Over 90% of case managers in the brain injury field would recommend their career to others – and more than seven in 10 say they enjoy their job.

This is well above the UK national average and on par with the satisfaction levels found among the clergy, teachers and chief executives, says Nockolds Solicitors.

It is also in stark contrast to members of the legal profession, with whom case managers work closely, finds separate research.

Over half of personal injury solicitors say they would not recommend their line of work to others, reports Exchange Chambers.

Angela Kerr (pictured) is the chair of BABICM (British Association of Brain Injury Case Managers), which has over 700 members in the UK. She is also managing director at Nottingham-based AKA Case Management.

Being able to work closely with clients, and contributing positively to many difficult, individual situations can be life-affirming for case managers, she believes.

“Case managers support their clients to overcome life changing injuries, working individually with them to access services unique to that individual’s needs. The closeness of the relationship that develops over a long period of time allows case managers to see the value they can bring, to each and every person they work with.

“Generally, positive outcomes are achieved albeit over many years. Case managers ride the rapids of a client’s recovery through the highs and lows which enables them to connect closely and build trust with them.

“Support is also offered to families, allowing them to develop an in-depth understanding of the situation and adjust to the limitations of the client’s disability.”

Kerr said these relationships develop over a long period of time – as a case manager, she is still working with clients 15 years on from appointment – allowing a deep bond to develop between all parties.

“In many ways your aim is to work yourself out of a job, and that’s fine, as the aim is for your patient to regain as much independence and where possible, for them to get to a certain level requiring minimum help.

“Your role then becomes one of adding value to their lives as they overcome the challenges they face. It’s a very rewarding professional life,” she added.

The job satisfaction findings come in a Nockolds Solicitors paper; ‘The Challenges Case Managers Face in Order to Achieve the Best Possible Outcomes for their Clients’. Meanwhile Exchange Chambers finds 56% of solicitors would not recommend a career as a personal injury/medical negligence specialist to others.

Bill Braithwaite (pictured), QC, head of Exchange Chambers, said: “The reason so few personal injury solicitors would
recommend their career to someone else is that so many of them aren’t involved in really satisfying work.

“Much personal injury litigation is low value, high volume, which may produce lawyers’ profits, but certainly doesn’t look like a worthwhile career.

“Case managers, on the other hand, are undoubtedly setting out to achieve something of real value for people who need all the help they can get.

“In my world of catastrophic brain injury, which is where case managers started – I lectured at the first public meeting of BABICM in 1996 – the first thing a good lawyer will recommend, if money is available, is the appointment of a specialist brain injury
case manager.

“If the patient is lucky enough to have a good case manager, he or she will achieve an enormous improvement in condition and prognosis, and will help to make rehabilitation and later life a much more enjoyable experience for the patient and the family. “Why wouldn’t you recommend that career to someone else?”

Rachel Davis (pictured below), a serious injury specialist at Nockolds Solicitors, said: “I expect the big difference is down to the fact that case management is about assessing a client’s needs and improving their quality of life through care and rehabilitation, while personal injury lawyers deal with the litigation side, the defendants and the costs regime – it can be very frustrating at times.”

Stresses exposed; Further research required

Both pieces of research also highlight the stresses that surface in the relationships between care managers, clients, client’s families and personal injury solicitors. Exchange Chambers’ Case Management Process Survey found 56% of claimant solicitors have sacked and replaced the case manager during the course of their client’s recovery process. Also, over three-quarters of claimant solicitors say they have experienced a situation where the family has not acted in the best interests of their seriously injured relative.
Rachel Davis

In more positive findings, 73% of solicitors say case managers always act in the best interests of the client. However, the Nockolds Solicitors survey found that 81% of case managers have experienced a situation where a claimant solicitor has ‘clearly not acted in the best interests of the client’.

It reports the biggest headache for case managers is the rate at which funding is released; while also finding that over two- thirds of case managers have been verbally abused by their client or client’s family and 13% have been physically attacked.

Braithwaite said: “The themes emerging from this research can act as a catalyst to improve the whole claims and rehabilitation process. “An open dialogue between all parties needs to start now. Serious issues need addressing. Everyone must act in the best interests of the injured person, otherwise the whole system breaks down.”

Davis concluded: “There is clearly a perception that family members, solicitors and case managers are, on occasions, not acting in the best interests of the injured person.

“Whether this is intentional or not, there is simply no excuse for not putting the injured person first. It is particularly worrying because in serious injury cases, traumatic brain injury for example, survivors are likely to have complex long-term problems affecting their personality, their relationships and their ability to lead an independent life. They are extremely vulnerable and often dependent on the support of those around them.”

Commenting on the role case managers play, Braithwaite added: “I’ve always thought that a good case manager was the key to a successful outcome for the injured person, the family, and the compensation claim.

“If you appoint a good case manager early, and that person has the ability to get to know the family, gain their trust and confidence, and help to manage the stormy voyage through recovery and rehabilitation, that person will be an invaluable contact point for the solicitor, frequently helping him or her to avoid disturbing and distressing the family.

“So much of the litigation is bound up with the injured person and the family, and the plan for life, that it seems to me to be obvious that the case manager should be involved in some part of the litigation process.”
Kerr described the research as interesting, “having triggered many questions”.

She continued: “We have spoken to Exchange Chambers in acknowledgement of its research which is adding to the conversation between professionals.

“The survey is interesting, although we would not necessarily support its findings and would like to develop a more validated hypotheses in conjunction with BABICM’s research partners at Plymouth University.”

She went on to say members of the BABICM council had not been approached to participate in the research and felt further work was needed to more accurately quantify the value of case managers.

She also explained that BABICM was looking to establish a regulatory body in conjunction with the other professional bodies involved in case management work.

Braithwaite summarised that the surveys show there is room for improvement in managing the relationship between case managers and personal injury solicitors.

He continued: “Moving forward, the starting point for me would be to ensure that personal injury lawyers are truly expert in what they do. “Since time immemorial, personal injury has been an area of work that many or most lawyers think they can manage alongside their other areas.

“I’ve found, over more than a quarter of a century, that true specialisation really works; clients appreciate the knowledge that you bring to their problem, and the whole rehabilitation and litigation process is much better managed.

“That expertise in the lawyers would naturally lead them to appreciate good case managers and recognise bad ones. That would lead to more scrutiny of what case managers do, and so raise the standards.

“Equally, good case managers would – as they do now – help the family to identify the non-specialist or inappropriate solicitor or barrister and support them in finding a good alternative.

“Developing the relationship between the two professions, and enlarging their knowledge, would inevitably improve standards.”