Having had a subarachnoid haemorrhage the day after full lockdown was imposed on the UK in March, Lee Atkinson faced the trauma of a lengthy recovery without seeing his family. Here, he shares his story of how he coped.
For millions of people across the country, the onset of the COVID-19 pandemic marked the start of a hugely challenging period. But for Lee Atkinson, that challenge was one of survival, after he experienced a subarachnoid haemorrhage the day after the UK went into lockdown on March 23.
Having felt unwell for about three weeks, Lee, a car garage manager, was seeking medical attention for his developing situation.
“He had been coming home from work feeling really tired and he’d had a few headaches,” recalls his wife, Petra.
“He went to the GP and they thought it was down to high blood pressure. He was even seen at the hospital for a scan and then he went back to work.
“But then I came home one morning after a night shift and found him collapsed in the bathroom.”
Lee, 47, was rushed to the Royal Preston Hospital, and underwent life-saving surgery after it was established he had experienced a haemorrhage. In the aftermath of his operation, Lee realised he had become partially paralysed and was struggling to communicate.
As the pandemic escalated, Lee was transferred out of hospital and into the Sue Ryder Neurological Care Centre Lancashire. The purpose-built centre had only recently opened its doors after an 18-month construction project to bring it to life, and fast-tracked its ability to welcome patients to help relieve pressure on the hospital and other local partners.
“I went into Sue Ryder on a stretcher on April 30, and at that point I was paralysed on my left hand side and my speech wasn’t great. I couldn’t use my left arm,” remembers Lee, a father of two.
“But over a period of time, they helped me get back on my feet, but they were very cautious with me.
“I had a set timetable over the week so everything was planned for me. It was really good for me to have that structure because I was in a bad place to start with. I was quite depressed but they really helped me through that.
“I was wanting to push to walk and they were being cautious because I had a period where I still had a hole in my skull from the operation. They leave it like that for about three months and you have to wear a helmet.
“I still have that helmet – all the Sue Ryder staff signed it for me. We really appreciate what they did. I was really lucky to be moved there.”
Due to the stringent restrictions on visiting imposed as a result of COVID-19, Petra was only allowed to visit her husband once in hospital, and with the pandemic escalating quickly, the opportunity for in-person visits was not possible at Sue Ryder, to protect the centre and its residents from the deadly virus.
However, keen to offer families the opportunity to be together however possible, visiting ‘of sorts’ was enabled by the team.
“After a week or so they let me and the kids go and visit him through the window, just to be able to do that meant a lot to us because we had not seen him for so long,” says Petra.
“Then, after a little while, Lee got better with his phone and was able to Facetime us. The staff were always happy to help with anything like that.
“It was obviously all new for the staff too, because usually the families would be really involved in someone’s care, but because of COVID, we weren’t able to be there.”
But while Lee was parted from his family, he was making strong progress in his recovery, buoyed by the thought of going home and working with the centre’s occupational therapy team to make that happen.
“We really didn’t know if he was going to walk again but the physio team were fantastic and some of the assistants who helped with the cognitive treatment were great,” recalls Petra.
“The staff really catered to his needs. They were so understanding about what he liked to eat and let him eat when he wanted to. They even got him involved in some games. They were just fantastic.”
On August 28, five long months after Lee’s life-saving surgery, he was able to return home, with the assistance of the Sue Ryder occupational therapy team. He is now supported by the local community team for ongoing rehabilitation.
“They arranged for Lee to have an overnight stay before he was discharged so we could make sure everything was in place that we needed,” recalls Petra.
“I went and picked him up and it gave me a chance to talk to them about things I was worried about. It really has changed our lives. It has changed everything. We were just a normal family before this.”
Lee’s recovery continues, but he is grateful for the support of the team at Sue Ryder Neurological Care Centre Lancashire during such a traumatic time for him, and particularly without the ability to see his family.
“I found it really helpful at Sue Ryder because while I was going through a really stressful time in my life, they were really great helping me to get through it,” adds Lee.
“I was just lucky that they were able to open when they did.”
New case management business continues to grow
One of the most recently-established businesses in UK case management is growing strongly, with ongoing recruitment and an increasing case load.
Birchwood & Co was formed in December last year as a specialist complex injury case management company and has already assembled a sizeable team of case managers with expertise in a host of areas.
The business is also the only case management company nationally to have in-house clinical psychology expertise.
While having only been in business for four months, Birchwood & Co – based in Sheffield with a satellite office in London – is continuing to win new work nationally, and is recruiting in case management, business development and marketing roles as it aims to keep pace with its fast-developing workload and profile.
Partner Jordi Brunes, who left JS Parker to establish Birchwood & Co, believes its complex injury specialism sets it apart in the field.
“For me, I think a lot of case managers overlook complex injury, so that’s where we really come in as that’s one of our unique selling points,” says Jordi.
“I have worked in A&E theatres with people who have had catastrophic injuries in road traffic accidents and other incidents, and then moved into physiotherapy where I’d be treating these people, and after that came into case management.
“Our team understands complex injury – my own expertise is in orthopaedic, spinal, brain injury and amputation, and as a business we are able to offer this complex specialism to get great results for our clients.
“The training in complex injuries is lacking, whereas there is so much out there in areas like traumatic brain injury, and that’s why we have the specialism we do.
“The fact we have clinical psychology in-house is also important – having Dr Kate Woollaston on board means we can refer to the right therapy quickly and avoid delays for our clients.”
In establishing a new business, Jordi and his team are developing solutions which will make the process more efficient for their national network of referrers.
“From the companies I’ve worked with previously, I’ve taken both advantages and disadvantages of how I think they work, and we’re creating something here which is very different and is what our clients and the solicitors and insurers need,” he says.
“For example, we will fund treatments as long as we have authorisation from insurers, and then send one invoice every month. You have to be mindful that some insurers have 250 cases on their workload, so we’ve recognised the need to streamline the process of sending invoices.
“We’re also looking at creating specialist groups of case managers, which can focus our resources and specialism into these areas and will hopefully make it easier for solicitors to match with their clients.
“One of the biggest challenges in building a new business is finding the right people. We’ve built a great team so far but there is more to do. There are a lot of people who are probably still quite reluctant to change and wonder whether now is the right time, but now that we’re hopefully coming out of lockdown, we hope people will consider whether we could be their next move.”
Having considered setting up in business for the past two years, Jordi decided to establish Birchwood & Co even despite the challenges of becoming a business owner during a pandemic.
“It was probably January last year when I knew I was going to do it, but then COVID came and it became a case of knowing when was the right time,” he recalls.
“But the support of JS Parker was crucial, we were able to bring quite a few clients over from them to us, and that has been important in enabling us to grow quickly.
“Despite what is happening in the world, the clients are still there and they still need the support, the only thing that has really changed is that we had to step back from seeing clients face to face.
“We’ve been lucky to work with a lot of private therapists who are doing some really innovative work in enabling them to continue treating clients, there has been some very good innovation in how to deliver services – but apart from the delivery, the focus on clients and the fact they’re our priority is the same as ever.”
Case managers support heroes to rebuild their lives
Seriously injured armed forces personnel are being helped to rebuild their lives through the work of a case management company in their support of Help for Heroes.
AJ Case Management has enabled the much-loved charity to build their own case management service, to serve the unique requirements of service men and women who are injured in action and enable them to access the healthcare they need.
In addition to the in-house support they have enabled at Help for Heroes, AJ Case Management supports a number of veterans directly in securing the specialist rehabilitation package for their needs.
The work with Help for Heroes is part of AJ Case Management’s commitment to the armed forces, with the business also being part of the Armed Forces Covenant.
“We were initially approached by Help for Heroes to do a bespoke report for a very seriously injured serviceman, and I think they liked our very pragmatic approach,” says Ali McNamara, clinical director of AJ Case Management.
“Securing a package for someone isn’t about it being all bells and whistles, it’s about making it exactly what they need. We’re very experienced in case management and deliver a holistic service, we know the private sector well so can get the very best package together for the person concerned.
“These men and women have been injured serving us, serving this country, and while the NHS meets their needs in their early recovery, we are helping to take that forward and help these service men and women in rebuilding their lives.
“There’s a big push from major trauma centres at the minute for the NHS and case managers to work collaboratively, and I think our work with Help for Heroes is a great example of how collaboration can work.”
The requirements of service personnel can often be unique, says Ali.
“Very often in case management, it’s a priority to get people back into their own homes, or to find a new suitable home. But often with service personnel, they’re used to living with their mates and fellow personnel, they don’t want to live on their own,” she says.
“I think this is the true person-centredness of what we do, as we’ll always do what’s in the best interests of the client. If they’d rather be part of a community than on their own, then we will support them, and that’s what Help for Heroes is really fantastic at doing. It’s great to work with them.”
Carol Betteridge, head of welfare and clinical services at Help for Heroes, says: “AJ Case Management are a professional, dynamic and efficient case management team. Help for Heroes has employed them to provide holistic assessment and detailed case management to a number of complex cases.
“The veteran population are sometimes a challenge to work with, they have often been left to their own devices or are only being supported by their families. It requires tact and patience to build trust and understand their unique needs.
“AJ Case Management have demonstrated their ability to do this whilst understanding the need for flexible and innovative thinking to ensure the veterans receive the care they deserve.
“They also have the ability to think out of the box as veterans do not receive the financial assistance that some civilian cases receive. As well as ensuring statutory services are in place, they ensure any private care gives value for money.”
Having signed up to the Armed Forces Covenant, AJ Case Management’s proximity to RAF Cosford means they are committed to offering opportunities to former military people and current reservists, as well as to the partners of serving service personnel.
“We like to do things differently here and look at the bigger world and how we can help. Through the Armed Forces Covenant, we have the platform to offer training and careers to those who have links with the forces and support them in building a career for themselves,” says Ali.
“For many who leave the army, they’re used to having a really active life and the opportunity of working with clients with brain injury is very varied. It could be things like supporting young men in going to the gym, not what people may have in mind as a ‘traditional’ role in health and social care.
“One of our team was a medic on the frontline but when you leave the forces, those skills aren’t transferable, so she’s building a new career with us. Also, for women with children whose husband is serving, we can offer opportunities there too.
“It’s a great way of us supporting our local community too, being so close to RAF Cosford, and being part of the Armed Forces Covenant is something we’re really proud to do.”
Case management community expands nationally
A community established to support independent case managers is expanding across the UK.
3HUB was created to help self-employed, independent case managers with both clinical and business-related aspects of running their own venture, while also providing valuable access to peer support through them becoming part of the community.
By bringing together case managers from across the country, 3HUB also provides a single resource for referrers to match the expertise of members of the community with their clients’ needs.
The national network, which has a sizeable membership in its native South East, is growing strongly across the UK, and recently added its first case manager in Scotland.
A new model for the market, 3HUB was established in 2018 by directors Viv Cooper, Sophie Greengrass and Kaaren Wallace, to create alternative opportunities for case managers, away from the traditional corporate ways of working.
As experienced case managers, Viv, Sophie and Kaaren recognised the need to offer case managers the opportunity to work for themselves but in a supported way.
“We’ve turned the traditional model upside down. We are empowering case managers to make a cultural shift in their working practices by offering them choice around how they work and the opportunity to take the step into independent case management,” says Kaaren.
“Previously, there was little choice if you wanted to progress your career and earning potential as a case manager; you could head into management, or take the brave leap from the of the traditional structure of an employed position to working for yourself.
“3HUB seeks to address this by enabling case managers to take that leap into independent work, but in a supported and safe way. Working for yourself has many benefits, it means you have choice over your caseload, work/life balance and earning capacity.”
Having set up a charity for refugees using Community Organising as a tool, Kaaren could see the power in bringing together people with shared interests and help them work collaboratively towards a common aim.
The 3HUB community model offers case managers, who are all fully qualified healthcare professionals, membership of a structured and governed case management community with the shared aim of providing an individualised and comprehensive case management service to their clients.
“We support our community with everything from business, tech and office support, through to the clinical support needed to practice as a case manager, from an extensive programme of training events to supervision and support to become CQC registered,” says Kaaren.
“While case managers often have amazing clinical skills, none of us trained in order to be business people, we’re all from NHS or health and social care backgrounds – but the support now exists so case managers have another way; they can be independent – together.”
And through its unique offering to case managers, 3HUB is growing strongly, with the home working and flexible patterns necessitated by the pandemic showing many Case managers the benefits of having more freedom permanently.
“We’re all now very used to working with technology through the pandemic, so I think that will give even more case managers the confidence to become part of the 3HUB Community as they recognise the benefits from both the real and virtual world support the community offers,” adds Kaaren.
“We started in the South East so most of our members continue to be based here, but we are growing organically and reaching a wider geographical base.
“We are excited about the future to see 3HUB grow and offer case managers and clients all the benefits that come with working as an independent.
“The 3HUB Community provides a safe, supportive and innovative environment for case managers to work independently so they can excel at what they do best – helping clients rebuild their lives.”
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