The COVID-19 pandemic has forced huge changes within case management and the traditional ways in which clients have been supported. In our continuing series of Q&A features with case managers across the country, Martin Gascoigne of Neuro Case Management UK (NCMUK) shares his experiences.
Can you summarise how the past few months have been for you.
The past few months for NCMUK have been extremely challenging. This is due to the Government initially ring fencing all of the PPE supplies for NHS staff which made it very difficult for us to procure the necessary equipment. Also, due to our Paediatric Clients Parents furloughing, we have experienced different challenges with the type and level of care that they felt they would like us to provide whilst still working in accordance with National Minimum Standards.
How did you adapt to the restrictions of lockdown? Were you able to do this quickly or did it take a bit of time?
We managed to adapt to all of the new guidelines effective immediately as we were informed by the Government that failure to conform with these would mean that we were no longer able to deliver the care needed. NCMUK therefore reassigned staff to new roles to deal with the new daily/weekly challenges set, identifying new sources of equipment provision, medication and standards of care.
What have been the main challenges – were you able to overcome them?
The main challenges we found were that of procuring PPE at a clinical level. Unfortunately we could not identify or purchase any in the UK and so in order to overcome this it was necessary for us to establish a regular supplier overseas who was able to both meet our needs and the needs of our clients.
Has the use of telerehab been of benefit to you?
NCMUK has indeed benefited from digital technology including Zoom and Facetime. During this period of lockdown, telephone calls and digital contact was the only way the case managers/directors could maintain a high level of communication with our suppliers, clients and families.
At this time we also relied on a digital marketing organisation which made sure that our company stayed at number one on page one with Google. This meant that we could maintain our on line presence and as a result of this we would benefit from new referrals which continued to keep us busy.
How have your clients responded? Was it difficult for them to adapt to?
Our clients did find it difficult just understanding the pandemic initially, as we all did, with the obvious additional worries that they would be infected by our carers. This concern, however, was alleviated as the NCMUK team provided all care in a fully barriered manner using face masks, aprons, gloves and hand wash following the Government guidelines set.
Do you feel the lack of face-to-face contact with clients or/and colleagues has been damaging?
Our carers have been continuing to attend their home visits following the correct guidelines throughout the pandemic. This meant that they continued to have face to face contact. New links have been established via digital marketing and Zoom calls but this has been a positive addition to our communication network and as we already undertake telephone reviews with our staff, there was no change to our relationship with our colleagues.
How central do you think the use of telerehab will be for you going forward?
The demand for digital technology going forward should mean that we can develop a better working practice combining the face to face home visits and the human side of our meetings/assessments alongside digital meetings. This has the benefit of reducing the carbon emissions of our team, whose level of travel is reduced.
How do you think the future of case management has been shaped by the pandemic?
The NCMUK team will have the opportunity now to work more from home, allowing them to complete basic administrative tasks within their own environment, thus reducing emissions due to unnecessary travel.
It will also mean that when completing some assessments, these can be carried out via Zoom/Facetime meaning that more out of reach areas throughout the England/Wales can be contacted more easily. It has been necessary for us to think of alternative methods of communication moving forward and these will probably be maintained in the future as they have been a success.
Will you be doing anything differently within your business going forward, compared to your working practices pre-pandemic?
The pandemic has changed our business considerably as we are all now working more from home with the benefit of our staff reducing their overall carbon footprint. This will continue and streamline the industry as there will be more work undertaken on a virtual basis as staff are able to complete the basis administrative tasks within their own home environment in lieu of travelling to the office. It will also allow NCMUK to have clients referred to us who live in more inaccessible areas of the England/Wales which should provide more people access to more services.
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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