cycling helping the client achieve the very accident serves to demonstrate how the right treatment plan was The right rehabilitation best possible recovery outcomes for them personally. pertinent to his recovery outcomes. techniques must be If according to official His behaviour was and remains implemented from the government stats, a third of all challenging which can affect the people aged 65 or over fall ‘once a rehabilitation process on any given beginning of treatment year’, with this figure rising to half day. But over the past year, for people who are 80 or above, a preventative measure physiotherapists have been able to help him regain needs to be considered, and music therapy remains the his strength, although he is still in a wheelchair as cognitive function remains impaired. Physically he has clear answer. It is clear an appointed therapist should be present on each expert panel to ensure the right improved immensely. treatment plan is determined and undertaken immediately and effectively and to ensure recovery A COST-EFFECTIVE MEASURE outcomes serve as a further preventative measure for To help improve communication, the introduction of Chroma’s Neurologic Music Therapists helped the client the rest of their lives. ■ become more willing to communicate and to verbalise. Watching music videos of artists he recognises and can relate to has helped him become more willing to answer yes or no questions. And, supported by a physiotherapist on each arm, whilst engrossed in music For more information about Chroma Neurologic Arts videos, he is able to stand and work on improving his Therapies within neurorehabilitation settings, please balance – demonstrating the effectiveness of a contact Daniel Thomas, Chroma via multidisciplinary team working at its best. daniel@wearechroma.com or 0330 440 1838 The right rehabilitation techniques must be www.wearechroma.com

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Neuro Occupational Therapy

RECOVERY & REHABILITATION

Benchmarking independent neurological occupational therapy services Specialist Neurological Occupational Therapist, Jo Throp, Clinical Director of Krysalis Consultancy, advises on the complex process of choosing an independent provider. The clinical experience and expertise of a treating clinician is an essential component of a successful therapeutic relationship and feeds positive rehabilitation outcomes. The clinician’s knowledge, however, is only one component of delivering a high-quality service; a skilled back-office team working to defined, quality standards in the management of staff and clinical operations should also be in place. The recent inquiry conducted by the UK Government into the working practices of disgraced breast surgeon, Ian Paterson, and the hospitals where he worked, highlighted the importance of organisations setting, and adhering to, consistent clinical, legislative and regulatory guidelines. The findings made it clear that professionals must ensure that measures are taken to mitigate risk. Exercising due diligence when choosing a treatment provider is, therefore, of paramount importance.

Defining the gold standard The clinical team at Krysalis Consultancy works within a framework of quality standards that guide and inform day to day practice and act as a compass in complex cases. This offers immense value.

and learning. Supervision, mentoring, and means to implement and monitor competency standards ensure a consistent service. It is vital, too, to consider an organisation’s structure, in particular its leading team, to ensure there is the expertise to operate a front-facing clinical service. Effective audit processes with clear accountability and options for redress are also key, but are not necessarily offered by every independent provider. Referring parties should feel comfortable questioning a rehabilitation provider about the framework they have in place, over and above the details of a clinician’s profile. Policies and procedures should confer confidence in the provider’s ability to deliver and alarm bells should be ringing if the information requested is not forthcoming.

Clinical Excellence and Expert Knowledge Krysalis seamlessly blends clinical operations with operational efficacy, securing confidence in our ability to deliver. We provide specialist neurological occupational therapy for people with brain injury and neurological conditions. Follow us @KrysalisNeuroOT, on Twitter, Facebook or LinkedIn, and meet our client, Chris, through our Talking Heads initiative at www.krysalisconsultancy.co.uk

All rehabilitation providers should have in place policies to support legislation, and should be able to demonstrate an in-depth knowledge of the regulatory framework of their specialist area. Quality companies also embrace a culture of support

...realising potential, transforming lives 29

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

RECOVERY & REHABILITATION

Inspiring recovery,

TOGETHER! Inspiring. Recovery. Together.

NPP Neuro Group provides a bespoke rehabilitation and medico legal service to both adults and children alike.

W W

NPP Neuro provides a bespoke rehabilitation and medico legal e offerGroup our patients a complete multi-disciplinary rehabilitation service to both adults and children alike. journey adapted to their needs,

delivering Neuro Psychology, Adult Physiotherapy, Paediatric e offer ourPhysiotherapy, patients a complete Occupational Therapy, Medico Legal, Speech and multi-disciplinary rehabilitation Language Therapy and Pain Strategies. journey adapted to their needs, delivering Neuro Psychology,

WHY WE DIFFERENT AdultARE Physiotherapy, Paediatric Physiotherapy,

Degrees in Neuro Rehabilitation and Cognitive Neuropsychology and was appointed as one of the first Neuro Physiotherapy Consultants in 2002. Peter believes in doing his very best for patients and this is the reason why Peter set up NPP Neuro Group. Peter felt that due to a number of constraints, patients were not being provided with the best care and quality of service they clearly deserve and need. It is this foundation of integrity and best practice that puts NPP Neuro Group in a league of its own and due to a number constraints, motivates all ofof our experts. patients were not being At provided with the best quality of NPP Neuro group wecare offerand ambitious and service they clearly deserve and need. It is promote this forward thinking treatment options that foundation of integrity and best practice that putsat the neurological rehabilitation keeping our patients NPP Neuro Group in a league of its own and centre of all we do. motivates all of our experts. At NPP Neuro group we offer ambitious and forward thinking an treatment options promote To schedule appointment or that to have a neurological rehabilitation, keeping our patients at discussion about any of our services the centre of all we do. ■

WeOccupational are unique inTherapy, offering Medico a range of specialities Legal, Speech and within the same organisation. Each specialty Language Therapy and Pain Strategies. can offer expert individual interventions, as well as working across NPP Neuro Group to offer a Why are we different multidisciplinary This makes We are uniqueinput. in offering a rangethe of patient’s specialities journey more therapeutic, delivering quality within the same organisation. Each high specialty can clinical interventions that adhere to standards offer expert individual interventions, as well of as clinical governance. ByNeuro working as a multi-disciplinary working across NPP Group to offer a multiteam delivering compassionate evidence-based disciplinary input. This makes and the patient’s journey care, wetherapeutic, innovate recovery andhigh rehabilitation. more delivering quality clinical We provide the best patient delivered by the interventions that adhere to care standards of clinical best specialist practitioners, recovery team governance. By working asinspiring a multi-disciplinary together. All compassionate members of theand NPP Neuro Group team delivering evidence-based care, arewe handpicked based on their knowledge, innovate recovery and rehabilitation. training and qualifications. With over 70 combined years of We provide the best patient care delivered by healthcare experience, our team consists of some of Call: 0800 917 3330 the best specialist practitioners, inspiring recovery LOCATIONS: thetogether. UK’s highest quality practitioners, specialists and All members of the NPP Neuro Group team OUR Email: enquiries@nppneurogroup.com leading consultants. Our expertise ensures we do Stourbridge Practice: Sandford House, 6-7 Lower are handpicked based on their knowledge, training what is right for our patients, a principle which High Street, Stourbridge, West Midlands, DY8 1TE Website: www.nppneurogroup.com and qualifications. With over 70 combined years of inspired our founder, Peter Harding. healthcare experience, our team consists of some Birmingham Practice: 22 George Road, Edgbaston, of the UK’s highest quality practitioners, specialists OUR STORY Birmingham, B15 1PJ Stoke-on-Trent Practice: 1441 Leek Our Locations: and leading Consultants. Our expertise ensures we Peter qualified as a physiotherapist in 1986 and Road, Stoke-on-Trent, Stourbridge Practice:ST2 8BY do what is right for our patients, a principle which continued to develop his passion for neurological Sandford House, 6-7 Lower High Street, Stourbridge, inspired our founder, Peter Harding. rehabilitation whilst working in the NHS for 22 years. West Midlands, DY8 1TE HeOur completed story a further two Masters - Inspiring. Birmingham Practice: Recovery. Together. Neuro Groupinprovides Peter qualified as aNPP physiotherapist 1986 anda 22 George Road, Edgbaston, Birmingham, B15 1PJ bespoke rehabilitation and medico legal service to continued to develop his passion for neurological both adults and children alike. Degrees in Neuro Stoke-on-Trent Practice: rehabilitation whilst working in the NHS for twentyRehabilitation and CognitiveaNeuropsychology and schedule an appointmentST2 or to 1441To Leek Road, Stoke-on-Trent, 8BYhave a two years. He completed further two Masters Inspiring. Recovery. Together. was appointed as one of the first Neuro discussion about any of our services NPP Neuro Group provides Medico Legal and Neurological Rehabilitation to adults and children with acquired brain injury and spinal cord injury. Physiotherapy Consultants inOffering 2002.ambitious Peter believes in Call: 0800 917 3330 and forward-thinking treatment options we provide patients with a unique multiNPP Neuro Group provides a bespoke rehabilitation and medic disciplinary team approach to deliver the best patient care. doing his very best for patients and this is the reason Email: enquiries@nppneurogroup.com service to both adults and children alike. Leading inwhy the fieldPeter of rehabilitation multi-disciplinary teamPeter is led by felt that set NPP upNeuro NPPGroups Neuro Group. www.nppneurogroup.com

Inspiring. Recovery. Togeth

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.

e offer our patients a complete multi-disciplinary rehabilitation journey adapted to their needs,

Degrees in Neuro Rehabilitation and Cognit Neuropsychology and was appointed as on first Neuro Physiotherapy Consultants in 20

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

DEDICATED

RECOVERY & REHABILITATION

n o i t a t i l rehabi Established in 1984, CHD Living is an award winning, family owned and operated provider of care services. With two rehabilitation centres located in Greater London, CHD Living provides neurological rehabilitation and specialist nursing care to adults over the age of 18

CHD Living's rehabilitation centres are led by expert GP's and suported by a Consultant in Rehabilitation, experienced in the management of long-term conditions and complex disability. Both centres are purpose built, state-of-the art facilities, located conveniently in Kingston-upon-Thames and Bagshot.

Each facility has a choice of private rooms, with full en-suite wetrooms. The centres are wheelchair accessible throughout with lift access to all floors. There are a number of lounge and dining facilities, which are tastefully decorated and accessible gardens to enjoy in the Summer months.

A trulyÂ stateÂ of the art centre for excellence in rehabilitation.

Therapy facilities include fully equipped gyms, treatment rooms, hydrotherapy pool and occupational therapy kitchen.

-Esther McVey MP Former Minister for Disabled People

CHD Living's in-house highly experienced MDT provides a robust inpatient therapy service: Physiotherapy Occupational Therapy Speech & Language Therapy

At CHD Living's Rehabilitation Centres, there is a strong focus on facilitating the best possible recovery of those in their care, combined with enabling patients to live as independently as possible in stimulating, home-like environments.

Psychology

Both centres are registered with the Care Quality Comission and have been inspected and rated GOOD. TO FIND OUT MORE OR MAKE A REFERRAL PLEASE CONTACT HELEN Bagshot Park 01276 450 800 Kingston Rehab 0203 961 6920 www.chd-rehab.co.uk

Email: enquiries@enabletherapyservices.co.uk | Tel: 0113 273 3638 | www.enabletherapyservices.co.uk

Independent, client focused rehabilitation company delivering the highest standard of service

Case Management

We provide Occupational Therapist Case Managers with special interests in Acquired Brain Injury, Spinal Injury, ComplexÂ Orthopedic and other clinical conditions who deliver a client-centered service that facilitates the smooth coordination of rehabilitation recommendations and interventions, aiming for both a return to function and or maintenance of function encompassing all the activities that are important to the individual

Vocational Rehab

We offer a nationwide network of over 180 of highly qualified Occupational Therapists

Full Indemnity Insurance HCPC registered Membership of RCOT Enhanced DBS clearance Current report writing experience

100% Quality assured clinical assessment reports identifying rehabilitation needs

We offer a wide range of comprehensive treatment including:

Immediate Needs Assessment Vocational Assessment Work Site Assessment/Job Demands Analysis Ergonomic Workstation Assessment Hand Assessment Cognitive Assessment Postural and Seating Moving and Handing OT Neurological Assessment

Promoting the use of rehabilitation and early intervention 34

RECOVERY & REHABILITATION

The truly

PERSONAL TOUCH T Here at Enable Therapy Services (ETS) we appreciate that no two patients are the same.

hat is why we offer a truly client focused rehabilitation service, partnered with the highest levels of vocational case management, all provided by specialist OT Clinicians and covering the whole of the UK. Catering for all requirements from moderate to severe and catastrophic injuries and illnesses, including acquired brain injury and spinal injuries, ETS are amongst th e most trusted names in the industry.

assists in identifying the most appropriate assessment for your client, ensuring a swifter process and quickens the path to rehabilitation while offering a transparent service. ETS Case Managers liaise with our Occupational Therapists, other treating healthcare professionals and both private and statutory services in the provision of a range of complex interventions aiming for restorations of function through rehabilitation, compensatory and adaptive strategies.

Q Why instruct ETS? Q What might an assessment involve? l Dedicated Occupational Therapist Case Managers A We take a whole person approach to assess the who personalise each intervention with flexible and client, considering physical, cognitive, social and responsive approaches. psychological factors. Our Occupational Therapists l Ensuring value for money by offering fixed cost treating ABI patients are skilled in using cognitive assessments. assessments to gain an understanding of how any l Maintaining an eye on client’s progress, impairment may impact upon the Catering for individual’s potential for recovery; in verifying that they are receiving the right level of support and progressing as planned. all requirements collaboration with the client, their family l Thorough assessment and planning of support network, we devise strategies from moderate and rehabilitation intervention, ensuring all to address their rehabilitation needs, to severe parties are kept up to date. striving to increase independence in l Committed Case Managers allocated to the client, activities of daily living, including leisure activities. We their family and other services involved after the injury. complete assessments for home adaptations and l A head office team providing strong infrastructure equipment such as wheelchairs, moving and handling that encompasses clear guidelines and quality equipment and bathing adaptations and equipment. assurances of our services. Q When is the best time to refer my client to ETS? Q How does ETS create a treatment plan for an A We believe it is important to identify the client’s individual’s rehabilitation? difficulties and rehabilitation needs as soon as possible. A We understand the importance of providing early Clinical evidence suggests people will have better intervention for any client seeking rehabilitation. A rehabilitation outcomes, the sooner they can access bespoke plan is created to support the client in the right high-quality rehabilitation. ■ achieving SMART goals (Specific, Measurable, Achievable, Realistic and Timely) which will be agreed and driven by the client, ensuring they feel included and engaged in their rehabilitation. We tailor bespoke assessments to meet individual client needs, offering a Email: enquiries@enabletherapyservices.co.uk free telephone consultation with our Occupational Telephone: 0113 273 3638 Therapists to any referring parties. This accurately www.enabletherapyservices.co.uk

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The Importance of early intervention and diagnosis of

PAEDIATRIC ACQUIRED BRAIN INJURY Do we need early intervention or diagnosis for brain injury rehabilitation? By Gerard Anderson, Head of Brain Injury Services at the Child Brain Injury Trust.

ach year, thousands of children are admitted to AED with head injuries. NICE guidance advises that children presenting with a GCS of less than 15 should be assessed within 15 minutes of arrival to AED by a trained Gerard Anderson member of staff and receive a CT Head of Brain Head scan within one hour of a Injury Services risk factor of a brain injury being identified. Some of the children admitted to AED are diagnosed as having a concussion or postconcussive syndrome and discharged with some advice, others are admitted for overnight observation then discharged. Those who make it onto a trauma, surgical or general ward may be coded using the International Classification of Disease version 10 (ICD-10) with intracranial injury, skull fractures or crushing injuries of the head. With different imaging taking place, diagnosis given, and treatment prescribed, we are faced with a variation in coding and inconsistencies in accurate reporting of overall brain injuries caused by external force to the head.

NON-TRAUMATIC BRAIN INJURIES

Although traumatic brain injuries are a major cause of acquired brain injury, there are many other brain injuries that can at times be equally difficult to diagnose. Diagnosis of encephalitis, meningitis or other illness may cause cognitive impairment, but the long-term impact may be difficult to predict and can lead to a lack of reporting of secondary brain injury. This is true where brain injury is secondary to injuries caused by heart conditions, diabetes, or poisoning. If imagining is unremarkable, this can also be challenging, especially where conflicting presentation implies cognitive impairment. This can lead to 36

reintegration to normal routine sooner than may be advisable. Predicting recovery can also depend on the spread of injury as global injuries can be more difficult to recover from due to neurons being destroyed. This makes the brain injury harder to recover from, whereas traumatic or focal injuries tend to cause damage to the axons, allowing the brain to rewire itself and create new connections. Although this is based on those cases where imaging occurs, the reality is that most head injuries are mild and go undetected or are not accurately recorded, leaving the reported figures that are used, conservative.

IMPACT OF COMMUNITY INTEGRATED SERVICES

When a child is discharged from hospital, ‘Medically fit for discharge’ is the term often used and is what we define as the point at which there is no longer a need to continue the care of a patient in an acute setting, and where a patient can then continue their recovery in a non-acute environment. The true impact of these four words is often lost on a family. It is true that a large majority of children do make a good recovery and go back to their normal every-day activities, however for many others, medically fit for discharge is the beginning of their journey. From 1st April 2019 – 31st March 2020, the highest number of referrals made to the Child Brain Injury Trust for support were children involved in road traffic collisions (n-98). While medically fit for discharge, many families incorrectly assumed that the cognitive recovery would follow a similar trajectory as the physical recovery. For patients without a formal diagnosis or remarkable imagining, it makes it even more difficult. By working in partnership with clinical and nonclinical healthcare professionals, the Child Brain Injury Trust can support improved recovery post brain injury from the initial stages of injury, assisting in the transfer

RECOVERY & REHABILITATION to step-down wards and discharge into the community and onwards transition into adult services. At each transition stage, the Child Brain Injury Trust supports the child, their family and the wider network around the child. This support can also include access to specialist legal support teams and case managers experienced in catastrophic injury or community services. For those children who do not have a formal diagnosis, remarkable imaging or referral onto community services, yet still have cognitive impairment, early intervention and access to appropriate rehabilitation and support can still have a positive impact. For these children, early intervention albeit for a shorter period can still make a difference to recovery if integrated as part of a focus of early intervention, especially in school.

EDUCATION SUPPORT POST INJURY

For most of us, the key formative experiences in our lives tend to occur in the first 20 years or so. For many children, these experiences occur in a school environment. As a source of information, discharge letters and rehab prescriptions are key to proving the physical impact of an insult to the brain yet many parents still don’t share these documents with schools, leading to children going back to school in ways that may be less than ideal. Without a formal diagnosis of acquired brain injury, a discharge letter with only clinical terminology and no detailed rehabilitation prescription, if presented to a school with a lack of knowledge of brain injury or suitably qualified SENCO, it can lead to the presentation of a child recovering from a brain injury being assigned to non-injury causes, labelled as misbehaviour, defiance and non-engagement or learned behaviour.

clinical teams in ensuring a cohesive wraparound service for families impacted by concussion, PCS, traumatic and non-traumatic acquired brain injury. This service is available both in hospital and within the community.

CONCLUSION

Without accurate recording and coding of head injuries we are unable to report accurate incidences of acquired brain injury. Without accurate diagnosis it can lead to a lack of support with the phased return to education following a brain injury. Many parents due to the length of time it can take to reintegrate effectively end up taking time off work and having to access financial and social support they would ordinarily not need. By working alongside clinical and non-clinical teams, the Child Brain Injury Trust can support the effective reintegration and phased return to community life and into education. With early intervention and appropriate assessment and diagnosis, the Child Brain Injury Trust can improve knowledge and understanding around a child’s injury and support access to appropriate community services post injury for long-term positive outcomes. ■

REFERENCES

l McKee, A.C. and Daneshvar, D.H., 2015. The neuropathology of traumatic brain injury. In Handbook of clinical neurology (Vol. 127, pp. 45-66). Elsevier. l Masel, B.E. and DeWitt, D.S., 2010. Traumatic brain injury: a disease process, not an event. Journal of neurotrauma, 27(8), pp.1529-1540. l Tennant, A., Headway. Acquired brain injury: the numbers behind the hidden disability; 2015.

MODEL OF INTEGRATED SUPPORT

Working across a network of 16 major trauma centres and specialist hospitals across the UK, the Child Brain Injury Trust Brain Injury Team work across ICU, HDU, Surgical and illness wards, supporting clinical and therapy teams providing non-clinical and non-medical advice, information and support to families affected by childhood acquired brain injury. This is a vital service to

To make a referral or find out more, contact us at Child Brain Injury Trust Unit 1, Great Barn, Baynards Green Farm Nr Bicester, Oxfordshire. OX27 7SG Tel: 01869 341075

www.childbraininjurytrust.org.uk

An intensive therapy programme helped Mike on his road to recovery CASE STUDY In August 2017, Mike Curran, 33, and his partner Sara O’Shea took on a challenge to cycle from China to Ireland. Mike and Sara were around 1,300 kilometres from their end goal and were cycling in single file when a car travelling at speed crashed into Mike. Mike has no memory of the crash. Mike’s injuries were severe; he had suffered a traumatic brain injury which included five brain haemorrhages, as well as a punctured lung, broken nose and two broken ribs. After spending some time at a French hospital, Mike was transferred to The Wellington Hospital’s Acute Neurological Rehabilitation unit in the UK to be treated under the care of Dr James Teo, Consultant Neurologist. Mike could walk when he arrived, but he had many issues with his balance. In addition to physical difficulties, Mike also required cognitive therapies. Mike remembers, “It was like feeling drunk; I couldn’t walk in a straight line. I felt dizzy and even began suffering from heightened dizziness and nausea. It was really unpleasant.” While an inpatient, Mike underwent up to 40 sessions of intensive therapy per week. These therapies included working with physiotherapists specialising on his vestibular system, the

thewellingtonhospital.co.uk 020 7483 5348 020 7483 5363 The Wellington Hospital North Building, Circus Road, St John’s Wood London, NW8 6PD

musculoskeletal team, an occupational therapist, a neuropsychologist and a speech and language therapist. The therapy was designed around Mike’s injuries and adapted based on his progress. Mike says; “It was an incredibly positive experience. The team radiated positive energy. There was no question of an ‘if’ you will recover it was ‘when’ you recover. Straight away I fell in love with the team and I knew I was in safe hands. Dr Teo made me feel comfortable enough to ask any question I had, and I always felt reassured.” Mike left the unit in March 2019 and returned to his home in Ireland. Almost fully recovered from his accident, Mike has plans to return to work as an accountant in the future and resume normal life with Sara. They are excited for the future and the accident hasn’t put them off future adventures!

RECOVERY & REHABILITATION

PERSONALISED, GOAL-DRIVEN NEUROLO GICAL REHABILITATION Celebrating 20 years at the forefront of rehabilitation medicine. 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 Neurological Rehabilitation unit at The Wellington Hospital, London (part of HCA Healthcare UK), we care for patients from the UK and overseas and deliver a rehabilitation programme to meet their needs, no matter how serious or complex their condition. Working with experts to identify goals and create treatment programmes Our intensive rehabilitation programmes are expert-led. We can care for patients who are in a critical state with the support of an intensive care unit and full diagnostic capabilities. 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.

Specialists available to support patients include: • • • • • • • • •

Physiotherapists Neuropsychologists Music therapists Occupational therapists Speech and language therapists Consultants Dietitians Rehabilitation nurses Vestibular physiotherapists

Assistive technology available includes: • • • • •

Lokomat Indego Exoskeleton Functional Electrical Stimulation (FES) Bike Armeo Spring Bioness Hand Rehabilitation system or upper limb programmes

Outstanding clinical outcomes The unit retains an international reputation for clinical excellence. 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 us a first choice for patients, no matter how severe or complex their condition.

Home to the largest private neurorehabilitation unit in the UK D I D YO U K N O W ? In collaboration with the University of Birmingham, the Prolonged Disorders of Consciousness (PDOC) unit at The Wellington Hospital is embarking on a research project which aims to assess the potential for a non-invasive form of electrical brain stimulation, known as transcranial direct current stimulation (tDCS). The aim is to modulate the activity of the brain regions that control movement, and increase motor responsiveness as a result. By combining tDCS with neuroimaging and using advanced analysis methods, our research team will be able to increase our understanding of the relationship between the different brain regions involved in movement. The final goal of this research is to develop effective and readily available interventions to increase responsiveness in patients in prolonged disorders of consciousness.

A hazardous

RELATIONSHIP A look at Traumatic Brain Injuries and Falls by Dr Anna Ziemer Specialist Neurological Physiotherapist and Balance Champion, SP Therapy Services, Greater Manchester.

Therapy Services looks at the unexplored area of falls and traumatic brain injuries (TBIs). The TBI and falls relationship is closer than most health professionals appreciate, and falls interlock with TBI in a two-way relationship: Falls are the leading cause of TBIs especially amongst children and the older adult population. Traumatic Brain Injury exposes the survivors to much greater risk of falls due to complex multisystem impairment and often challenging therapeutic interventions involved in the rehabilitation process.

incontinence and visual deficits. Considering those factors, it is clear that the risks could be modified, therefore the falls can be prevented, rather than accepted as an inevitable part of later life.

The preventative activities should be multifactorial and according to the World Health Organisation the elements to include in programmes preventing falls are: ● Motor-cognitive falls interventions for people with falls risks, fear of falling or history of falls. ● Education strategies raising awareness about falls risk and prevention. FALLS AS A TBI CAUSE ● Creating safer environments. Falls remain a very serious socio-economic issue and ● Training health care professionals about falls risk, remain a critical problem of a worldwide aging burden and prevention. population. Falls-related injuries are a serious burden Research shows that long-term interventions (50 hours over 26 weeks) addressing on the individual, their family, the NHS In the general behavioural change and impacting and society due to the cost of treatment and loss of productivity. The population of over lifestyle choices are the most effective. NHS itself spends approximately £5.6 65s, one in three million to treat falls-related injuries every day. Therefore, falls-related issues people will fall within TBI AS A CAUSE OF FALL remain a focus of various clinical each year leaving a In the general population falls occurrence is very concerning, but groups and public health. quarter of them with what if you have a condition which According to NICE a fall is an might affect the risks of falls? What if unintentional or unexpected loss of serious injury you have a neurological condition like balance resulting in coming to rest on the floor, or the lower ground, or object below knee TBI or spinal injury and one or multiple of the risk level. Falls are currently surpassing the road traffic factors are magnified by neurological damage which accident as a TBI cause and although they mainly aggravate your fear of falling or decreased muscle occur in children and older adults, they contribute to strength or diminished balance reactions repertoire? TBI across the population. What if the prescribed medication, cognitive deficits, In the general population of over 65s one in three anxiety or incontinence overlap or are more severe people will fall within each year leaving a quarter of than those related to natural aging? What if you are in them with serious injury like TBI, hip fracture or a process of aging having sustained the neurological dislocated joints. People who fall are automatically at damage earlier in your life? greater risk itself and 25% of people with history of a Then the risk of falls doubles or triples, and the fall will fall again within a year. chances of serious injury like the second head injury or Apart from age and history of falls, the main risks of fracture increases twice fold. Unfortunately, the falls involve fear of falling, decreased muscle strength research shows, that if you had a brain injury and and flexibility, altered balance, polypharmacy, cognitive experience falls, it will be more difficult to return to deficits, low mood and related medication, your previous level of function.

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RECOVERY & REHABILITATION TBI sequalae should be offered falls prevention interventions and professional advice longer term upon discharge from Neurorehabilitation Services, as the risks do not decrease with general improvement.

HOW CAN WE HELP?

At SP Therapy Services we are passionate about patients with complex needs and strive to provide the best possible care to people with neurological conditions. Therefore, we are inclusive to all and we have developed problem, rather than, diagnosis specific protocols. Following the falls-related evidence we, therefore, routinely screen ambulant patients with brain or spinal injury for the risk of fall. When risks are identified our Physiotherapists can provide comprehensive balance assessment, falls risk assessment and offer individual treatment targeting the risk of falls and addressing the movement domains contributing to mobility or balance problems. The SP Therapy Services Team appreciates that programmes containing strength, balance and functional exercises when supported by education and environment adaptations help to reduce the number of people falling, risk of falls and number of DR ANNA ZIEMER Specialist Neurological falls. Therefore, we offer a holistic approach to falls Physiotherapist and prevention and engage not only Physiotherapy but Balance Champion also our Occupational Therapy Team. Occupational Therapists can help with environmental review, adaptations for occupation, sports or hobbies and TBI sequalae, often multiple and complex, overlap fatigue management. When required we signpost our with problems contributing to falls risk and often clients towards other professionals for vision involve physical and cognitive deficits, balance assessment, medication review or continence advice. impairment and mood changes. Moreover, At SP Therapy Services we also offer to our patients medication used to manage epilepsy, pain or with brain or spinal injuries a Falls Prevention Course spasticity often interferes with cognitive abilities or which allows them to engage in physical activities contribute to dizziness. Some TBI survivors might being socially engaged. The SP even not talk to their Physiotherapist 25% of people with when Therapy Services’ falls prevention about falls considering them as a part history of a fall will fall service has been developed with our of the new norm. neurological patients’ needs and The risk of fall following TBI is not again within a year inclusiveness at heart. age related and people with traumatic At SP Therapy Services we are also happy to brain injury are at risk of falls at any age. Approximately collaborate with local health care providers and other 30-65% of survivors of traumatic brain injury report services. We regularly share our experience and disequilibrium or dizziness in sitting or standing, which knowledge and speak to our colleague therapists, local affect activities of daily living and mobility. The patients’ groups and charities to benefit the wider severity of the problems depends on the severity of community, especially patients with complex needs the traumatic brain injury, the location of the injury, like those who sustain brain or spinal injuries. ■ other injuries or comorbidities and medication related to the traumatic brain injury. It needs to be noted that Neurological Rehabilitation itself imposes increased falls risks and there is a trend of increased falls in neurorehabilitation settings during active times. We as therapists should ask about the falls and screen for risks routinely when Call 0161 764 3799 our patients get in touch with us. Email info@SPTherapyServices.co.uk When the risks are identified the people living with www.sptherapyservices.co.uk

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Kemsley, St Andrewâ&#x20AC;&#x2122;s Northampton

Neurobehavioural services 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 Huntingtonâ&#x20AC;&#x2122;s disease

Tailored care to manage cognitive, emotional and behavioural challenges

On-site vocational, educational and voluntary facilities

Full-time MDT from the most established service in the UK

Dedicated environments for men and women

Services for patients detained under the Mental Health Act 1983 (amended 2007)

Getting in touch For more information about our neurobehavioural rehabilitation services or to make a referral: t: 0800 434 6690 (we welcome text relay calls) e: enquiries@standrew.co.uk w: stah.org/neuro Registered Charity Number 1104951

RECOVERY & REHABILITATION

The ULTIMATE GOAL A KMA - experts in Vocational Rehabilitation and Occupational Therapy. t KMA, we work across all aspects of vocational rehabilitation from transitioning out of education, to exploring work options or accessing/returning to work.

The journey may entail identifying accommodations and adjustments to current roles, sourcing alternative positions most suited to our clients, or working collaboratively to develop new occupational potential. We work with individuals, employers, life and health insurers, general insurers, legal services and solicitors across the UK.

Accident, illness and injury can change a person’s life. Our services support individuals to overcome barriers and return to or maintain daily activities. Our occupational therapists take a personalised approach, building step-by-step rehabilitation or vocational programmes which recognise that each individual is the expert in their recovery. The goal of vocational rehabilitation is to enable someone to engage in meaningful, sustainable, occupational routine. This could involve supporting someone to; become work ready, establishing a sustainable occupational routine, making reasonable adjustments to work/home environments, identifying

and engaging in appropriate vocational opportunities or returning to employed occupation following a period of absence. We work using a vocational case management model which includes liaison with the individual, their employer and professionals involved in their care to ensure best outcomes for all. Our vocational rehabilitation services adhere to strict professional codes of conduct and best practice in the industry. All our consultants have achieved the international Certified Disability Management Professional (CDMP) accreditation. At KMA we always work with success in mind. Client testimonial: “KMA gave me the confidence to get back into work after my brain injury by providing invaluable support. I’m now a supervisor at my workplace and could not have achieved this without them.” ■

Occupational Therapy Services

www.katemeadsassociates.com Tel: 01264 326308

KMA is a leading provider of occupational therapy & vocational rehabilitation services, working across the UK KMA works across the key areas of physical, mental and developmental health. Our occupational therapy services use evidence-based practices to establish and implement realistic, achievable and sustainable goals to ensure a positive outcome. As specialists in neurological conditions and injury, we provide outcome focused assessment and intervention ensuring achievable and sustainable outcomes.

Basepoint Business Centre, Caxton Close, Andover, Hampshire SP10 3FG.

t > 01264 326 308 e > office@katemeadsassociates.com

www.katemeadsassociates.com 43

Twenty-five

NOT OUT... ... the British Association of Brain Injury and Complex Care Case Management - Penny Haysom looks back at the first quarter century.

BABICM

will be 25 next year. From case managers the opportunity to small beginnings it has improve and develop, so now there become the key organisation in the UK for case are 3 case managements managers working with clients with a brain injury membership categories: Practitioner, and/or complex needs, but it wasn’t always thus. Registered Practitioner and In 1992 a group of people working in the field of Advanced Registered Practitioner. brain injury and complex care, who saw the problems Advanced membership is achieved when clients were discharged from rehabilitation by a process of peer review of case managers who facilities into the community without support, set up a have 3500 hours experience of brain injury/complex Steering Group for those interested in the care case management and one of the 7 accepted development of case management. Four years later relevant qualifications, which are: Chartered BABICM was founded, the first professional Psychologist, Doctor of Medicine, Registered Nurse, association established to promote the advancement Occupational Therapist, Physiotherapist, Social Worker and improvement of case management in this country. and Speech and Language Therapist. From the start, it sought to encourage high standards Other registered professions are submitted to the and an ethical and professional structure in which the council for consideration so long as applicants are discipline could flourish. registered with a professional body that is A network of support and training programmes was responsible for actively monitoring the registrant’s developed and best practice Continued Professional BABICM was the first Development, and recently the guidelines written, all with the aim of promoting the interest of case professional association council agreed to add accredited managers and increasing the members of BACP to the list. established to promote efficiency of their work by the advancement of knowledge, skills and HOW BABICM IS ORGANISED the advancement techniques applicable to the effective council is formed from and improvement of BABICM management and support of those volunteers, voted on at the AGM. case management in There is a minimum number of 12 with brain injuries or other complex conditions, and their families. members. There are 4 specialist this country subgroups that help the association MEMBERSHIP deliver its aims. The Professional Practice Membership Membership has always been open to those with an Group (PPMG) is responsible for enhancing and interest in brain injury and/or complex care case supporting the professionalism of case managers management as well as practising case managers. working with clients with brain injury and/or complex Initially, because case management is not a needs. Its aims are to champion best practice, to protected profession and thus there is no higher promote professional standards and to oversee authority to whom dissatisfied clients can complain membership criteria as well as responding to and seek redress, it was a requirement that case membership queries. The Children and Young People’s manager members had to have a relevant Group’s main purpose is to provide CYP advice and to professional qualification and registering body who signpost CYP resources for clients, families and oversaw their practice. professionals; while the Research Group aims to However, this prerequisite was later changed when it encourage research, and the dissemination of research, was acknowledged that in its role as best practice into brain injury and complex care and case champion, BABICM should also be offering unqualified management.

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CASE MANAGEMENT

The Training and Events Group is, as the name implies, the very successful training arm of BABICM. Its aim is to arrange training events that contribute to the professional development of members and of other professionals working with people with brain injuries and other complex conditions. It offers a varied selection of workshops and conferences on a range of subjects, including the very popular New and Would-be Case Managers, as well as seminars on subjects as diverse as sleep, litigation, dual diagnosis, protecting clients online and ethical challenges.

COLLABORATIVE WORKING

For a small organisation, BABICM has always punched above its weight. One of the earliest achievements was drawing up best practice standards to which members should adhere, and in 2008, in collaboration with CMSUK, a Code of Ethics for Case Managers was published. In 2010 the BABICM Competencies for Case Managers was developed plus, in 2011, accompanying Standards of Practice for Case Managers. Working with other organisations to improve client outcomes has always been one of BABICM’s key features, as demonstrated by its Joint Case Management Framework with CMSUK and

VRA. As well, BABICM continues to have a recognised voice within other policy making groups such as the ABI Alliance, Rehabilitation Code and Serious Injuries Guide, by contributing to the development of best practice guidelines. However, perhaps the most exciting collaborative endeavour is the current Quality Case Management Project, a joint initiative between BABICM, CMS and VRA, with the aim of setting up a professional body for case managers, leading to a regulatory pathway for those working in the field of case management. Talks are already underway with the Professional Standards Authority, the organisation which sets out national standards for healthcare professionals working in the life sciences industry, to ensure we can meet their robust standards. The aim of the QCMP is to develop a Case Management Institute, which would: ● Maintain & publish a public register of properly qualified members of the professions ● Approve & uphold high standards of education & training, & continuing good practice ● Investigate complaints & take appropriate action ● Work in partnership with the public & other groups including professional bodies ● Promote awareness and understanding of the aims of the Council Being part of the QCMP meetings has been inspiring. Now that there is a clear plan for the Institute to be achieved, and the registration of case managers is a genuine possibility, it has made all the hard work BABICM has put in over the years worthwhile. There is a lot to do until it all comes to fruition, but it has been wonderful to see the three organisations united in this common goal. Finally, may I say that there hasn’t been a better time to become a member of BABICM. We have a number of categories including Affiliate, Corporate, Student and Charity, and there are online Forums where you can connect with other BABICM members. We have over 800 members and would love to welcome you, just in time for our 25th birthday next year. ■

www.babicm.org 45

THE UKâ&#x20AC;&#x2122;S LEADING CASE MANAGEMENT SERVICE FOR CHILDHOOD BRAIN INJURY Our UK-wide service is passionate about the individual needs of each and every child we support. All levels of injury are assessed to achieve the right outcomes for each child and your case manager will ensure that through assessment, care planning and rehabilitation each child is placed at the heart of every decision.

To access our online case manager search tool, make an enquiry and to find out more visit:

www.cbirs.co.uk

SUPPORTING OUR CLIENTS TO LEAD FULFILLED LIVES SIA Case Management is the UKâ&#x20AC;&#x2122;s largest case management service working solely with adults and children following a Spinal Cord Injury. Our expert team works closely with clients and their solicitors to identify, plan and meet specific needs to help rebuild lives following a spinal cord injury. To access our online case manager search tool, make an enquiry and to find out more visit: www.siacasemanagement.co.uk

SIA Case Management delivered by: Bush & Co Registered Charity No. 1054097 Charitable No. 3175203 The SIA Case Management logo is a trade mark of Spinal Injuries Association

@SIA_CaseMan

RECOVERY & REHABILITATION

Owning GOALS With proven research into the effects of sport on mental wellbeing, Bush & Co case manager Stuart Berry tells us how he uses sport as an important tool after a catastrophic injury.

s a case manager for but this connection to sport is so incredibly Bush & Co, I work important socially, mentally and physically that I will always look for an outlet. When injuries are severe, it with lots of clients can be that my clients are no longer able to take part who have sustained in a sport they once loved which can come as a life changing injuries and might shock. I work with wider teams such as physiologists, think that for them, playing physiotherapists and consultants to ensure clients are sport is no longer an option. It supported emotionally and continue to work on forms such an important part their rehabilitation and find other suitable and of so many people’s lives STUART BERRY meaningful activity, which can at times also involve whether it’s going to the gym, exploring parasports. playing on a local football team, swimming at the Sport creates community. To share leisure centre or taking a long walk. We work at a interests with likeminded people, to see That’s why for those who enjoy physical activity we use this as part of our unique manageable pace them every week, work as a team and achieve something at the end has such a goal setting. Working in a goal orientated building fitness way helps give clients something to aim positive effect on mental wellbeing, it for and helps motivate them in their rehabilitation. can help motivate clients and ensure they’re approaching their rehabilitation with a positive MANAGING EXPECTATIONS attitude. At Bush & Co we see the whole picture, My experience helps me look for ability and creatively and can work with clients to help strengthen body think outside the box to find what I think my clients and mind to reach the end goal. ■ can achieve. I start the process slowly, being realistic about abilities and managing their expectations. We may start with going to a practice and sitting at the sidelines, simple exercises at the gym or a quick trip down the street to get clients back amongst their teammates, in the open air or reacquainted with their surroundings. We then build on this at a manageable pace, building fitness and working on confidence. For some, we have to adapt and find alternatives www.bushco.co.uk

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Spinal Injuries Association-

SUPPORTING EVERYONE AFFECTED BY SCI Written by Sophie Davis

We are the Spinal Injuries Association (SIA), the expert voice and leading source of support and information for people with spinal cord injury (SCI) and for over 40 years, we have been helping SCI people throughout the UK to lead fulfilled lives.

e provide support to both SCI THE IMPORTANCE OF PEER SUPPORT people and their families, as well as “I work with SCI people and their families from the representing the wider SCI moment they are injured, during their rehab and at any community to government and time afterwards. My role is to help people move other decision makers. forward with their lives and ensure they have all the From the moment of injury and throughout their right information, support and care they need to live lives, SCI people – and their families and carers – want an independent and fulfilled life. expert advice and support. However, often they do Part of my role is to work with SCI people who are not know where to turn. However, with our help, we waiting to be admitted to the Pinderfields SCI Centre, show people that they are not alone. or to keep in touch with people after The NHS and wider they have left rehabilitation to offer We are also incredibly proud to be a ongoing support. I am also a link to user-led organisation that reflects the government must views of our 11,000 members. other important services such dramatically increase SIA’s as Advocacy and the Advice Line, vital and extremely SCI POPULATION and I use these links to signpost SCI It is estimated that there are 50,000 people to other organisations such specialist healthcare people living with SCI in the UK, with as SPINE.” 2,500 people diagnosed with an SCI each year. These Andy Wharton – Peer Support Officer for figures are higher than previously estimated and SIA is Yorkshire – Spinal Injuries Association calling on all government departments to ensure that every SCI person has the care and support they need HOW WE CAN HELP and deserve to lead a fulfilled and independent life. ● Our Peer Support Team, who all have personal Nik Hartley OBE, Chief Executive of the Spinal experience of SCI, help newly injured people from the Injuries Association says, “The revelation that there are moment of injury or diagnosis, through their hundreds more people across the UK who will suffer rehabilitation and beyond. They also support those an SCI every year is stark. However, it is not just the with longer established injuries. increased numbers; it is the decreasing provision of ● Our Campaigns Team fights for change and fairness, specialist services alongside that, which is truly lobbying government and other decision makers. shocking. The NHS and wider government must ● Our Advocacy Team supports SCI people on a wide dramatically increase vital and extremely specialist range of areas including travel companies, airlines, rail healthcare and support to the 2,500 people each year companies, hotels and retailers, as well as more who have to come to terms with a life of paralysis complex and in-depth problems. from SCI. We will not stop fighting until that change in ● Our SCI Nurse Specialists drive improvements to investment happens.” the quality of care and nursing standards through the

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SPINAL INJURY

education of healthcare professionals, and provide clinical support to people treated outside of specialist SCI Centres. ● Our Freephone Telephone Advice Line receives over 1,600 calls a year on a wide range of topics from access to specialist rehabilitation, to information about benefits. ● 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.

OUR SUPPORT GOES A LONG WAY

SIA Member Miranda Jenks sustained her SCI 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 older people, and there was certainly no peer support available. I was feeling lost and alone and was searching for information.” That search took Miranda to SIA’s Freephone Advice Line and finally 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 Paul is there – and he has so much knowledge and experience! It’s just been amazing.” ■

Freephone Advice Line: 0800 980 0501 Email: sia@spinal.co.uk

www.spinal.co.uk

Registered Charity No. 1054097 49

EMPOWERING YOUR QUALITY OF LIFE Our ethos is to tailor our work to our client’s individual needs, putting the client at the centre. At StanleySmith Case Management we:

Who we are, the team:

Î Have the experience, knowledge and skills to steer case management so that it is individual to the client’s needs.

Î We are a friendly team of highly experienced HCPC registered Therapists and Case Managers.

Î Listen to the client and their families promoting autonomy.

Î Members of CMSUK and BABICM.

Î Lead case management through adopting a collaborative approach with the client their family, professionals and services involved.

Î We each have over 10 years experience within our individual discipline.

Î Promote quality of life, rehabilitation, vocation and recreation which underpins our work. Î Value individual carers, ensuring that they are skilled and competent to manage the client’s individual needs. Î Are registered with the Care Quality Commission (CQC).

Î We are directed and supported by dynamic and experienced clinicians. Î We ensure Case Managers are appropriately trained, supported and valued to complete their role effectively. Î We have administration, finance, HR and office support to ensure swift and effective Case Management implementation.

www.sscasemanagement.co.uk 50

01752 891930

RECOVERY & REHABILITATION

The experience, skills &

KNOWLEDGE

Our case managers have specialist skills, empowering their clients to reach their potential and engage in activities which are meaningful to them during childhood, adulthood and older age.

e offer bespoke and flexible case management which is driven by the client’s needs and wishes. Case management can be long term, goal driven or short term crisis intervention. Our ethos is to be innovative, adult and child friendly and think outside the box so that the client’s independence and quality of life is maximised. We are CQC registered and able to provide innovative care solutions.

SOME OF OUR TEAM

Veronika is an experienced adult occupational therapist, her work has spanned adults and older people with complex disability, multi-pathologies, orthopaedic, neurological and palliative conditions, with experience across health and social care. VERONIKA Veronika currently works with THOMPSON adults and older people with BSc Hons acute illness, palliative care, Occupational complex disabilities, multiTherapy pathologies and traumas. Providing case management and OT assessment and interventions to address physical, cognitive, emotional, social and environmental needs, equipment, adaptations and moving and handling assessments.

LUCY URQUHART BSc Hons Occupational Therapy

Lucy is an experienced paediatric occupational therapist and has excellent experience and insight into supporting children who have had a brain injury. Lucy has expertise in working with children who are deaf and is able to competently sign to British Sign Language (BSL) level 2. Prior to training as an occupational therapist, Lucy studied Psychology at the University of Sussex. She is able to use this

knowledge within her case management practice when supporting clients and their families with difficult issues.

OUR DIRECTORS...

Have a wealth of knowledge in the area of Case Management spanning children to adults, rehabilitation to care. They take a proactive approach to Case Management and supporting the friendly dynamic HEIDI STANLEY StanleySmith team. BSc Hons Feedback from one of our Occupational Case Managers Zoe Cocksedge: Therapy “I decided to join StanleySmith Case Management as I felt that both Heidi and Nikki offered a working environment that was more aligned with my values and how I wished to work with clients and external agencies. The ethos is client centred and not process/organisationally driven, NIKKI SMITH which makes such a difference BSc Hons in how case management is Physiotherapy delivered. Everyone in the team from the office to case manager feels a valued member of staff and everyone’s view is taken into consideration which is refreshing and non-hierarchal. I can highly recommend StanleySmith as a professional but personable company I am proud to be working with. The support and experience is excellent and it is a pleasure to be working in an innovative and creative way with such amazing people.“ ■

www.sscasemanagement.co.uk 01752 891930 51

MAIA REHAB

Serious Injury Rehabilitation Specialists

Calling All Case Managers Are you an Independent Case Manager overwhelmed by CQC Registration? Are you concerned, that these regulations may begin to outweigh the benefits of being a Case Manager? We recognise that for small businesses, this could have enormous ramifications on time, infrastructure, expense and constraints on how you operate. Which is why we are offering any Independent Case Managers who do not wish to register themselves with CQC but would like to work under a CQC registered company, to join us and get in contact to see how we can help. We want to ensure that you can continue treating your clients without worry of losing work due to your registration status.

Please contact Maia Rehabilitation to speak with us on 01234 262863 or email on:

admin@maiarehab.com

The Maia Team are here to help.

RECOVERY & REHABILITATION

Struggling to find trained, rehabilitation assistants who have SOMETHING SPECIAL? Maia Rehabilitation have been building rehabilitation teams around clients who have received catastrophic injuries for over 12years.

e have experienced the difficulties in finding and keeping support workers with the skill and passion to meet our client’s needs and who can accurately identify and record their findings. Because of this, we developed our own SeriousInjury-RehabilitationService (SIRS). Our very carefully selected teams are often psychology Experts, Neuro Psychologist and training team. graduates or experienced; with personal knowledge of We ensure the most recent medical injuries, an ability to learn, observe, feel compassion and encourage. We can equip them with tools to be developments are implemented and we work with, fully aware and tuned-in to the and listen to the client’s We strive to identify and symptoms of clients. We provide case managers, adjusting necessary training wherever maximise potential and growth the support package possible for the client they work accordingly. We believe so we can help individuals be with and we provide First Aid so clients must have a solid they can manage medical risks in and enjoyable relationship the best they can be the client’s home. We run with those who they are responsive, monthly seminars on brain and spinal comfortable investing their time. Our process is to injuries and we supervise SIRS monthly, monitor their match the client with the most appropriate SIRS to recordings weekly and, encourage them, nurture them meet their needs. ■ and usually keep them!

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PRODUCING CLEAR EVIDENCE

For a monthly fee, we can produce court friendly electronic daily report sheets which provide clear details for teams while producing clear evidence for instructing parties. SIRS are Personal Assistants trained to the highest standard of care in Brain and Spinal Injury Rehabilitation by our in-house Care

For further details please contact: Tel: (01234) 262863 Email: admin@maiarehab.com

www.maiarehab.com

ACCREDITATION FOR CASE MANAGERS background and progress to date Since 2010 members of BABICM, CMSUK and VRA have been progressing the development of a professional body for case managers.

his was based on the responses to The tripartite group undertook an extensive surveys and research related to the review of a number of alternative mechanisms for views of case managers and other accreditation which included Chartership, the stakeholders regarding the need for Professional Standards Authority (PSA) and regulatory mechanisms underpinned by schemes such as the one operated by the standardized training and a professional Association of Personal Injury Lawyers (APIL). pathway that includes an educational Following this review, it was agreed that the PSA framework. was the most suitable route. There has been extensive work via members and The PSA is an independent body accountable to leaders of BABICM, CMSUK and the VRA to develop the UK Parliament and responsible for the oversight a professional pathway for case managers in the UK. of the nine health and social care regulators who This was based on the “strong evidence in support of maintain professional registers such as NMC and the need for a professional pathway that includes an HCPC. They assess the standards and processes that educational framework.” In addition, evidence a professional association (such as CMSUK, BABICM suggested that partnership working between case and VRA) uses to determine whether a practitioner management organisations would be the most should be on their register, in order for that register effective way of implementing any change. to be accredited (or quality assured) by the PSA. Building on the joint work of BABICM and CMSUK They also review fitness to practice decisions as which resulted in the development of the Joint part of their oversight function. The individual Code of Ethics (revised 2017 and practitioner then gains some gravitas There has been from being accepted onto that PSA amended to reflect the inclusion of the VRA) this tripartite working party accredited register. extensive work has been continuing its common In light of this decision, the group to develop a goal of achieving the highest quality obtained legal advice related to the professional pathway legal structure and the business and of case management services alongside protection of service users for case managers tax implications for both the new and the public. Professor Edgar entity and BABICM, CMSUK and in the UK Meyer, Associate Dean at Imperial VRA. The advice obtained was that College Business school and a specialist in the any new entity which would be a not-for-profit Development of Education programmes and organisation and separate from the three main Education quality was appointed as a facilitator and organisations, should be a company limited by has continued to support the direction and guarantee. Such a structure allows rights of development of the goals. membership and would have a board inclusive of Research related to accreditation models and representatives of BABICM, CMSUK and VRA. processes identified that current UK Government Following the approval of all three Boards: policy is only to regulate further groups in An application will be submitted to the PSA. A exceptional circumstances and where voluntary new company, has been established trading as the registers are insufficient to manage the risk involved. Insitiute of Registered Case Managers.

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CASE MANAGEMENT

Deborah Edwards (left) RTW Plus and Chair VRA in association with Karen Burgin Chair Karen Burgin Ltd and Chair CMSUK

Angela Kerr, Managing Director AKA Case Management and Chair BABICM

An initial Vision and Mission has been agreed as:

and a financial model and business plan is in development. Funding of this work to date has been MISSION via membership fees paid to the organisations. In To safeguard people who use case management order to continue this development the group will be services, by setting and upholding standards for engaging with a range of stakeholders for their registered case managers. support in this exciting development. BABICM, CMSUK and VRA wish to reinforce their commitment to continue to collaborate in their provision of services VISION to their memberships and work towards accreditation We will be fair, proportionate and effective in which ultimately provides reassurance to stakeholders administering a nationally recognised register, ensuring protection of the public. protection of service users and the public A comprehensive andA comprehensive awareness raising by promoting and upholding high programme including informations standards of practice and ethical conduct awareness raising campaigns, conference and social for the case management profession. programme media marketing is being planned. Our Over the last 8 months, the group has is being planned first event will be a presentation at the worked tirelessly to review each APIL Annual Conference in 18-19 November 2020. We organisation’s standards of practice alongside those in are delighted to have been invited to attend this existence with other professional groups. They have event and would welcome other approaches from utilised internationally recognised research undertaken across case management sectors so that we can by Sue Lukersmith to create first draft technical access as many stakeholders as possible. ■ standards for its process of accreditation with the PSA. These technical standards will be supported by an education strategy to develop joint training events that underpin the standards and potentially offer a way of raising funds to support the accreditation process. Business standards including finance, governance, PR and marketing are currently being developed. The group has extended its membership to include NHS representation as we are actively seeking to include case managers in other sectors as well as those working within the medico-legal/insurance industry. Phone: 0161 762 6440 or 0333 2070755 THE FUTURE email: VRA.CMSUK.BABICM@togetherstronger.org.uk Plans for an official launch in early 2021 are being made www.togetherstronger.org.uk

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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.

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HELPING TO RECLAIM LIVES FOR OVER 30 YEARS Harrison Associates specialise in providing expert witness, case management, care packages and rehabilitation services for individuals with catastrophic and life-changing injuries and conditions.

EXPERT WITNESS

CASE MANAGEMENT

Call us now to discuss your case: 020 8998 2992 www.harrisonassociates.org

REHABILITATION

@CorporeUK

Corporé

RECOVERY & REHABILITATION

Quality of Care FOR QUALITY OF LIFE Quality Care OF LIFE Active Care – it’s whatof we do, how we workFOR and why weQUALITY exist. Ruth Smith, Chief Operating Officer.

T T

Activehe Care – it’sCare what we do, how weleading work and why we exist. Ruth Smith, Operating in people’s homes, and inChief residential and Officer Active Group is the UK’s community-based settings. A number our national of complex With an in people’s homes, and in residential andof communityhe Activeprovider Care Group is the UK’scare. leading residential services are accredited by Headway, innovative, holistic approach, we help based settings. A number of our residential services are national provider of complex care. With because ofby the specialist care we children, people and adults progress accredited Headway, because ofcan theprovide specialistfor care an young innovative, holistic approach, we help people with complex, physical and/or cognitive towards young a morepeople independent future and to lead we can provide for people with complex, physical and/ children, and adults progress impairment due to acquired brain injury.brain injury. their best life. independent future and to or cognitive impairment due to acquired towards a more We’re committed to helping We harness innovation to raise lead their best life. We’re committed to helping every person we care for every person we care for feel standards and deliver better It all starts with a feel happy, safe and empowered. We harness innovation to raise happy, safe and empowered. Our outcomes, with a unique It all starts with a simple belief that better Our progressive user-centred standards and deliver better progressive user-centred approach approach to personalised care approach means that right from outcomes, with a unique approach quality of care means a simple belief that better means that right from the start we pathways. These pathways the start we work with people to personalised care pathways. These with people individually to combine clinical expertise, better quality life a work of careof means individually to design a bespoke pathways combine clinical expertise, quality design a bespoke care pathway personal support and therapeutic care pathway that fits around personal support and therapeutic better quality thatof fits life around their lifestyle, personal goals and services, in a range of different environments their lifestyle, personal goals and services, in a range of different ambitions, and responds to their personal, social and to meet people’s evolving needs. ambitions and responds to their personal, social and environments to meet people’s evolving needs. emotional needs. Ultimately, we aim to support them We have extensive specialist experience working emotional needs. Ultimately, we aim to support them We specialist to grow in confidence, independence and progress with,have andextensive understanding theexperience complex working needs ofwith to grow in confidence, independence and progress to and understanding complex of people with to lead the life they want to. ■ people with spinalthe cord injury, needs brain injury, epilepsy, lead the life they want to. spinal cord injury,physical brain injury, epilepsy, as learning learning and/or disabilities, well asand/ or physical disabilities, as well as people with highpeople with high-dependency ventilation and 01732 779353 dependency ventilation and respiratory needs. respiratory needs. enquiries@activecaregroup.co.uk Our specially trained, clinically led team delivers Our specially trained, clinically led team delivers activecaregroup.co.uk passionate the country, passionate and anddedicated dedicatedcare careacross across the country,

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When life changes direction ....

Live your life your way Spinal and brain injury specialists 24-hour adult and paediatric care at home Registered for services in England (CQC) and Wales (CIW) Emphasis on personal outcomes

0333 121 5301 enquiries@completecare.co.uk 58

www.completecare.co.uk

RECOVERY & REHABILITATION

COMPLETE CARE... complex care at home

Complete Care supports and empowers adults and children with complex needs to realise their unique potential, achieve personal ambitions and live their lives their way.

and to travel on holiday. ur nurse Highly personalised care led, cost plans and dedicated effective Health Care Assistant homecare teams are put together in services enable people partnership with our with diverse complex clients, ensuring that our needs to live work reflects their independently in their choices, preferences and own homes, remain in targets their personal work and education and goals and aspirations. That enjoy active and fulfilling way we can provide care social lives. that meets their needs We are a forward and fits with their life thinking organisation with from day one. an outstanding and Complete Care continually evolving training challenges the perception programme. Our workforce that receiving care is a is skilled in a wide spectrum ✓ Spinal and brain injury specialists passive activity. We work of complex health care ✓ 24 hour adult and paediatric nurse-led care alongside our clients, techniques including ✓ Experienced nurse and operational teams building on their strengths long-term ventilation, and capabilities to tracheostomy care, ✓ Digital care planning with evidence maximise their gastrostomy care, based outcomes independence; medication management ✓ Inclusive recruitment processes empowering them to and bowel and bladder with client involvement maintain choice in every care. We support people ✓ Client specific training aspect of their lives. who have: ✓ Registered for services in England l Spinal cord injuries and Wales (CQC & CIW) FUNDING l Acquired brain injuries Complete Care’s team l Domiciliary ventilation has extensive experience of a wide range of funding l Cerebral palsy mechanisms including: l Stroke (CVA) l NHS Continuing Healthcare l Other neurological conditions l Private Financing l Local Authority Direct Payments PERSON CENTRED CARE l Personal Health Budgets Complete Care’s inclusive approach and commitment l Personal Injury Claims to providing holistic, person-centred care is at the core of everything we do. We consider physical, emotional and social needs to be of equal importance and focus on providing well-balanced care and supporting positive risk taking that enhances every aspect of a client’s life. Regardless of the complexity of a client’s needs, we can support clinically with personal care and medication management. We recognise the importance of social Call our team today on 0333 121 5301 inclusion and assist clients in educational or or email to enquiries@completecare.co.uk employment settings, to take part in clubs and activities www.completecare.co.uk 59

COMPLEX ComplexCARE care MADE SIMPLE! MADE SIMPLE! Choosing a care provider is a big decision but no one should have to remain with an unsuitable provider.

Choosing a care provider is a big decision but no one should have to remain with an unsuitable provider. HERE IS BEN’S EXPERIENCE: “I was involved in a road traffic accident in 2006, HERE IS BEN’S EXPERIENCE:

suffering a spinal cord injury at C4/5 level (complete). “I was involved in a road traffic accident in 2006, Upon discharge from hospital in 2007 my care suffering a spinal cord injury at C4/5 level (complete). package had been set up to be jointly funded by Upon discharge from hospital in 2007 my care CHC/local authority and a care provider was package had been set up to be jointly funded by selected to cover all my care needs. CHC/local authority and a care provider was selected Ten years later my life was being ruined by to cover all my care needs. appalling levels of care, with a total lack of empathy Ten years later my life was being ruined by shown towards myself and my needs to try to live as appalling levels of care, with a total lack of empathy normal a life as possible. There was no settled care shown towards myself and my needs to try to live as team and different staff turned up every day, normal a life as possible. There was no settled care sometimes not at all! These were mainly agency staff team and different staff turned up every day, who accepted the shift, regardless of whether they sometimes not at all! These were mainly agency staff were competent. Recruitment only found me one who accepted the shift, regardless of whether they

applicant in a year of searching. Billing and payroll were competent. Recruitment only found me one messed up every invoice. applicant in a yeardad of searching. payrollmy My concerned contactedBilling SIA. I and discussed messed every invoice. situationupwith an SIA representative and with their My concernedresearched dad contacted SIA. I discussed my encouragement online, taking the plunge situation with TCC. an SIAFrom representative with their of contacting day one theand difference in encouragement researched online, taking the the phone plunge approach was noticeable. They answered of contacting TCC. and From day one promptly, listened assured methe thedifference company in approach answered would be was ablenoticeable. to support They my care needs. the phone promptly, listened and assured company The change in attitude mademe methe realise how bad would be able to support my care needs. things had become and highlighted that there was a The out. change attitude made me realisewhich how bad route TCCinput together a proposal I things become and highlighted that thereto was a sharedhad with my joint funders and we agreed route out. TCC put together a proposal which I shared proceed. with my joint funders and we agreed to proceed.

Providing bespoke care nationwide for clients with spinal and brain injuries

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: info@totalcommunitycare.co.uk W: totalcommunitycare.co.uk

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Image courtesy of www.backuptrust.org.uk

COMPLEX CARE if end of the phone for support The team is always doing tra The team is always doing training to date with Dad’s care needs w and keeping up to date with Dad’s checking if all is well careTCC needsstaff with regular visits from SECTION TAG TCCrunning staff checking if all is well and theDad’s b smoothly. Since Image courtesy of www.backuptrust.org.uk package is running smoothly. Since end of the phone for support if we needbeing them. around his have Dad’s beenchanged home his spirits have The team is always doing training and keeping up we have. changed being around his family and to date with Dad’s care needs with regular visits from theifteam TCC staff checking allWithout is we wellhave. and the package the helpis and organi thebeen helphome and his organisation running smoothly. Without Since Dad’ spirits I sdon’t how myself a we given have been given and Iknow don’t have changed being around his family the know team got this without t we have. howhave myself andthrough my family could Without the have help and organisation wewithout have been got through this their positio If anyone in thecould same given I don’t know how my family care andmyself help.and If anyone in the same great Igreat would definite have got through this without their care help. position is company looking for aand If anyone in the same position is looking for a Robert, s son also adde company I would Colin’ definitely great company I would definitely recommend TCC. recommend TCC. Robert, son Chr genuine from theColin’s Directors Robert, Colin’s son also added, ‘the company is also added, ‘the company is genuine genuine from the Directors Chris and Reg at TCC down to the individual from the Directors Chris and Reg atcare tea down to the individual care team assistants on the TCC down to the individual care package. package. team assistants on the The training the team has received haspackage. been The training the team has rec excellent and the the standard ofreceived care he has received The training team has has been The handover process is much simpler than you The handover process is much simpler than you excellent the standard of c has beenand firstthe class. We haveof had aand few ups and excellent standard care he has received could imagine. I worked closely with TCC to set up a imagine. I worked closely Thecould handover process is with much simpler than you downs along the road with staffing has been first class. has We have hadfirst a fewclass. ups and care plan and jobup advertisement. been We have ha TCC to set care plan andWe job had a successful could imagine. IaWe worked closely withWithoutdowns but these haveissues been ironed road with staffing but thesealong th response and interviewed eight potential candidates. advertisement. had a successful the along help the issues downs without further have been ironedout outsuccessfully successfully without further I selected whoup Iand wanted on my andorganisation eight TCC toresponse set ainterviewed careemploying plan and jobteamand incident. The support and advice I issues potential candidates. I selected who I also said incident. The support andfrom advice I received from but thes gave notice to my previous carea provider. we have been given advertisement. We had successful received Lana our Care Without the help I wantedtoemploying our Care andout Paula our that I wanted take oneon ofmy myteam staffand Manager and Manager Paula our Trainer hassuccessfull I don’t know how Lana response and eight gavewith notice totomy previous care Trainer has been brilliant. You can tell members meinterviewed TCC. This was a Without the help and organisation been brilliant. You can tell they incident. The s myself and my provider. I also said that I wanted to they genuinely care about my Dad. To very smooth process. potential candidates. I selected who genuinely care about my Dad. To and organisation take one of my staff members with family could have been we have given received from sum it itupupmy could not My team employing of staff completed my the team and sum myMam Mamand and I could not I wanted me to TCC. This was aon very smooth got through this we have been given have askedfor foranything anything better asasa a have asked better mandatory TCC induction training Manager and P I don’t know how process. gave to my previous care Care teamwhen whenwe we selected selected TCC’. Care team TCC’. coursenotice and I set up the first working I don’t know how My team of staff completed the been brilliant. Y and my rota. Eighteen months on and I have a courseto provider. I also said that I wanted mandatory TCC induction training and I set up andmyself myself my genuinely care HERE EXPERT’S IS A CAREEXPERIENCE EXPERT’S care team three to my theof first working rota.working HERE IS Acould CARE take one of mypeople staff members with family have family have EXPERIENCE (anonymous): personalised rota to on fit and in with myalife 18 months I have care team of three could sum it up my M (anonymous): me topeople TCC.Iworking This was very smooth to mya personalised rota to fit in with got through requirements. haven’t seen any agency Total Community Care are my ‘go to’ this got through this Total Community Care are my ‘go to’ agency provider have asked for my lifestaff. requirements. I haven’t seen any agency or or unfamiliar My monthly invoices agency provider for clients with process. for clients with complex needs, particularly those unfamiliar staff. My monthly invoices are correct; my Care are correct; my staff get paid on time and correctly. complex needs, particularly thoseminimal with high levelteam whe with high level spinal cord injuries, awareness Mystaff team of staff completed themay getcontinue paid on time and correctly. Long Long may this in making my life hassle freethis and spinal cord injuries, minimal awareness and ventilator and ventilator dependency. continueTCC in making my life hassle free and course with a mandatory induction and I Iset up with a much higher level standard oftraining care.” dependency. have audited a significant number of Total much higher level standard of care.” I have audited number of Total Community Care’as significant past and current care packages the first working rota. HERE IS Acare CARE EXPERT HERE IS SALLY’S & ROBERT’S Community Care’s current packages within my role as apast Care and Expert and I am confident 18 months on and I have a care team of three (anonymous): HERE IS SALLY & ROBERT’S that they haveas robust andExpert professionally ledconfident systems EXPERIENCE: within my role a Care and I am EXPERIENCE: people working to my personalised rota to fit with inin place, with well trained clinically managed My name is Sally. 3 years ago my Dad was involved that they have robust andand professionally led systems Total Community Care are my ‘g workers. a result, clients and their families’ My name is Sally. through 3 years ago dad was involved in a road traffic accident nomy fault of hisany ownagency in support place, with wellAs trained and clinically managed my life requirements. I haven’t seen or are happy with the services they receive. trafficdriver. accident at no fault of clients with complex causedinbya aroad careless The impact of his myown Dad’s support workers. Asfor a result, clients and their familiesneeds, unfamiliar staff. Mydriver. monthly invoices are correct; my by a careless Thefor impact of my Dad’ injuriescaused were life-changing not just my Dad but hiss are happy with the with serviceshigh they level receive.spinal ■ cord injur injuries wereon life-changing not correctly. justacross for myTotal DadLong but his may this staff paid time and wholeget family. Our case worker came and ventilator dependency. whole family. Our case worker came across Total Community Care (TCC), Chris one of the Directors continue in making myChris lifeone hassle free and with a Community Care (TCC), of the Directors came tocame meet us as ausfamily and the the ballball started I have audited a significant n to meet a family andof started much higher levelasstandard care.” rolling to find a 24-hour care team ready for when mymy rolling to find a 24-hour care team ready for when Community Care’s past and curr Dad came The recruitment process ranran Dadhome. came home. The recruitment process withinT: my role as a Care Expert smoothly and weand picked our team. Some are are stillstill smoothly we picked our team. Some 01858 469790 E:469790 info@totalcommunitycare.co.uk with us from day one along with new members Tel: 01858 with us from day one along with new members HEREjoining IS the SALLY & ROBERT’S that they have robust and profe W: totalcommunitycare.co.uk team. TCC staff are always there joining the team. TCC staff are always there at at thethe Email: info@totalcommunitycare.co.uk EXPERIENCE: in place, with well trained and c end of the phone for support if we need them. www.totalcommunitycare.co.uk support workers. As a00result, cli My name is Sally. 3 years ago my dad was involved 61 are happy with the services the

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Health and Social Care Services, a specialist provider of home care services for people with complex care needs. Health & Social Care Services Ltd, born through a vision of a clinically sound and truly nurse led bespoke complex care provision. Being fully nurse owned and led means our clientâ&#x20AC;&#x2122;s safety and wellbeing are 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 a responsive and seamless clinically led care package in your own home. Health & Social Care Services Ltd specialises in a wide range of conditions, with a team of Specialist Nurses. Contact us today: Head Office

Regional Office

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Devon, Cornwall, Avon & Somerset, Herefordshire, Gloucestershire, Midlands, Worcestershire, Suffolk, Norfolk, London & Wales

Email: info@hascs.co.uk 16 Eaton Court Road Colmworth Business Park St Neots Cambridgeshire PE19 8ER

Email: Riza.tongson@hascs.co.uk 5 Warsash Road Warsash Southampton Hampshire SO31 9HW

Email: Ali.Pipe@hascs.co.uk 12 Hanley Court Business Centre Tidenham Chepstow Gloucestershire NP16 7NA

COMPLEX CARE

Born through a vision of

NURSE LED BESPOKE CARE PROVISION H&S Care Services Ltd, a specialist provider for people with complex care needs.

s a nurse led and managed clinical team, we understand that our clients have complex needs and every care package is unique to each individual. Therefore, we tailor all our services to enable our clients to live a more meaningful life despite their diagnosis. We can provide as much support or care as required, either a 24/7 care package or less and we can be involved as much as or as little as you wish to maintain an independent lifestyle. All of our care packages are managed by experienced and specialist nurses and a supportive, highly trained care team, which are matched to your unique personality.

HEALTH & SOCIAL CARE SERVICES LTD BRAIN INJURY

With a wealth of experience behind us, Health & Social A specialist provider for peoplethat with needs Care Services Ltd understand thecomplex effects ofcare brain WE GUARANTEE THAT CLINICAL injury vary enormously s a nurse led and managed clinicalfrom person to person. SPINAL INJURY team, we understand that our SAFETY WILL ALWAYS BE OUR Every brain injury is different and the care we clients have complex needs and Renowned the high-profile Spinal Injury NUMBER ONE PRIORITY! provide truly toindividualised to thatforperson. every care packageis is unique each packages that we have managed, Health and Therefore,&we tailor allCare our Services Ltd will build a With a passion for truly personalised care and the individual.Health Social Social Care Services Ltd specialise in the care of services to enable our clients to live a more individuals with injury the Spinal Cord. knowledge and experience to support a highly skilledmeaningful bespoke care team to your specification andof work diagnosis. life despite their care team, we pride ourselves on the quality of our We canclosely with dedicated Brain Injury Specialists. â&#x2013; team will be Your care provide as much extensively trained by Spinal service, the positive experiences and feedback from support or care as Specialist Nurses to provide either a 24/7 other multi-disciplinary teams, our clients, care team required, an exceptional level of care care package or less and and unparalleled support for we can be involved as and staff.

SPINAL INJURY

much as or as little as you wish to maintain an independent lifestyle.

you and your family. BRAIN INJURY

Renowned for the high-profile Spinal Injury With a wealth of experience All of our care packages behind us, Health & Social are managed by packages that we have managed, Health and Care Services Ltd understand experienced and specialist Social Care Services Ltd specialise in the care of that the effects of brain nurses and a supportive, injury vary enormously from highly trained care team, individuals with injury of the Spinal Cord. person to person. are matched to Your care team will be extensively trained by Spinal which Email info@hascs.co.uk your unique personality. Every brain773 injury is different and the care we Specialist Nurses to provide an exceptional level of Telephone 03300 020 GUARANTEE THAT CLINICAL SAFETY provide is truly individualised to that person. care and unparalleled support for you and your family.WE www.hascs.co.uk WILL ALWAYS BE OUR NUMBER ONE PRIORITY. With a passion for truly personalised care

Health & Social Care Services Ltd will build a 63 and bespoke care team to your specification work closely with dedicated Brain Injury

Our specialism is the provision of care packages for clients with complex care needs including:  Ventilator dependency  Spinal cord injury  Tracheostomy support  Neuromuscular conditions  Neurological conditions  Brain injuries

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.

For further information regarding our service, please contact:

Premium Care Solutions

Our specialism is the provision of care packages for clients with complex care needs Ltd including:  Ventilator dependency 63 Headl ands, Kettering, Northamptonshire NN15 7EU  Spinal cord injury Tracheostomy Tel: 01536 213680 Fax: support 01536 482716 Neuromuscular conditions

Email: enqui ries@premium-care.co.uk Neurological conditions  Brain injuries 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 W

Premium Care Solutions Limited (PCS) is a national complex care provider that provides support to adults and young people across the UK.

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.

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 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 being “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 throughout the implementation and the delivery of our bespoke care packages. ■

63 Headlands, Kettering, Northamptonshire NN15 7EU Tel: 01536 213680 Fax: 01536 482716 Email: enquiries@premium-care.co.uk

www.pcs.uk.com

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.

SPECIALISTS IN NURSING, REHABILITATION & NEUROLOGICAL CARE

WWW.CHASEPARK.CO.UK For referrals please contact jane@chasepark.co.uk 0191 691 2568

We specialise in providing tailored care and support to clients with spinal injuries and brain injury helping them to lead as full and independent a life as possible, from the comfort of their own home.

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.

Tel: 0333 772 0156 Email: info@fouroakshealthcare.co.uk Visit: www.fouroakshealthcare.co.uk 66

www.ccmservices.co.uk 01602 682 522

COMPLEX CARE

Enjoy life OUTDOORS A The UK’s leading specialist for quality mobility scooters.

TGA also provide Powerpacks, proudly built in the s the UK’s leading mobility scooter UK and suitable for the majority of wheelchairs, specialist for over 30 years, TGA provide providing reliable performance so days out are the most comprehensive range of quality pleasant and stress free for both carers and users of scooters that deliver unsurpassed reliability, attendance-controlled wheelchairs. comfort and style. Outstanding Whichever product you choose, you As a family-run business with can rely on an outstanding nationwide engineering heritage, TGA brings nationwide service service from TGA. This is why TGA is a together a caring service with products from TGA preferred partner of Parkinson’s UK and that perform. Its multi award-winning works closely with the charity to supply scooters to scooters include models for all mobility needs and people living with Parkinson’s. Safe driving awareness, lifestyles – supplied through personalised specialist insurance, finance, warranties and assessments to ensure the right product is supplied approved-used products are all offered by TGA – every time. Confident, stress-free independence is resulting in complete peace of mind. ■ the hallmark of a TGA scooter. Ranging from compact scooters that fold and fit in a car boot to lightweight attendant controlled and self-propelled wheelchairs, TGA has something for everyone. The award-winning Strongback wheelchair features a curved, supportive backrest, whilst the seating surface moulds around the body to help For more information call 0800 368 9983, prevent slipping and, conveniently, removes the need email info@tgamobility.co.uk for extra support cushions. www.tgamobility.co.uk

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ALWAYS HERE When you need support, we can help Our award-winning Strongback wheelchair offers comfort in a unique design for lumbar support whether you are inside or out.

For our full range visit tgamobility.co.uk

FREEPHONE 0800 368 9983 or email info@tgamobility.co.uk QUOTE: BSI0520

The UK’s leading range of mobility products since 1985

Accessible vehicles designed to enable you to drive or sit upfront Based in the West Midlands, Sirus provide adaptations for standard cars for drivers and passengers. We are also proud to support Back Up Trust, a charity set up to help people and their families who are affected by spinal cord injury. Find out more: backuptrust.org.uk Contact Sirus Automotive for a free home demonstration.

0121 505 7777

www.sirusautomotive.co.uk

Sirus Automotive design high quality accessible vehicles enabling wheelchair users to drive or travel upfront next to the driver. Sirus carefully select compact fuel-efficient vehicles including the VW Caddy Life and Ford’s Grand Tourneo Connect which due to their size, are user-friendly and can be parked with ease. With over 15 years’ experience, the wellknown Sirus build quality has reinforced the company as one of the UK’s preferred upfront converters. DRIVER AND UPFRONT PASSENGER OPTIONS INCLUDE:

Drive From Wheelchair This option enables you to drive whilst remaining in your wheelchair. Your wheelchair is secured safely using an automated wheelchair locking system and bespoke driving adaptations are fitted. The tailgate and ramp are fully automated, so it is the perfect solution for independence.

Internal Transfer

Amy’s Story

Expertly designed to enable a wheelchair user to drive from a standard driver seat, and is also with a fully automated tailgate and ramp.

Transfer is assisted by a rotating a six-way seat base fitted to the OEM driver’s seat and the wheelchair is safely secured behind the passenger seat.

Upfront Passenger An increasingly popular choice for wheelchair passengers, this conversion enables you to sit up front next to the driver and remain in your wheelchair, so you can enjoy travelling next to your companion. Choose from a manual or automated tailgate and ramp and wheelchair locking system.

Combined Drive & Upfront Sirus’ latest conversion is designed with side-entry, providing drive from wheelchair and upfront passenger options. The flat floor at the front of the vehicle and removable front seats allow you to swap places during your journey. The expertly designed conversion has optional lowering suspension, an automated side-sliding door and ramp which is just 70cm in length, so it’s really easy to park in a disabled bay. The conversion also has the advantage of two OEM rear seats and a spacious boot to carry equipment or luggage.

Amy has been a Sirus customer for eight years and this is her second VW Upfront Passenger conversion. “My car has given me so much freedom. It’s so much better sitting in the front because I want to chat with the driver, or maybe even have a sing-along! My Sirus car has also given me the confidence to travel without worrying about having enough room as its compact but spacious inside. I often holiday in the UK and travel to wheelchair football tournaments where it’s essential that I take lots of equipment, including my sports chair, everyday chair, hoist, shower chair plus my luggage which all fits easily into my car. I have two fold-down seats in the back so I have space for up to five people”.

RECOVERY & REHABILITATION

POWERCHAIR PERFECTION from Precision Rehab Looking for a bespoke powerchair solution? Precision Rehab has the knowledge, product range and experience of working with OTs to help.

ith over 25 years’ experience in the assessment, sales & servicing of powerchairs, and working closely with clients, their Occupational Therapist, Case Manager and family members, the Precision Rehab team understand more than most what is required to ensure every client gets the powerchair they need. “Every powerchair we supply is bespoke as each of our clients is unique and I have always believed the chair should fit the person as opposed to the person fitting the chair” commented founder Matthew James. To be able to meet the needs of some of the most complex disabilities, Precision Rehab has developed relationships with the UK’s leading specialist seating manufacturers and OT to ensure the end product always meets the requirements of the user. “Many of our clients require extremely bespoke seating solutions and adaptations for their powerchair and no matter how unique it maybe we can deliver thanks to these relationships. We also believe in personalising each chair to reflect the personality of the client such as the correct shade of fire engine red for ex-fireman Nick Packman” continued Matthew. Nick, who was left paralysed from the neck down following a car accident is one example of how Precision Rehab can help clients regain their independence. Despite his disability, Nick still plays an active role within the Fire Service, thanks to his Paravan PR50 powerchair from Precision Rehab. Nick heads up a team of volunteers which responds to operational incidents and supports people affected by a fire or accident, as he explains: “I am on call 24/7 and would be unable to respond to incidents if it wasn’t for my Paravan PR50 and wheelchair accessible drive from vehicle as I have to be able to travel independently”. Nick’s PR50 is fitted with a Paravan lock down system which locks his powerchair into the driving position and enables him to drive independently. The lock-down system charges the PR50 as soon as it is in the driving position, ensuring when Nick arrives, his chair is fully charged. The Paravan lock-down system is the only one of its kind to offer this. “The combination of the

PR50, lock-down system and vehicle is simply brilliant” Nick continued. Nick has known Matt for over 15 years having previously used him to supply his powerchairs. “When it was time to replace my last powerchair I knew Matt was the best person to speak to and he didn’t let me down. The PR50 is without doubt the most comfortable powerchair I have had since my accident thanks to the great postural support and the stability I have when driving is second to none”. Nick’s PR50 features a special headrest and extra power supply both of which are fitted as standard factory options. Whether the user is at home, shopping, socialising with friends or at work, the PR50 has been designed to ensure they can lead an independent life. Being able to turn within its own length due to its width of just 64cm, the PR50 is highly manoeuvrable and can fit through standard doorways and if, unlike Nick, the user is unable to drive from the chair themselves, the same system can be used as a passenger option with its integrated seatbelt - both options are crash tested. ■

To discuss the full range of powerchairs available from Precision Rehab or book an assessment call 01256 300111, email: info@precisionrehab.co.uk

www.precisionrehab.co.uk

Ask the EXPERT Lucy Weech Director of Wheel of Health Limited

Lucy manages a team of 18 self-employed Clinical Associates. She has been an independent practitioner for 15 years working with individuals either during the litigation process or post settlement. She also manages a highly complex caseload of children and adults with disabilities, ranging from physical disability following trauma to those with profound and multiple learning difficulties. Within this role, she completes 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. Liaison with the individual and their families and close multi-disciplinary working with case managers and other professionals are fundamental to her role. She is involved in the training of support workers and recommendation of appropriate accommodation. Her work ethos strives to maximise independence and ensure intervention is holistic. To contact Lucy. Email: lucy.weech@wheelofhealth.co.uk Tel: 023 8076 8583/07830072700 Wheel of Health Limited 17 Monks Wood Close, Southampton, SO16 3TT www.wheelofhealth.co.uk

Lucy Weech answers our questions on the importance of early intervention with the provision of clinically appropriate postural management solutions for those with severe and multiple disabilities. Q Why is postural management so critical for wheelchair users? A 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. 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 and behavioural changes. A wheelchair user’s very independence can hinge on effective postural management within the wheelchair. Postural management can influence:l Systemic function (i.e the effect of posture on all the bodily systems including the respiratory system and digestive system) l Ease of propulsion in a manual wheelchair. l Ease of access to driving controls in a powered wheelchair. l Management of the interface between the wheelchair and other equipment of daily living. l Access to and completion of all activities of daily living inclusive of personal care. l Access to communication and other assistive technology devices such as environmental controls. Q How does a postural management specialist/expert evaluate a client’s needs when assessing? A 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. Q How do the findings of that evaluation influence the selection of the most appropriate equipment? A 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

EXPERT ADVICE 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. Q What clinical factors need to be taken account of? A During the course of a postural assessment and analysis, typical considerations would include: l Current presentation in current equipment. l Presentation on a flat surface. l Presentation in lying and range of movement assessment. l Assessment of deformity and subsequent correction and/or accommodation. l Issues surrounding pressure care. l Consideration of external and/ or environmental factors. Q Which comes first; the wheelchair or the vehicle and why? A 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 “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.

A The efficacy of postural management equipment provision depends upon the effectiveness of positioning the client within it. It is therefore critical for example, that the moving and handling equipment is capable of achieving the intended and prescribed positioning of the client.

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Research has identified that the total cost in the UK for the treatment of pressure ulcers is between £1.4 and £2.1 billion annually

Moving and handling equipment is not merely an aid to move the client from “A to B”. Poor postural positioning leads to a negative impact upon systemic function, management of spasticity, access to activities of daily living, functional independence and quality of life. Q What is the relationship between posture management and pressure care? A Research has identified that the total cost in the UK for the treatment of pressure ulcers is between £1.4-£2.1 billion annually, comprising 4% of total NHS expenditure; (Dealey, Posnett, Walker (2012). BUT, we know that 95% of all pressure ulcers are PREVENTABLE. (Waterlow). In sitting, we are asking wheelchair users to weight bear through parts of the body that

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are not inherently designed for that task. Bony prominences take weight, and skin to skin contact occurs, causing skin damage as a result of a combination of shear pressure and skin humidity. Additionally, many of our wheelchair users have increased pre-disposition to skin breakdown because of their general clinical state including compromised systemic function, poor nutritional status, altered sensation, reduced motor function and generalised inactivity. Posture management products, if appropriately used, seek to address this, but guidelines as to their appropriate application is fundamental. Q Bearing in mind that everyone spends at least a third of their life lying in bed, does this affect management of good posture? CONTINUED OVER

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Q How does wheelchair seating/ posture management solutions link with other equipment e.g. moving and handling equipment/ access to bathing and toileting

equipment/access to communication equipment etc.?

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EXPERT ADVICE A In order to prevent or reduce the risk of progressive deformity and skin trauma, it is important to take account of other times of the day when a wheelchair may not be used or indicated. For example, the 30% (or more) of the day that a client spends in bed, should receive as careful an intervention as provision of posture management in a wheelchair. For some clients, they also use comfort/static chairs, commode/shower chairs, classroom and/or office seating for extended periods of time due to their inability to independently change their position. A 24-hour holistic approach is necessary to encompass all these elements. Q How can you ensure that equipment selected meets both the needs of the present as well as being able to futureproof ongoing clinical needs? A Competent clinicians need to

Opens doors to maximise independence Opens doors tothe maximise independence We believe that best outcome for the client is achieved when the wheelchair We the bestisoutcome the andbelieve seatingthat specialist involved for from client is achieved when the wheelchair initial assessment through to final set up of and seating specialist is involved prescribed equipment plus on-goingfrom review. initial assessment through to final set up of prescribed equipment plus on-going review.

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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.

technological developments to maximise independent function for the client? A The speed of the advances in technology means that now, more than ever, more and more clients can increase their level of independence. Now it is no longer just a case of selecting a few activities that can be accessed from a wheelchair. The provision of integrated systems encompassing access to communication, driving, environmental control systems and other technology (inclusive of iPads/iPhones for example) is now the norm. Effective posture management facilitates access to these systems. It can quite literally be the difference between independent function or not. ■

Q How can we harness increasingly sophisticated Who are we? • Specialist wheelchair seating and 24 hour posture management clinical practice. Who are we? • Specialist provider of wheelchair, posture management and allied equipment • Specialist wheelchair seating and 24 hour posture management clinical practice. solutions for adults and children with complex needs. • Specialist provider of wheelchair, posture management and allied equipment • Staffed by skilled occupational therapists / physiotherapists with additional solutions for adults and children with complex needs. post graduate training and expertise in this specialism. • Staffed by skilled occupational therapists / physiotherapists with additional • UK coverage. post graduate training and expertise in this specialism. • UK coverage. Why is posture management so important? • Increases ergonomically efficient function and comfort. Why is posture management so important? • Assists effective management of muscle tone and spasticity issues • Increases ergonomically efficient function and comfort. to improve sitting balance and functional ability. • Assists effective management of muscle tone and spasticity issues • Minimises development of deformity and pressure care issues. to improve sitting balance and functional ability. • Enhances self esteem. • Minimises development of deformity and pressure care issues. • Improves cardiovascular function. • Enhances self esteem. • Improves visual, perceptual and cognitive function. • Improves cardiovascular function. • Improves urinary and digestive tract function. • Improves visual, perceptual and cognitive function. • Improves urinary and digestive tract function. Why use us? • As well as a detailed clinical assessment and consequent identification Why use us? of suitable products we are committed to the maintenance of an on-going • As well as a detailed clinical assessment and consequent identification review relationship with the client. of suitable products we are committed to the maintenance of an on-going • We only use equipment suppliers who have experience and skills appropriate review relationship with the client. to the needs of clients with complex disabilities. • We only use equipment suppliers who have experience and skills appropriate to the needs of clients with complex disabilities.

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www.wheelofhealth.co.uk | lucy.weech@wheelofhealth.co.uk | 023 8076 8583 | 078300 72700 7663

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www.wheelofhealth.co.uk | lucy.weech@wheelofhealth.co.uk | 023 8076 8583 | 078300 72700

MART Wheelchairs Limited

Wheelchairs I

At SMART Wheelchairs we are able to meet and accommodate the needs of some of the most complex disabilities. Our aims and objectives are to provide as much independent access for all of our customers by using the latest technology and equipment available. Here at SMART we believe we’re best equipped to deal with your needs. From electric and Wheelchairs I M I manual wheelchairs, specialist seating systems that deal with a wide range ofL conditions toT E D control systems that allow the user to control anything from a light switch to a PC or even a Sky TV Box. We realise that everybody is an individual and that is why all our chairs are tailored to you, the individual. Our aim is to provide each client with maximum comfort and functionality. You can rest assured that SMART will only recommend the right wheelchair or equipment that is best suited for our customer’s needs.

Think Wheelchairs Think SMART 01553 404200 • info@smart-wheelchairs.co.uk • www.smart-wheelchairs.co.uk

R5 - PB CONVERSIONS 1/4_- PB CONVERSIONS 08/07/2013 16:43 Page 1

With my partner’s severe disabilities, I feared we could never again enjoy a holiday away from home… Then we found out about

“Specialists in vehicle adaptations for people with disabilities”

MAISON DES LANDES HOTEL in spectacular Jersey

Maison des Landes is a hotel catering exclusively for guests with disabilities and their families and carers.

OPEN FROM MAY TO MID-OCTOBER

❖ Hand Controls ❖ Drive from the Wheelchair ❖ Auto Adapt Platinum Dealer ❖ On site service available ❖ FREE advice ❖ 3 Year warranty on PBC products ❖ 20 years experience ❖ Left foot Accelerators ❖ Radio remote systems ❖ Annual service reminders

Rates per person per day include full board accommodation, daily excursions and tours plus transfers from airport or port and return. Bed & breakfast or self-catering available.

Find out more on our website

Call for friendly service and Free advice on:

01525 850588 • www.pbconversions.co.uk PB Conversions, Unit 6 Acacia Close, Cherrycourt Way, Leighton Buzzard, Beds LU7 4QE t: 01525 850588 f: 01525 850588 e: pbconversions@aol.com

A08.13/R5/d

We Now Stock Mobility Scooters

St Ouen, Jersey JE3 2AA Tel: 01534 481683 Email: reservations@maisondeslandes.co.uk Website: www.maisondeslandes.co.uk

LONG TERM SUPPORT

Brotherwood case study

THE COLLINS FAMILY When the Collins family were looking for a high quality, safe and discrete Wheelchair Accessible Vehicle for their son Mark, they were drawn to the Brotherwood Klastar - a unique lowered floor WAV conversion for the Mercedes-Benz V-Class.

ark has an acquired brain injury as well as a stroke, which was the result of a motorbike accident that happened 21 years ago. As a result of this, Mark has a wide variety of needs which their vehicle needs to accommodate for; however the Collinses wanted a normal, ‘car-like’ vehicle which did not compromise on quality and safety. The Klastar conversion, with its central wheelchair location, Mark enjoys an inclusive, enables Mark to travel in central travelling position comfort, with a good with excellent visibility. view out of the Brotherwoods we would not get our vehicles from windows. The remote-controlled ramp takes the anyone else and we will be continuing to use them in effort out of loading, whilst the PAWRS (combined the future.” winch and restraint system) and STORQ self“We are extremely happy with our tensioning restraint system were The Collinses wanted vehicle and would recommend this features that particularity appealed a normal vehicle which vehicle to others because of the as the safest and most suitable system for Mark’s needs. did not compromise on safety aspects and the luxurious spec that vehicle provides.” The Klastar is used and relied on quality and safety The team at Brotherwood are daily, and enables the Collins family delighted to have helped the Collins family find their to carry out everyday tasks including shopping, going perfect WAV, and look forward to keeping them for meals and many family activities. mobile in future. ■

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THE STANDARD OF SERVICE AND QUALITY WAS OUTSTANDING

Mrs Collins added: “This is our second vehicle from Brotherwoods, we have experienced many other companies that provide a similar service however, the standard of service, quality of product and overall experience from Brotherwoods was outstanding compared to the other companies. After discovering

www.brotherwood.com 0808 274 5888 75

e t a m i t l u e h T in intimate s s e n i l n a e l c

“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 00

www.closomat.co.uk

tel: 0800 374 076 Email: info@closomat.co.uk

LONG TERM SUPPORT

How appropriate living aids

CAN TACKLE SPINAL INJURY When injury limits your ability to deal with your most intimate hygiene, little things that restore your dignity and independence matter much more.

ormer garage owner Dave Ralph is a case in point. On a friend’s advice, and assistance from his local Occupational Therapy team, he now has his dignity and independence back. His WC has been changed for a Closomat Palma Vita wash and dry toilet. The philosophy he has applied to all aspects of his life - even in the Dave’s injuries limited his bathroom. His injuries ability to clean himself after using the WC. limited his ability to clean himself after client’s condition. using the WC. “I had Adds Dave, “I am so already had the toilet grateful I have it. It is raised to help me, brilliant. I just push the but it was getting pad with my elbow, more and more and the Closomat difficult to clean does the rest”. myself, as I couldn’t get my hands behind BEST OF BRITISH my back. I wouldn’t Closomat was the first expect my wife to wipe my bottom: company to introduce the concept of wash and dry it’s embarrassing!” explains Dave. toilets in the UK, almost 60 years ago. Today, it is ASPIRATIONAL NOT INSTITUTIONAL the established brand leader. The Closomat looks like, and can be used as a The Palma Vita is the only WC of its kind conventional WC. For optimum developed specifically for disabled It’s embarrassing to people. It is also the only one hygiene - whether or not the user has an impairment - remain seated have someone wipe manufactured in the UK. and operate the flush mechanism. Closomat is also unique in giving your bottom The process triggers simultaneous clients a complete in-house flushing and warm water douching, followed by support package - design specification advice, warm air drying. supply, install, commissioning, and ongoing service There is no need to wipe - or be wiped - clean. & maintenance. ■ The Closomat’s operation can be set up to suit individual needs. It can be operated via the standard cistern-mounted flush pads, a soft touch hand/foot pad, infra-red, or proxy switch. Operating options Find out how we can help your clients: email can be tailored to suit at initial point of installation, info@closomat.co.uk or call 0161 969 1199. or retro-fitted to accommodate a change in the www.closomat.co.uk

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dm orthotics

DM Orthotics have been supporting patients with Brain and Spinal Injuries for over 15 years. Our dynamic movement orthoses work using a combination of compression and strategically placed reinforcement panels. These factors influence sensory and proprioceptive feedback helping to guide the body into a better postural or functional position. For over 15 years our elastomeric orthoses have helped both adults and children with Brain and Spinal Injuries with the following benefits: - Clinically proven - High patience compliance - Comfortable and easy to put on - Increase independence - Increase function and ability - Help manage fatigue - Proprioceptive feedback

To find out more about DM Orthotics or the orthoses used in the management of Brain and Spinal Injury visit www.dmorthotics.com Designed and constructed in the UK

live your life.

LONG TERM SUPPORT

How dynamic movement orthoses are

HELPING CHANGE LIVES “I can achieve what I want to now,” says Chloe, a teenager who loves ballet, drama and tap-dancing. “My condition doesn’t dominate my life – it doesn’t define who I am.”

ot long ago, that Chloe Alex wouldn’t have seemed possible. Aged 11 and crippled with pain from the curvature in her spine caused by Scoliosis, Chloe found it hard just to get dressed. “There was very little information available about the condition,” said Chloe’s mum, Jo. “We searched for something that could help her as she was in such agony. I found DM Orthotics who were extremely supportive and arranged for her to be fitted with a scoliosis suit.” Chloe couldn’t be happier with the support the orthosis provides. “It was a little strange at first and threw my balance,” she says. “I was reassured though that this meant 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 others or losing his balance,” says mum Jacqui. “Alex got used to it and it now feels like another layer of hasn’t fallen in the last 12 months, so he hasn’t skin. Combined with physiotherapy, the scoliosis suit needed his usual trip to Accident and Emergency to has enabled me to stand more upright, improved my be glued. As well as running and balance and given me greater The scoliosis suit playing football, he has the confidence.” has enabled me to confidence to climb climbing frames, ALEX NOW HAS THE hop and jump around - whereas stand more upright CONFIDENCE TO CLIMB before, he was fearful in case he Alex is a young boy who loves to run and play injured himself or the activity hurt”. football with his friends. Not so long ago he “When he isn’t wearing his DMO, he no longer couldn’t keep his balance as he has Ehlers-Danlos hyper extends his knees, rotates his legs or sticks his Syndrome which means his body’s connective tissue bottom out to maintain his posture – instead he and collagen becomes fragile and stretchy. The stands in a beautiful midline symmetrical position.” ■ condition was causing him an immense amount of pain in his lower body and he would often fall as a result. Now, after being fitted with dynamic movement orthosis (DMO) leggings, he is much more in control and active. “His teachers have commented on how ‘steady’ For more information, visit he is and are no longer afraid of him stepping on www.dmorthotics.com

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RENOWNED & RESPECTED medico-legal consultancy

We are the largest provider of healthcare professional expert witnesses in the UK, meet some of our Experts...

or over 20 years Somek and Associates has been delivering quantum reports (care, occupational therapy, physiotherapy and speech and language therapy) for personal injury and clinical negligence litigation cases. Experts are based across the UK, all continue to undertake clinical practice and many are also case managers, ensuring their recommendations and opinions are current and robust. SAM HIGGINS Sam has been an Occupational Therapist since 2000 and has experience in spinal cord injuries, upper limb injuries, orthopaedics and loss of service.

To discuss any potential expert witness needs, please email us at admin@somek.com or call and speak with one of the team on 01494 792711

DIANE KRUGER Diane is a senior Speech and Language Therapist with experience in brain injury, swallowing and communication disorders and alternative augmentative communication. TANYA OWEN Tanya is a physiotherapist and has an MSc Global Health and Development. Her experience includes neurology, spinal cord and cauda equina injury, brain injury, stroke and cerebral palsy.

To discuss specific case needs and to obtain the full CV of any of our 200+ experts please contact admin@somek.com or call 01494 792711.

We are the largest provider of healthcare professionals expert witnesses in the UK, renowned and respected in the field Why Somek and Associates? Over 200 experts have undergone comprehensive medico-legal training, based in locations across the UK with the full range of different specialist backgrounds Balanced portfolio of Claimant and Defendant instruction illustrating our professionalism, objectivity, independence and understanding of legal principles and CPR, leading to a good reputation in the field Direct involvement of senior experts for every report, ensuring quality control www. somek.com

FINANCIAL & LEGAL

WE ARE A TEAM OF CARE EXPERTS with a focus on delivering factual concise and robust reports Jane James and Associates is an Independent Medico Legal Reporting Company.

e have been providing an expert witness service for over 35 years. As an independent medico-legal reporting company we provide professional reports in the fields of clinical negligence and personal injury. We work with both Claimant and Defendant legal representatives. Our associates are highly experienced clinicians still working in their specialist fields, these include general nursing, paediatric nursing, occupational therapy, neuro physiotherapy and manual handling, with several associates also working as case managers. Our quantum care reports are succinct, robust, easy to read and clear on costs. Each report is estimated with proportionality and cost effectiveness in mind. We offer liability reports in a range of areas including general nursing, neonatal nursing, mental

health nursing, accident and emergency nursing, practice nursing, manual handling, tissue viability, and care provision including nursing and care homes. Please visit our website or call the office if you require any further information, Lucinda Lloyd, is Head of Operations and Clinical Support; and will happily discuss any of our experts and services we offer. We pride ourselves in offering our clients a personal and professional service in the clinical negligence and personal injury litigation arena.

Tel: 01249 456360 Twitter: @jjaltd LinkedIn: Jane James and Associates

www.janejamesandassociates.co.uk

As an independent medico-legal reporting company we provide professional reports in the fields of clinical negligence and personal injury. We work with both claimant and defendant legal representatives EXPERT WITNESS SPECIALISTS

01249 456 360

www.janejamesandassociates.co.uk

LONG TERM SUPPORT

Accommodation EXPERTS Steven Docker Associates design homes for severely disabled individuals.

teven Docker Associates (SDA) specialise as Accommodation Experts arising from Personal Injury and Clinical Negligence Litigation. Our practice has long established and very successful departments dealing with...

needs. SDA carry out property searches, viewings, feasibility assessments, valuations of the property, preparation of illustrative floor layout plans, 3D drawings, price negotiations and overall management of the buying or renting process.

ACCOMMODATION REPORTS

ARCHITECTURAL SERVICES

SDA is one of the country’s leading specialist accommodation needs practices. Our experience in designing homes for severely disabled individuals throughout the UK provides us with the “hands-on” practical experience necessary to provide the Court with accurate and impartial reports. Solicitors and barristers instructing or recommending our firm consider our reports to be unparalleled in providing reliable and comprehensive expert evidence. All members of our Expert Witness Department hold the Certificate of Expert Witness and RICS Accreditation and are also RICS Registered Valuers.

PROPERTY FINDING

Buying the wrong property for a disabled individual can be costly and, even when adapted, the dwelling may not be entirely suitable. Drawing on our extensive experience, we are able to identify the most suitable property for adaption to suit our client’s individual

We can assist with all aspects of the building/ adaptation process, from inception to completion. Our design team prepare bespoke design solutions specifically to suit the needs of each individual client. We receive instructions from solicitors, deputies and case managers, as well as directly from private clients. Our practice focuses on a person’s abilities rather than the negative aspects of their often severe and complex disabilities. Our expertise in adapting existing properties and the construction of new purpose designed dwellings, culminates in providing safe and accessible inclusive environments, which encourage the maximum possible degree of independence and the associated benefits of an enhanced quality of life. ■

www.stevendocker.co.uk

Accommodation Experts Accommodation Experts Accommodation Experts

Park House | Parkway | Holmes Chapel | Chesh www.steve

Steven Docker Mag Ad 176 x 120.indd 1

01/05/2019 11:15

Accessible and Inclusive Environments Removing barriers by design

BUILDING SURVEYING ARCHITECTURE & DESIGN CONTRACT ADMINISTRATION PRINCIPAL DESIGNER / CDM COST CONSULTANTS EXPERT WITNESS PROPERTY FINDING SUITABILITY REPORTS

LONG TERM SUPPORT

William Martinâ&#x20AC;&#x2122;s specialist personal injury division comprises senior, experienced accommodation experts who lead a team of architects and designers to provide a service to those requiring a home intended to promote their independence, mobility and rehabilitation. We have undertaken many successful new build and adaptation schemes including adaptations to temporary accommodation. We are accustomed to working closely with the injured party often in conjunction with their Case Manager, Occupational Therapists and legal team. We are able to offer innovative and bespoke solutions to meet the needs of each client.

Julian Rendall: jrendall@william-martin.co.uk James Nocker: jpn@william-martin.co.uk London: +44 (0)207 378 5800 Manchester: +44 (0)161 457 0336 32 Threadneedle Street, London, EC2R 8AY 3 Hardman Square, Spinningfields Manchester M3 3EB www.william-martin.co.uk 85

WINNING THE CASE & WINNING THE COSTS

- how to avoid the technical traps lying in wait for the unwary There can be little worse than winning a case for a claimant who has suffered catastrophic injuries than going on to throw away the fruits of victory by losing the argument on costs.

his article examines several traps which await even the most able and dedicated lawyers, who may have achieved COLIN CAMPBELL an admirable result, only then Consultant at to find themselves running into Kain Knight the buffers when it comes to the assessment of the costs of the action. It also emphasises how, by using Costs Lawyers such as Kain Knight, such disasters can be avoided.

so all the work he had undertaken to win the case, he had done for nothing. Assuming however that the retainer is enforceable, the next thing to ensure is that when the case ends, either through settlement or at trial, all the hard work in winning is not undone by making a dog’s dinner of the costs order. In an action for personal injury or clinical negligence, there may be several defendants. Suppose, in these circumstances, the claimant loses against defendant one (D1), wins against D2 and discontinues under CPR 38 against D3: The starting point is the retainer. Underlying all Prima facie, he will recover costs from D2 but will be costs law is the indemnity principle. The liable for the costs of D1 and D3. Remember the However, if his legal advisers are worth client must have a liability to pay legal costs so if you say to your favourite their salt because they have kept up to liability of the Aunt “Don’t worry, Aunt, we will recover with their costs law, they will be party paying them date all our costs when we win and it won’t aiming for (a) a Bullock order under which D2 is required to indemnify the cost you a penny”, there are no costs for should go in the claimant for the costs which he would the losing party to indemnify and the order itself otherwise have to pay D1 and D3, and solicitor will go unpaid for all that good (b) a Jabang order, directing that D2 to also pay the work on the case. claimant’s own costs of pursuing D1 and D3. Forget to What if there is a liability to pay costs, but the do that, and the claimant will be stuck with an issue solicitor does work outside the scope of the retainer, based costs order, which will be a nightmare to sort for example, if the work is unauthorised because the out at detailed assessment, as well as costing him or client did not agree that the solicitor should do it? her a great chunk out of their damages. What about the form of the order for costs? WORSE WAS TO COME Remember the liability of the party paying them That happened in Radford v Frade [2018] 1 Costs LR should go in the order itself, not in a schedule, 59 where the solicitor’s Conditional Fee Agreement otherwise there is no authority to begin a detailed covered advice on procedure, but not a strike out assessment under CPR 47.7 if the costs cannot be application, so the firm went unpaid for everything agreed. In that eventuality, the order will have to be they had done without authority on that aspect of amended (embarrassing, even if possible) in default the case. Worse was to come. Counsel’s attempt to of which, the claimant will have to issue fresh rectify his CFA after trial, went crashing down in proceedings on the agreement to pay the costs, with flames. Once a costs order has been made by the all the extra expense and delay that that will involve. trial judge, it is too late to enlarge the paying party’s On to the detailed assessment! If recovering costs, liability. Accordingly, counsel’s attempt to add the thought must always be given to making a Part 36 names of the paying parties who had not been offer, since if the offer is not accepted and the identified as defendants in his CFA, proved fruitless,

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FINANCIAL & LEGAL will be ticked through – see Harrison v University Hospitals Coventry & Warwickshire NHS Trust [2017] 3 Costs LR 425 unless “good reason” is shown not to do so under CPR 3.18(b). In practice, they must be aggregated (as assessed), with the pre-budget costs (as assessed) and CPR 44.3(5) applied to the bottom line figure to ensure that it is proportionate. If, on an eyebrow test, (there is no other guidance), the judge thinks they are still out of proportion, individual items must be reconsidered, for example, counsel’s fees, and if necessary, more chopped off to bring them down to proportionate sums receiving party recovers more at detailed assessment, -see West v Stockport NHS Foundation Trust [2019] Costs LR 1265. the treasure trove under Part 36.17(4) will be available Any escape? Yes, obtain a costs order on the - an additional 10% of the assessed costs (up to indemnity basis. In contrast to the standard basis, such £75,000), enhanced interest at up to 10% over base costs are not subject to CPR 44.3(5). Nor does the last rate and the costs of the detailed assessment on the approved or agreed budget apply to them: it can be indemnity basis, so the proportionality test under torn up and the costs assessed as if there was no CPR 44.3(5) will not apply to them. budget, with the receiving party having the benefit of How should that offer be presented in order to any doubt -see Lejonvarn v Burgess make sure that it is effective to deliver Costs is a [2020] Costs LR 45. A powerful weapon the automatic consequences under the rule? The answer is that the offer must specialist area with in the receiving party’s armoury. is a specialist area with plenty be inclusive of interest. An offer plenty of traps for ofCosts traps for the unwary and not just purportedly made under Part 36 but the unwary those discussed above. Such difficulties expressed to be “exclusive of interest”, is can be avoided by using experts in this not a Part 36 offer -see King v City of field. Despite the Jackson reforms, there still is a place London Corporation [2019] Costs LR 2197, so none of for Costs Lawyers and for firms such as Kain Knight the benefits under Part 36.17(4) will be conferred. to be part of legal teams, perhaps even more so now Imagine telling the client – “sorry, we made a mistake than before. ■ in the wording of the offer, so the £75,000 you would otherwise have received if we had expressed it correctly, is not payable after all”. Professional indemnity insurers here we come! What recovery can be expected on detailed assessment? There used to be an old rule of thumb that about 75% of what was claimed would be a For further information please contact good result, but that was before costs budgeting. enquiries@kain-knight.co.uk or call 01279 755552 Does budgeting help? In principle, budgeted costs www.kain-knight.co.uk

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FINANCIAL PLANNING AND INVESTMENTS

HUNDREDS OF DEPUTIES TRUST US TO MANAGE FINANCIAL INVESTMENTS FOR THEIR CLIENTS. brewin.co.uk/ solicitors-and-accountants

To find out more please contact Hannah Rockey on 0203 201 3216 or hannah.rockey@brewin.co.uk

The value of investments can fall and you may get back less than you invested. Brewin Dolphin Limited is a member of the London Stock Exchange, and is authorised and regulated by the

Financial Conduct Authority (Financial Services Register reference number: 124444).

FINANCIAL & LEGAL

WORKING WITH DEPUTIES

and their clients

Whether you are a professional acting as a trustee, or a deputy acting for an injured person falling under the care of the Court of Protection – we will deliver a personalised financial planning and investment service.

e understand that empathy with your clients and their families forms the foundation of a durable, trusting relationship. We will take the time to listen to their Matt Sullivan, story and understand the Head of life-changing impact of what Professional has happened to them. Services With experience managing over £240 million in relation to compensation claims, our advisers are well versed in supporting individuals and families, removing jargon and providing advice in plain English. Our compensation management service is made up of two distinct roles which, when combined, can help provide the best long-term outcome for the individual. A financial planner will talk to professionals about their client’s financial planning needs after the damages award has been made. They will consider the client’s short, medium, and long-term objectives. An investment manager will build a portfolio of investments that will cater for the client’s growth and income needs.

create an investment plan that is fully tailored to the client’s circumstances and needs. We will consider: l Means-tested welfare benefits, property adaptations, and health care needs. l Your client’s tolerance for risk and capacity for loss. l Any immediate need for income. l Suitable flexible investments to meet the evolving needs of the injured person, their family and the care team. l An emergency cash fund. l An appropriate tax-efficient investment plan. l Cashflow analysis to build a broad understanding of what your client’s income needs and finances might look like following the settlement. l The investment options and our recommendations, ensuring there is a clear understanding of the reasons behind our recommendations. 3. Investing in action Once the investment plan has been agreed your dedicated wealth manager will make the relevant investments.

HOW DO WE HELP? OUR ADVISERS ASSIST AT 4 KEY STAGES:

4. Continued support Once the investments have been made our relationship does not stop there. We continue to work closely with deputies, families and the individual as financial objectives and care costs evolve. ■

2. Preparing a plan Once the settlement figure has been agreed we will

www.brewin.co.uk/ solicitors-and-accountants

1. Approaching settlement Before the compensation claim is settled, if possible, it helps to be given an understanding of your client’s income and expenditure together with your client’s objectives.

Visit us online at

The value of investments and any income from them can fall and you may get back less than you invested. Please note that this document was prepared as a general guide only and does not constitute tax or legal advice. While we believe it to be correct at the time of writing, Brewin Dolphin is not a tax adviser and tax law is subject to frequent change. Tax treatment depends on your individual circumstances; therefore you should not rely on this information without seeking professional advice from a qualified tax adviser. Brewin Dolphin is authorised and regulated by the FCA (Financial Services Register reference number 124444)

VFS LEGAL FUNDING R E L E A S I N G C A S H F L OW

VFS is the partner of choice - providing finance to law firms working in litigation Cash flow is king Many law firms, including profitable ones, struggle to grow their business through lack of cash resources. VFS provides modern, effective and proven funding solutions to provide the required cash flow.

What makes VFS different?

Proven track record of delivering a quality service

Why use funding?

Cost effective funding; low interest-only payments

Certainty: Funding aligned to the time it takes to run a case through to settlement

Capital repayment at the natural conclusion of the case

Profits: A strong cash flow and financial stability gives the law firm the upper hand in bill negotiations, increasing the profitability on the case by removing the need to accept low settlement offers Growth: VFS releases the cash tied up in a case for marketing and/or investment in the practice Bank: Complements your bank facilities, releasing your overdraft for short term needs

Our products include Disbursement Funding – ALL third party costs incurred in running a case, including the Court Fees Cost Advance – releasing cash tied up in your issued bills High Cost Funding – similar to Cost Advance but releasing funding against your accrued WIP when AN ADMISSION OF LIABILITY HAS BEEN RECEIVED Use of Funds – the funds released are the Law firm’s to use as they require

SRA compliant Funding to the law firm, NOT a CCA loan to the client Quick, simple, effective funding solutions

Personal Injury Including: Clinical negligence Industrial Disease

NIHL/Whitefinger etc. Financial Claims Housing Commercial Litigation

SIMPLE. INNOVATIVE. PROVEN. For further information contact VFS Legal Limited, Kingfisher House, 21-23 Elmfield Road, Bromley BR1 1LT T: +44(0)20 3747 9333 E: enquiries@vfslegal.com W: vfslegal.com

Sectors we can fund

Increase your

FINANCIAL & LEGAL

FINANCIAL MUSCLE Release the WIP and cash tied up in existing cases. VFS Provides simple, competitive, effective cashflow solutions to law firms. Trading for almost a decade and already providing over £120,000,000 of funds across 80+ law firms.

ny company, settlement times of brain RICK GREGORY is the Sales even the and spinal injury cases put Director of VFS Legal Funding Ltd. profitable ones, financial pressure on the With over 25 years of experience in no matter what firm alongside expensive the personal injury market, Rick leads the company’s growth sector they are in, require disbursements, spiralling advising many firms of funding sufficient cashflow. Court fees and expert options available to ensure VFS provides modern, reports. profitability and expansion. innovative finance VFS provides a flexible solutions for Disbursement tailor-made solution Funding, Cost Advance and High-Cost Case funding on aligned to a clinical negligence firms cash flow. The cases where there is an admission of liability. facilities are aligned to an individual case and the The core of what we do is simple, a company does natural conclusion when payment is received. not exist on profits alone, there MUST be a positive COST ADVANCE FUNDING cash flow otherwise the company will fail. Once a case is settled, it can drag on for a long time Given the very nature and uncertainty in the way whilst your bill is negotiated, the Clinical negligence sector operates, VFS is the trusted significantly delaying payment. VFS can law firms are unable to predict with any certainty how much cash resource funder of choice to release the cash tied up in a case once is required to run a case and, of the bill is served, allowing you to the legal sector course, when they will actually receive negotiate the maximum costs and not payment (if at all). accepting a low offer due to cash flow pressure. For a multi-track or high-value PI case, a law firm will run cash flow negative for several years due to the HIGH-COST FUNDING complex nature of these types of claims. The Where there is a verifiable admission of liability, the VFS High-Cost Case Funding provides the cash flow. It is case-specific and ideal for multi-track cases. As the case moves forward there is ongoing funding against the accrued WIP and incurred disbursements. This ensures the law firm’s cash resources are not tied up in bringing a case to conclusion.

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DISBURSEMENT FUNDING

This funding can fund the disbursements and issue fees on an individual case and release the cash in disbursements already incurred. Don’t be left behind - VFS Legal Funding Solutions provides the financial space to focus on the case and not your cashflow. ■

Email: enquiries@vfslegal.com

www.vfslegal.com

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Frenkel Topping – The right people doing the right thing. Always ............................................................................................

Always Experts: 30 years’ experience as specialists in PI and Clin Neg. Our depth of understanding is unrivalled in our field. Regarded by the Ministry of Justice as a valuable source of knowledge in expert witness and the Ogden discount rate.

Always Principled: We’re always thinking about the impact we’re having – on our team, on our clients and their families, and on the world. We act with care and integrity and we will always do what’s right.

Always Proven: Helping litigators achieve maximum damages and clients achieve the best long term financial outcome is our core business and we’ve been instrumental in securing additional millions in settlements and providing financial guidance post settlement that allows for the most fulfilled life post injury. Our clients are clients for life.

Always Responsible: We work with clients during some of the most difficult periods of their lives. We know their money has to last a lifetime and we’re well aware of the challenges that life after injury can present. It’s a responsibility we take seriously. We pride ourselves on providing quality, unbiased advice with transparency and openness.

Always Reliable: For life’s decisions – from birth to planning the financial legacy you leave behind – we’ll be there. Always.

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FINANCIAL & LEGAL

INJURY DOESN’T DISCRIMINATE. Neither should we! Says Richard Fraser, CEO Frenkel Topping Group.

arlier this year before lockdown, Frenkel Topping celebrated a number of award wins and industry recognition thanks to the hard work of two of our Richard Fraser female team members. Katie Nutting, who heads up Obiter – our generalist wealth management business – appeared in the Sunday Times list of the country’s top financial advisers. While Bonnie Cassidy, one of the youngest members of the team, was named ‘Overall Apprentice of the Year’ and ‘Finance and Accounting Apprentice of the Year’ at the Annual Apprenticeship Awards run by Salford City College. Their accolades focused our attentions on the valuable role women play in financial services generally and of how their contribution is key to the strength of Frenkel Topping and its future growth.

IDENTIFYING AND NURTURING TALENT

experience can bring. The value they add is unquestionable. In return, they’re given the tools and opportunities they need to fast track their career without the burdensome debt that comes with a university education. We’re committed to doing what we can to make the financial services industry more accessible and promoting apprenticeships as a valid route in is one key part of that. Katie’s traits of emotional intelligence, patience and empathy, are undoubtedly key to the relationships she has with clients. Those attributes aren’t exclusive to female advisers but we see them in abundance from the women in our business. Our ratio of male:female advisers is better than average in a financial services firm but it is by no means equal. We’ve got work to do. For that reason, earlier this year we launched a company-wide initiative to promote equality, diversity and inclusivity in professional services. We believe our workforce should reflect the diversity of the clients it serves and of society in 2020. Personal injury doesn’t discriminate, and we shouldn’t either. ■

Bonnie’s achievements serve as a helpful reminder of why we decided to invest in our apprenticeship scheme a couple of years ago. Her journey highlights how important the alternative routes are in identifying talent and nurturing it to create the business leaders of the future. In the last few years our apprenticeship scheme has attracted young people who are bright, switched on and eager to progress. They’ve learned the ropes in a structured environment, got to grips with the theory and applied it in practice to real-life scenarios. . . . . . . . . . . . . . . . . . . . . . .Email: . . . . . . . .enquiries@frenkeltopping.co.uk ............................................................ They’ve developed at pace, defined their skillsets and Tel: 0161 886 8000 refined the softer skills that only on-the-job Frenkel Topping www.frenkeltopping.co.uk – The right people

doing the right thing. Always

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

T F E  W

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.

FINANCIAL & LEGAL

Periodical PAYMENTS

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 • Case conference attendance

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.

FINANCIAL & LEGAL

How should capacity to use SOCIAL MEDIA BE ASSESSED? The Internet, and particularly social media, can provide disabled persons with a great opportunity to express themselves, learn new skills and information, locate support, and interact with others. Sadly, it is not without its dangers.

n a recent case of ‘B’, social media sites which Cobb J has tackled are rude or offensive, or the issue of share those images, other assessing capacity people might be upset or for internet use and offended; social media contact in l Some people you vulnerable adults. meet or communicate B is a woman in her 30s with online, who you with learning difficulties don’t otherwise know, and epilepsy, living with may not be who they say her parents. Cobb J noted they are (‘they may that “she is somewhat disguise, or lie about, socially isolated”. themselves’); someone Concerns have been who calls themselves a raised to adult social care ‘friend’ on social media workers about B’s sending of intimate imagery to may not be friendly; strangers via social media. B has also provided l Some people you meet or communicate with on personal information to these individuals and has the Internet or through social media, who you don’t sent money to them. otherwise know, may pose a risk to you; they may lie More recently, B’s behaviour has brought her into to you, or exploit to take advantage of you sexually, contact with a male in his 70s, who is a convicted sex financially, emotionally and/or physically; they may offender. Unlike previous occasions, B’s relationship want to cause you harm; and with this individual has progressed to a l If you look at or share extremely Taking all practical rude or offensive images, messages ‘real-life’ one, causing authorities significant concern. In respect of social steps to help people or videos online you may get into media usage, Cobb J noted that trouble with the police, because you make decisions over may have committed a crime. capacity assessments had been attempted by professionals, but results Adult social care services and others their social media were inconsistent. will be able to contact Fundamentally, Cobb J has ruled that create resources the question of an individual’s capacity for internet and action plans around this test, use and social media contact is distinct from other with the intent of taking all categories and provides a list of what he considers to practical steps to help people be the ‘relevant information’ for the purposes of the make decisions over their social functionality test: media contact and internet use. l Information and images (including videos) which Hopefully this will result in greater you share on the Internet or through social media consistency and a reduction in Jane Netting could be shared more widely, including with people risk to vulnerable adults. ■ you don’t know, without you knowing or being able to stop it; l It is possible to limit the sharing of personal information or images (and videos) by using ‘privacy and location settings’ on some Internet and social Please contact Jane Netting media sites; Tel:0114 267 5588 l If you place material or images (and videos) on Email:jane.netting@wrigleys.co.uk

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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 98

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.

e are regularly instructed in cases involving issues around capacity, provisional damages, PPOs and statutory funding. Members work nationally and internationally, with leading provincial and London solicitors and national defendant insurer firms. 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. For 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 Acted for female claimant in mid-twenties, who sustained a severe TBI and poly-trauma as an unrestrained rear seat passenger in an RTA causing her to lose capacity, against a background of a complicated pre-accident medical history and to have life-long requirements for care and support. l Foreign national who sustained a severe TBI whilst riding a motorcycle, causing him to lose capacity, rendering him unable to work and to have life-long requirements for care and support. l Pedestrian who sustained a severe TBI with resultant neuropsychological and neuropsychiatric

symptoms, severe poly-trauma including fractured vertebrae, when struck in a hit and run RTA.

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. Case examples include: l Male in mid-twenties who sustained a T11-T12 fracture dislocation, when he fell from height during a maintenance cleaning operation at work, leaving him with paraplegia that is motor and sensory complete at T11 level rendering him wheelchair dependant. l Male in early twenties, who sustained either a Spinal Cord Injury Without Radiological Abnormality, or a Functional Neurological Disorder rendering him wheelchair dependant. l Delayed diagnosis of cauda equine syndrome following 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

“The ‘impressive’ Old Square Chambers is an ‘excellent choice’ In the personal injury market. The set has a longstanding reputation in

for claimants but has recently significantinjury defendant presence.” Legal 500 2020 “The ‘impressive’successfully Old Squareacting Chambers is an ‘excellent choice’ built In thea personal market. The set –has a longstanding reputation in successfully acting for claimants but has recently built a significant defendant presence.” – Legal 500 2020 “Old Square Chambers is well regarded for its expert representation of both claimants and defendants in complex personal injury matters. Areas of particular expertise for the set include catastrophic and fatal accident claims, and its members are often instructed in

“Old Square Chambers is well regarded for its expert representation of both claimants and defendants in complex personal injury cases involving injuries sustained in RTAs and workplace accidents.” – Chambers & Partners 2020 matters. Areas of particular expertise for the set include catastrophic and fatal accident claims, and its members are often instructed in cases injuries sustained RTAs workplace accidents.” Chambers & Partners 2020 and because Our clients choose Oldinvolving Square Chambers because ofinour firstand class reputation, because of– our experience and knowledge, 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

Our clients choose Old Square Chambers because of our first class reputation, because of our experience and knowledge, and because results. 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. For more information, please call one of our clerks on 0207 269 0300 or email clerks@oldsquare.co.uk LONDON

BRISTOL For more information, please call one of our clerks on 0207 269 0300 or email clerks@oldsquare.co.uk 9 Queen Square

10-11 Bedford Row

BRISTOL Bristol

LONDON London

BS1 4JE

WC1R 4BU

9 Queen Square

10-11 Bedford Row

T +44 (0) 117 930 5100

T +44 (0) 20 7269 0300

Bristol

London

F +44 (0) 117 927 3478

BS1 4JE

WC1R 4BU

DX 78229 Bristol 1

DX 1046 Chancery Lane

T +44 (0) 117 930 5100

T +44 (0) 20 7269 0300

F +44 (0) 117 927 3478

DX 78229 Bristol 1

DX 1046 Chancery Lane

Leading EXPERTS

Specialists acting for a multitude of clients in all forms of personal injury.

specialist set with 79 members, including rebuild their lives and cope with these life-changing 17 Queen’s Counsel, Old Square Chambers injuries with expert rehabilitation, medical care and provides advocacy, advice and drafting of support. Our team’s experience in other associated the highest quality, at trial and areas, such as clinical negligence, Recognised for their costs work, product liability and appellate level. Our exceptional clerking team are also recognised experience in high value professional regulatory disputes, and provide friendly and allow us to provide a fully and complex claims professional support. comprehensive service. Old Square Chambers has proven expertise, at all We put our clients at the heart of all we do. We levels of seniority, encompassing the full spectrum will fight tirelessly for your interests and to achieve of personal injury matters. Our members are the best interests. ■ particularly recognised for their experience in high value and complex claims, frequently acting for both claimants and defendants in cases involving catastrophic and fatal accidents, and traumatic brain, spinal and life-altering injuries. We service a For more information, wide range of work across the UK to get the please call one of our clerks on 0207 269 0300 compensation our clients and families need to help or email clerks@oldsquare.co.uk 100

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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”*. who instruct them, but also the network of 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 put 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.” ■ *Chambers & Partners

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. They are experienced in handling cases involving injuries of the utmost severity. 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

Email: clerks@parklaneplowden.co.uk

parklaneplowden.co.uk

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‘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

Cival 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.

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.

OUR OUTSTANDING SET INCLUDES: Bryan Thomas Year of call: 1978

Bryan has PPO experience at levels over £200,000 per 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 will 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. ■

For more information call 0845 0713 007

‘These highly respected Chambers have become totally focusedCHILTERN and expert at what they do’ NEURO & MEDICAL SERVICES

Passion I Empowerment I Respect I Collaboration

We are a specialist group of residential properties across the North West and South Yorkshire regions We can offer slow stream re-habilitation at our nurse led facility in Rochdale with access to... Neuro-consultant

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5 residential properties Between 4 to 8 individual rooms

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Homely communal areas Trained and for social interaction and experienced support teams’ engagement

Phone: 0333 305 0880 Email: enquiries@nationalcaregroup.com

NEURO & MEDICAL SERVICES

Setting service, and suc our clie

Providing award-winning, evidence-based Chambers and Partners Neuro and Medical Music Therapy services across the UK.

Brain injury, prolonged disorders of consciousness, neonatal and birth injuries.

Specialist ba law across En

One-to-one assessments, treatment and home programmes. Full-day services in hospitals, care homes and rehabilitation units.

■ Personal I Clinical N

www.chilternmusictherapy.co.uk

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t: 01442 780541 e: info@chilternmusictherapy.co.uk Chiltern Music Therapy Community Interest Company No. 7702358

The Mews, 38 Cathedral Road,

103 For further i

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FINANCIAL & LEGAL

Managing finances following a brain injury It’s important that the finances and welfare of the most vulnerable members of our society are protected; that’s the job of the Court of Protection. When someone suffers a serious head or brain injury, their mental capacity can be affected and they may no longer be capable of making decisions for themselves. In such cases, a Court can appoint someone to make or help make decisions on their behalf and act in their best interests.

Q: What is a deputy? If someone becomes mentally incapable of handling their welfare and/or their property and financial affairs, and a Lasting Power of Attorney isn’t already in place, it’s necessary for the Court of Protection to appoint a deputy to manage those affairs on their behalf. A deputy looks after the best interests of the person who lacks capacity. The deputy’s responsibilities will include: • Budgeting • Arranging payments • Completing annual reports, accounts and tax returns • Liaising with healthcare and medical professionals • Buying, selling or adapting property • Applying for welfare benefits • Investing damages awards A deputy works closely with the client and, where appropriate, their family. They help them to make as many decisions as possible for themselves, empowering them to manage their own finances where possible.

Q: What do professional deputies do?

Q: What are Personal Injury Trusts?

A professional deputy is an independent and regulated alternative to appointing a family member or a friend. This would usually be a lawyer with specialist expertise in the Court of Protection process, mental capacity law, finances and investments. The professional deputy must act in accordance with the Mental Capacity Act 2005 and their role is very extensive. They’re responsible for liaising with the litigation solicitor during personal injury and clinical negligence claims. They’re also responsible for the budgeting and management of interim payments, agreeing the implementation and recommendations for care, therapies, accommodation, specialist equipment and associated work.

If someone has capacity to manage their finances, they should consider sheltering their award in a Personal Injury Trust (PIT).

Q: What happens when a claim settles?

A PIT provides a way of ensuring that individuals retain their entitlement to means tested benefits after receiving compensation for a personal injury.

Once a claim settles, any compensation award will need to be properly managed and budgeted – and wisely invested. This will require the deputy to advise on investment strategy and to appoint investment advisers. The deputy will review their performance and meet annually with an investment managers to oversee investment and risk strategy of the investments. The deputy will meet at least annually with the client (usually more) and/or his/her family and work closely with all individuals concerned to enable the client to make as many of their own financial decisions as possible.

If someone claims means-tested benefits, any compensation money they receive may affect their entitlement to benefits and other statutory services. If their compensation, when added to the value of their own capital, exceeds fixed limit (such as money in a bank account, savings or investments), their means-tested benefits will reduce or may stop altogether. The law provides that personal injury compensation money which is held in trust for an individual’s benefit will normally be disregarded when assessing their entitlement to benefits such as Income Support, Tax Credits, Housing Benefit or Council Tax Benefit.

A well-drafted trust deed with supporting advice is a must in these circumstances.

Offices throughout the UK.

0800 884 0384 slatergordon.co.uk

Authorised and Regulated by the Solicitors Regulation Authority.

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When people suffer serious injuries or medical mistakes, they need specialist support. That’s why we’re here. Our Solicitors have a proven track record of dealing with brain and spinal injuries and are experts in helping victims and their families get the rehabilitation and support they deserve. Meet our brain and spinal injury specialists:

Matthew Clayton

Rose Gibson

Partner

Caroline Fox

Associate Solictor

David Thomas

Partner

Kay Barnes Partner

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. SIMPSON MILLAR The open lawyers

info@simpsonmillar.co.uk www.simpsonmillar.co.uk

Authorised and Regulated by the Solicitors Regulation Authority. Registration No. 424940.

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FINANCIAL & LEGAL

What safeguarding measures are in place to prevent

BRAIN INJURY AT BIRTH? For most women and families, the arrival of a new baby brings joy and happiness to everyone. However, labour and delivery can be hazardous, even for highly trained obstetric and midwifery staff.

hile most problems can be managed without injury to mum or baby, in some cases there may be lifechanging and catastrophic consequences, such as shoulder dystocia, brain damage and Cerebral Palsy. However, careful measures are taken antenatally and in labour to protect the mother and child.

suffering severe brain injury and Cerebral Palsy. Medical negligence during childbirth profoundly affects both the child and their parents, so families who find themselves in these very tragic circumstances will need lots of support.

HOW SIMPSON MILLAR CAN HELP

Simpson Millar have a team of highly trained lawyers who work with families to provide that support; recovering KEEPING MUM AND BABY SAFE significant damages to cover the cost of care and the many To prevent and reduce risks of therapies which may be injury, both maternal and needed, including foetal wellbeing are closely occupational therapy, monitored. This may include physiotherapy, recording the foetal heart rate KAY BARNES is a Partner in the Clinical neuropsychology, speech and on a CTG monitor, assessing Negligence Team and has over 20 years’ language therapy. foetal growth abdominally or experience in running clinical negligence claims. Before becoming a solicitor, Kay was a Midwife Accommodation experts, by ultrasound scan, taking in clinical practice for 14 years. meanwhile, can advise on foetal blood samples in labour alterations and refurbishment to check for levels of possible to property, so care and therapy can be delivered in the oxygen deprivation and checking the mother’s blood best possible environment. pressure, urine and blood readings. Simpson Millar has helped many families in these Cervical incompetence can be managed by inserting a circumstances to move forward, significantly improving suture to the cervix, which can be removed before quality of life for both the child and the family. ■ labour, while antenatal scanning can identify low lying placentas. By taking steps to identify possible complications, clinicians can take steps to minimise the risk of injury occurring.

MISTAKES CAN STILL HAPPEN

However, some complications cannot be anticipated or avoided, and unfortunately in some cases opportunities are missed, clinical findings wrongly interpreted or mismanaged and clinical outcomes result in a baby

Call us on 0808 250 6581

www.simpsonmillar.co.uk 107

LAWYERS SPECIALISING IN BRAIN AND SPINAL CORD INJURIES Understanding, Knowledge, Experience

We are one of the UK’s leading specialist legal firms dealing with brain and spinal cord injuries. Our personal injury team understands that a major trauma injury will require early, specialist, intensive and expertly delivered rehabilitation to help with you recovery. 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. Our award winning personal injury solicitors deal with a wide range of catastrophic and life changing injuries such as:-

✓

Acquired and traumatic brain Injuries

✓

Complex and multiple fractures

✓

Spinal cord injuries and amputations

✓

Fatal accidents and nerve damage

✓

Chronic pain and complex regional pain syndrome

✓

Psychological injuries such as PTSD and depression

For expert legal advice request a FREE initial telephone consultation by calling 0808 239 2605 FREE 24 hours a day To support our clients during this pandemic, video conferencing facilities are available.

Email: hja@hja.net Web: www.hja.net We are authorised and regulated by the Solicitors Regulation Authority (No 651238)

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LAWYERS SPECIALISING IN Brain & Spinal Cord Injury: BRAIN AND SPINAL CORD INJURIES

FIGHTING FOR WHAT’S RIGHT Understanding, Knowledge, Experience

Hodge JonesWe & are Allen of the UK’s specialist leading specialist firmwith dealing oneisofone the UK’s leading legal firmslaw dealing brainwith and spinal cordcord injuries. Our personal injury clients team understands that a major trauma injury will brain and spinal injuries, supporting throughout the personal injury require early, specialist, intensive and expertly delivered rehabilitation to help with claims process for over 40 years.

you recovery.

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Our Our team team o helping hand throughout FULLY FOCUSSED torstors have have a real a real depth depth andand diversity diversi list law with Anne Sanders GETTING YOUR LIFE thefirm claimsdealing process. ’s fering fering personal personal support, support, guidance guidance an e UK Partner f isth e osupporting Riffat Yaqub is BACK ON TRACK Ouron ethos - and always has llen injuries, throughout throughout thethe claims claims process. process. s r e d &alAcord h n it a S w Anne Sanders ne privileged to be part of your journey Partner ngwhat’s A nfeel ea lifor dclaims beenfi-rm to fight At HJA we personal pro- gright and Our Our ethos ethos is -isand - and always always hashas been been a li st lawinjury in Riffat Yaqub Partner rt er make a real difference. o p p to achieve thesubest possible result and wantPar totnhelp The right right and and to achieve tomajority achieve thethe bestbest possible possib es, ri ju Amongst widespread praise in b u rd o q c na l for you and your your your loved loved ones. ones. We We always always place placo at Ya - We always Partner R iffplace loved ones. our of our cases are dealt with on a No Win No Fee basis, s pro im c larecently ry juexpert heart heart of everything of everything wewe do.do. in here, the firm was l For legal advice request a FREE initial telephone consultation by calling a n o rs e p clients at the heart of everything we do. so there is never any financial risk or burden to you. e Partner pra ise read2605 Specialist Specialistbrain spin idesp wYear 2019” for FREE st0808 239 24 hours a day Our focus is always to get you the justice you brainandandspinal ongthe A mof .irm y tl solicitors solicitors n e c re s a SPECIALIST BRAIN SPINAL CORD deserve and to help you make the most of your life. fi rm wwork inical byAND thToe support Our Our major major trauma trauma team, team, including includinR sphere,negligence our2clients during facilities are available. for this pandemic, video conferencing ” 9 1 0 INJURY SOLICITORS We’ve been fighting for what’s right forSanders, over forty r a e Anne Anne Sanders, work work with with thethe UK’s UK’ le of the Y y n F ir mOur b majorgtrauma team, Riffat Yaqub and years. 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FINANCIAL & LEGAL

Adding insult

TO INJURY

A look at some of the issues following brain injury.

recent discussion with a client of mine has reminded me of the difficulties faced by people with brain injury following discharge from hospital. As is common, he received excellent medical care whilst in the hospital system, first at Kings College Hospital and later at a specialist brain injury facility in Kent. Whilst there, he received the benefit of daily physiotherapy, along with neuropsychology treatment and the other input that he required. Although still left with significant injuries which are likely to prevent him from ever working again, the excellent medical treatment he received has meant that he is very much better than he was when safety net and indeed I wonder how clients without he was first admitted with life threatening injuries. support manage at all (especially in view of funding The problems start, of course, once the patient has issues in social services). improved sufficiently to be discharged home. For those clients lucky enough to have a strong Although it is human nature for an injured person to case, there is plenty a personal injury solicitor can do want to return to a familiar environment to ease the burden, including seeking There is plenty funding for rehabilitation and obtaining as soon as they can, the problem is that once they are back home, the a personal injury interim payments to replace lost frequency of their treatment almost income (which can make a massive solicitor can do to difference to the injured person). My always reduces very rapidly indeed. In the case of the client mentioned above, ease the burden thoughts, however, are very much with he has gone from daily physiotherapy those whose claims are not strong sessions to a wait of three months (and counting) for enough to proceed, as they miss out not only on the his first outpatient physiotherapy appointment. No chance to recover compensation but also on the other treatment has yet been offered. medical treatment - which would enable them to rebuild their lives. ■ CHALLENGE OF APPLYING FOR BENEFITS By Jonathan Pidduck, Managing Director Leaving aside for a moment the medical challenges, the injured person also has to face the challenge of applying for state benefits if they can no longer work. Completing a long and complicated form is a challenge for most people, but after suffering a life changing injury it must be nigh on impossible. It strikes me that clients with a supportive family Call Jonathan Pidduck on 01227 828 299 cope very much better than those without this www.girlingspersonalinjury.co.uk

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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

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Subtle brain injury personal injury claims

DO NOT MISS THE SIGNS Have things not been quite right since suffering head trauma?

injury and where it is located. The most common id you suffer a mild concussion or a long-term symptoms of subtle brain injuries include: relatively minor ‘knock’ to the head and l Frequent headaches l Changes in behaviour expect a full recovery, but you just feel Cognitive difficulties like a different person after Subtle brain injuries can l l Dizziness l Balance problems many months? Can you not be disabling regardless of the There are a number of different think clearly? treatment options for subtle brain Have your doctors run a number initial trauma - which does injuries, which will depend on the of tests that seem to indicate not have to be severe severity and symptoms of the everything is fine, but you know injury. The most common treatment plans include input that things are not quite as they should be? You may be from neurologists, psychiatrists, neuropsychologists and suffering from a subtle brain injury. occupational therapists. ■ A subtle brain injury usually occurs when the brain is subject to trauma after a head injury, which may be due to a car accident, fall, or an accident at work. Often, the trauma to the head may not appear to be too serious, especially if there are no visible signs of injury to the head. However, there may be some damage to the brain after an accident that may cause long-term, disabling symptoms and affect one’s personal and working lives. Call us on 0161 737 9248 The long-term effects of a subtle brain injury depend Email advice@brianbarr.co.uk on a number of factors, including the severity of the www.brianbarr.co.uk

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WHAT OUR CLIENTS HAVE SAID ABOUT US “Brian Barr is a company that works extremely hard on behalf of their clients to get the very best outcome possible. Turning my case around after taking over halfway through, leading to a positive result, is to their credit.” - MRS J R, STOCKPORT “Alex Cohen and his team were nothing but amazing. They fully explained everything I needed to know throughout my entire case with a great deal of compassion and care. I would have no hesitation in recommending Brian Barr solicitors if a member of my family or friend ever needed it.” - MS O, LONDON

“I was really happy that I found Brian Barr Solicitors. My solicitor, Phillip Cohen, was an absolute gem from start to finish. If I had anything I wanted explaining or any worry, Phillip always talked it through with me. When I went for the final settlement meeting he put me at ease and talked me through it step by step. I cannot thank them enough. I really would recommend you to anyone who needs a competent firm of solicitors.” - SM “Thank you Nicky, for making a stressful time as easy as it could be! Eternally grateful for your support.” - NB

0161 737 9248

www.brianbarr.co.uk

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Specialist KNOWLEDGE O Morrisons Solicitors is a Surrey, Hampshire and South-West London based law firm.

present and/or long-term health, well-being and lifestyle ur Personal Injury and Clinical Negligence by facilitating the provision of privately funded department work exclusively for Claimants treatment and equipment. who have suffered catastrophic and life We have a strong network of experts who we work changing injuries, including brain and spinal injury. alongside to explore and provide bespoke rehabilitation The Personal Injury team at Morrisons Solicitors are plans such as medical experts, case managers, pain specialists in catastrophic, life changing injury cases. We management experts, prosthetic experts and home understand how traumatic and debilitating a life adaption and technology experts. changing injury can be for an injured We pride ourselves on Our approach is to deal with client and their family. We pride ourselves on taking a taking a rehabilitation cases compassionately and robustly, working to achieve the rehabilitation focussed approach. focussed approach best all round results for our This means we pro-actively work clients. We also maximise damages for our clients within, and encourage agreement of, The and are very confident in our ability to understand Rehabilitation Code 2015. This protocol encourages the impact that the injuries have on them personally, parties to a claim to use the Code to identify the to get their life back on track. ■ needs of any injured client and address the cost of providing for their needs on a private basis. This approach ensures that our clients make the best and quickest recovery. Acting in the best interests of our clients goes beyond just securing reasonable financial compensation. We work with our clients, their Tel: 020 8971 1020 families and independent experts, to improve their www.morrlaw.com/personal-injury/

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PERSONAL INJURY & CLINICAL NEGLIGENCE

We work hard to help you get your life back on track. Just when life seems to be going along smoothly, something can happen that turns your world upside down. At Morrisons we will support you through the claims process and help you move positively into your future.

morrlaw.com

0208 971 1055

FINANCIAL & LEGAL

Early notification scheme for birth injuries

IS IT WORKING?

By Kate Rushton, Clinical Negligence Senior Solicitor, Curtis Law Solicitors.

rom 1 April 2017 NHS Trust members were required to report to the NHSR (within 30 days) all maternity incidents of potentially severe brain injury following labour, diagnosed in the first seven days of life.

In principle, this is a great development, but in truth, the questions are; how thorough is the investigation? How involved are the families during the investigation itself? Do they even know that an investigation is happening? And, what happened in 24 admissions out of the other 722 cases? The problem is that the report is These are any babies that fall into 746 qualifying cases shrouded in a veil of limited the categories: information. Is independent advice being advised in all ● Was diagnosed with grade Ill hypoxic ischaemic qualifying cases? Who is determining the amount of encephalopathy (HIE) damages? Is the court of protection involved or does ● Was therapeutically cooled (active cooling only) ENS circumvent true access to justice for those who ● Had decreased central tone AND was comatose need it most? At the moment there are more AND had seizures of any kind. questions than answers, thus the need for The NHSR claim that in its first year of operation independent representation is reinforced. ■ (April 2017 to March 2018) 746 qualifying cases were reported to ENS. To date, 24 families have received an admission of liability, formal apology and in some cases, financial assistance with their care and other needs within 18 months of the incident. There are a further number of Tel: 01254 297130 cases currently being reviewed. www.curtislaw.co.uk

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THE UKâ&#x20AC;&#x2122;S LEADING CASE MANAGEMENT SERVICE FOR CHILDHOOD ACQUIRED BRAIN INJURY VISIT: www.cbirs.co.uk CALL: 01327 223817 EMAIL: enquiries@cbirs.co.uk

Supporting clients to lead fulfilled lives following spinal cord injury. Find a case manager online or call 01327 223 821 www.siacasemanagement.co.uk

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Nikki Smith MCSP BSc Hons Physiotherapy

Heidi Stanley

BSc Hons Occupational Therapy, MSc Management. CASE MANAGER, ADVANCED MEMBER OF BABICM

CASE MANAGER, CQC REGISTERED MANAGER

Specialising in brain injury, complex disability, catastrophic physical and psychological injuries.

Specialising in the management of children and young people with brain injury, complex disability, catastrophic physical and psychological injuries.

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09/03/2020 B&SI Handbook 13:14 Professional Profile V2.indd 2

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Veronika Thompson BSc Hons Occupational Therapy

Lucy Urquhart MSc Rehabilitation, BSc Occupational

CASE MANAGER

Therapy, BA Social Psychology, BSL Level 2. CASE MANAGER

Specialising in complex disability, multi-pathology, neurological, palliative conditions, trauma and manual handling.

Specialising in the management of children and young people with brain injury and hearing loss. Trained in British sign language.

t: 01752 891 930 e: veronika@sscasemanagement.co.uk

t: 01752 891 930 e: lucy@sscasemanagement.co.uk

www.sscasemanagement.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

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.

E: enquiries@nppneurogroup.com T: 0800 917 3330 W: www.nppneurogroup.com

VFS LEGAL FUNDING R E L E A S I N G C A S H F L OW

Rick Gregory

Associate Director - Sales Norman Kenvyn

Founder & CEO VFS Legal Funding is the leading funding provider to the legal sector. The products we offer will VFS can provide immediate funding maximise the profitability on a case at the time of against issued bill of costs cash or when issuing theyour bill, immediately releasing locked you a case with admitted up in have disbursements and WIP. We alsoliability. provide funding on cases with admitted liability. +44 (0) 2020 8315 65299333 +44 (0) 3747 +44 (0) 7789 686963 523965 +44 (0) 7748 Rick@vfslegal.com enquiries@vfslegal.com vfslegal.com vfslegal.com

Jane Morel

Head of Court of Protection

Dr Darren Conway PhD Head of Personal Injury & Medical Negligence

Areas of Practice: Court of Protection Deputyship PI Trusts

Areas of Practice: Birth injury Brain & Spinal injury Psychiatric injury

Telephone 0208 591 3366 E-mail jane.morel@sternberg-reed.co.uk

Telephone 0208 591 3366 E-mail darren.conway@sternberg-reed.co.uk

Norman Kenv 117

PERSONAL PROFILES

Jonathan Jones QC

Paul Bleasdale QC

A real specialist with a keen eye for detail - the most approachable QC in the country. (Chambers UK 2019)

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

Telephone: 0845 241 7006 Email: MT@no5.com

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Riffat Yaqub

Chris Bright QC

Serious and Catastrophic Personal Injury Specialist

He has a great ability to process a lot of information quickly and explain it in a straightforward and effective manner. (Chambers UK 2019)

0808 239 2605

Telephone: 0845 241 7006 Email: MT@no5.com

No5.com

hja@hja.net www.hja.net When people suffer serious injuries24/04/2020 or medical mistakes, they need specialist support. That’s why we’re here.

HJA77_BSI personal profile - new.indd 1

Jane Netting Partner

Our Solicitors have a proven track record of dealing with brain and spinal injuries and are experts in helping victims and their families get the rehabilitation and support they deserve.

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

SIMPSON MILLAR The open lawyers

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Personal profile-Jane Netting_v2.indd 1

13/05/2019 17:04

0808 239 1602 info@simpsonmillar.co.uk www.simpsonmillar.co.uk

18:22:31

FINANCIAL & LEGAL

TOGETHER we can help

Sternberg Reed is a law firm with compassionate lawyers and nurses, who work for those with brain and spinal cord injuries.

ur specialist team is led by Dr. Darren Conway Ph.D. Before Darren qualified as a solicitor, he had a career in genetics, obtaining a Ph.D. in London. As a geneticist, he worked on several cutting-edge projects trying to identify the genetic cause of specific neurological conditions, mainly at the Institute of Neurology and University College London, both in London, and at the Children’s Hospital of Philadelphia (USA). Since retraining as a solicitor he has specialised in acting for those - both adults and children - who have suffered an avoidable injury and consequential is one of those firms. losses as a result of their treatment and/or Our skilled team work for people who live all over management in a medical or clinical setting. He the country. Our clients vary in age from those straddles both legal and medical worlds, able to steer injured even before birth, and who a clear path through the sometimes Our skilled team work have a variety of complex medical impenetrable, and confusing, WE CAN HELP Sternberg Reed can assist medical and legal jargon. for people who live all injuries. you obtain compensation As a result of Darren’s background Specialist Brain Injury,to Spinal Injury and Medical Negligence Lawyersfor over the country negligently caused injuries. We can in molecular genetics, he has a Access to top quality healthcare, giving you the best recovery service also assist youNational to access those services you need to particular interest in more complex claims for clinical UK coverage, Home and Hospital visits available help alleviate and cope with living with injuries to negligence, including injuries to children at about the Free initial case review your brain or spinal cord. ■ time of their birth and cases involving inherited No win, No fee agreements available conditions and neurological injury.

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Together

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WE CAN ASSIST YOU

There are only a few Law firms who employ staff who are empathic, and with sufficient knowledge, specialism and expertise to pursue any claim for brain and spinal cord injury compensation. Sternberg Reed

Tel: 0208 591 3366

www.sternberg-reed.co.uk

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Brain & Spinal Injury

CONTACT INFORMATION

Support groups, charities and other useful contacts and organisations across the UK. Vocational Rehabilitation Association UK

The VRA represents all those involved in delivering vocational rehabilitation services. A number of professional groups are involved from both health (NHS and private) and other government agencies e.g. the Department for Work and Pensions. www.vrassociationuk.com

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 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 120

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 121

has a concussion or other type of THANK YOU brain injury? acquired

A VERY 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 Ltd. 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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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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VFS LEGAL FUNDING R E L E A S I N G C A S H F L OW

What makes VFS different?

Proven track record of delivering a quality service

Why use funding?

Cost effective funding; low interest-only payments

Certainty: Funding aligned to the time it takes to run a case through to settlement

Capital repayment at the natural conclusion of the case

SRA compliant Funding to the law firm, NOT a CCA loan to the client Quick, simple, effective funding solutions

Sectors we can fund Personal Injury Including: Clinical negligence Industrial Disease

NIHL/Whitefinger etc. Financial Claims Housing Commercial Litigation

SIMPLE. INNOVATIVE. PROVEN. For further information contact VFS Legal Limited, Kingfisher House, 21-23 Elmfield Road, Bromley BR1 1LT T: +44(0)20 3747 9333 E: enquiries@vfslegal.com W: vfslegal.com