Case managers and service providers across the UK have embraced new ways of working during the COVID-19 pandemic which could become commonplace going forward, but concerns still persist about the lasting effects practically and financially, a new report has found.
Though the adoption of technology and remote means of client engagement, rehabilitation has continued to be provided in ways that will most likely become part of the ‘new normal’.
The Coronavirus – Impact on Rehabilitation report also highlights how by using ‘telerehab’, clients can feel more connected to their service providers, as more time is freed up for communication by taking out travelling time.
Angela Kerr, managing director of AKA Associates and chair of BABICM, highlighted the importance of being able to break traditional sessions down into shorter online sessions, to give greater regularity of contact with clients.
She said that running 10, 20 or 30-minute ‘bitesize’ sessions can help overcome some of the cognitive drain seen in hour-long sessions for someone recovering from a brain injury.
However, she adds that there can be no substitute for some level of face-to-face interaction.
“Clients may paint a good picture but you can’t see what is being hidden when you’re not there. Sometimes you feel that things aren’t ringing true. You’ll not get that feeling if you’re not in the environment,” says Angela.
For independent businesses, the financial impact of the pandemic continues to have a significant effect, with the lack of clarity around when it will end a big ongoing factor. The report found that a quarter of those surveyed expect the industry will still be feeling the effects of the current turbulence two years into the future.
“The big concern is that we don’t see the future clearly yet,” says Toby Carlsson, owner of Pace Rehabilitation.
“For independent businesses like Pace, it’s been a big disruption commercially and we have yet to see the full fallout.
“Thankfully, I do believe that even in six months, we’ll have adjusted to the new normal and look back at this period (which is now hopefully nearing the end) and it will feel like a weird and distant dream.”
The report, from Irwin Mitchell, consults various key practitioners in rehabilitation from around the country, with consensus around the importance of using digital means now and into the future, as well as concerns as to when the COVID-19 restrictions will end.
Reflecting on the report, case managers agreed with the findings.
Alison Baker, managing director of ILS Case Management, says: “Our virtual platforms have enabled us to continue to provide client centred case management; including managing care teams for clients.
“A definite advantage of the technology is the speed with which virtual meetings can be organised for clients, from meet and greet appointments to multi-disciplinary team meetings. And the clients love not having to ‘tidy up’ beforehand!”
Martin Gascoigne, owner of Neuro Case Management UK, says that while his business and its near 100-staff across four offices have successfully adapted, there have also been significant challenges.
“The main issues that we faced were with the Government changing the rules from one week to the next, and also that all of the Personal Protective Equipment (PPE) was ring fenced and allocated to the NHS frontline staff,” he says.
“Due to this, we needed to develop strong links and work in partnership with many manufacturers around the UK so that we were able to build up a panel of specialists who we could go to for advice, support or assistance, ensuring that all of our staff remained as safe as possible.
“It has been a difficult year for us all and NCMUK is proud to continue to be able to offer all of the same services we could provide at the beginning of the year.”
New checklist in appointing a case manager unveiled
A new checklist has been created to support legal professionals in choosing a case manager in brain injury or complex conditions cases.
The checklist outlines a set of criteria case managers should meet in order to be appointed to such cases, and is aimed at solicitors, paralegals and deputies to help them appoint the right person for their client’s individual needs.
The initiative has been developed by BABICM as part of its ongoing commitment to set the highest standards within the sector and and further professionalise case management.
Its work also comes in support of the ongoing development of the profession by the Institute of Registered Case Managers (IRCM), which is setting a host of stringent technical and professional standards to enable Professional Standards Authority (PSA) accreditation.
The 16-point checklist was created by BABICM’s Professional Practice and Membership Group (PPMG) and builds on the existing guidance available to legal professionals through the organisation’s website.
“While we prepare guidance, support and information to our practicing case manager members, we also try and do the same for the wider membership whenever we can, which includes personal injury lawyers and deputies,” says Anna Watkiss, chair of the PPMG.
“I’d imagine it could be quite hard sometimes in making the decision of which case manager to appoint, so the checklist has been created to put a support framework in place for that.
“Lawyers and deputies of course want their clients with brain injuries or complex conditions to have the best care they can get, and this checklist is an embodiment of that, and adds further to the existing documents and best practice benchmarks we have in place.
“We are committed to ensuring the integrity of people working with adults and children and this checklist is another supporting document in doing that.”
The checklist offers points for consideration including registration, data protection, insurance and how the relationship would be built between the case manager and the client and appointing professional alike.
“This was put together by the whole PPMG, different members took on different elements, then we reviewed as a group and agreed it as a group,” says Anna.
“The aim of the PPMG is to ensure we are offering best practice, or are working towards that standard, as part of our commitment to professionalise the industry. That is the reason I got into this group, to make the role as professional as possible.
“This checklist is another step in us doing that.”
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.”
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