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The Legal and Practical Aspects of PI Claims – Warren Maxwell

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An introduction to Warren Maxwell

Warren Maxwell is a Partner at Stewarts Law, the UK’s largest litigation-only law firm. With over 400 staff and 80 partners, they have an international reputation for excellence, and we are delighted to be able to work with Warren Maxwell in providing this knowledgeable article.

At Stewarts, Warren works within the personal injury department and represents claimants in high-value and often complex personal injury claims. With significant experience in representing child and adult claimants with the most severe of cases, Warren is ranked Band 2 in Chambers and Partners and is described as “well versed in cases involved serious injuries arising from workplace incidents and RTAs”. Stewarts are also ranked Tier 1 in The Legal 500 with Warren noted as “at the top of his game and has a superb manner with clients and experts alike.”

When is an accident a claim?

At the outset, it’s important to recognise that accidents happen and not every accident gives the injured person a right to claim compensation.

Most of the accidents I deal with involve road traffic collisions, accidents at work or in a public area. I have also represented people injured while playing contact sports or horse riding.

In order to claim damages, it is essential to prove fault either in full or in part on another party, whether that be another driver, your employer or a contractor on site, local authority or sports player. That means being able to show that they:

  • owed you a duty to take reasonable care;
  • their conduct fell short of that duty; and
  • they exposed you to a reasonably foreseeable risk of harm.

Another consideration is whether the party who caused your injuries has insurance or other funds to meet your damages claim, and your potential legal costs. Often this is a straightforward issue, particularly with road traffic collisions and accidents at work as insurance is a legal requirement, but it can become complex. Investigations are sometimes required into cover held on household insurance policies and whether the wrongdoer has sufficient money to meet the costs of the claim personally.

I have successfully obtained damages for a number of clients who did not think they had a case so, if there is in any doubt as to whether a claim for compensation is possible, it is always best to check with a suitable lawyer.

When looking for a suitable lawyer, a useful starting point is to ensure the lawyers you speak with are experienced in handling cases involving the same type of injury as yours, for example spinal cord injury or brain injury. One way of doing this is to check whether they are accredited in that field by the Association of Personal Injury Lawyers (APIL)  www.apil.org.uk.

It is important to ask how many cases the lawyer currently handles. At Stewarts, each lawyer handles 10-12 cases at most as, in cases involving life changing injuries, it is important that no stone is left unturned in order to ensure the very best outcome is achieved for every client in terms of rehabilitation, care and damages.

Where a claim exists, the aim of the law is to put the injured person in the position they would have been in had the accident not happened, insofar as is possible. At Stewarts, our clients often have significant and lifelong needs, so that aim involves helping our clients to become as independent as possible so they can return to their previous lives as much as they are able.  We have an emphasis on ensuring our client’s quality of life is a good as it can possibly be, despite life-changing injuries.

The role of the personal injury lawyer in serious injury cases is to ensure their client recovers the maximum damages to which they are legally entitled. We do this by firstly ensuring our clients obtain the best rehabilitation and support available; introducing our client to experienced and suitable case managers as quickly as possible is the first step in achieving that aim.

How do you choose a case manager to work with your client?

Firstly, I always use the starting point that it is my client’s decision as to who they would like to appoint as their case manager.  The client is at the centre of the claim and this is integral to developing a trusting relationship, as claims usually take several years to conclude.

In our almost 35 years in practice, Stewarts’ personal injury lawyers have only represented accident victims with life changing injuries. As such. we have worked with many different case management companies and case managers across the country. Those we choose to work with are tried, tested and most importantly trusted, with excellent governance, record keeping, established working relationships with excellent clinicians in the wider MDT fields and a strong commitment to helping seriously injured people.

When choosing a case manager, I am a strong believer in the ‘meet & greet’ process. This is where clients are introduced to two or three case managers in order to decide who they wish to instruct. The case manager has to “fit” with the client, and with their family. It is important to remember that the client’s family are hugely affected by a life-changing injury to a loved one and must be included in accordance with the client’s wishes.  I am happy to attend the meeting to help guide the client through the process and ask any important questions.

This approach increases the client’s understanding of case management and the role the case manager will have in their rehabilitation journey, which in turn provides them with an informed choice. It also gives the client an opportunity to ask questions of each case manager as to their knowledge, their clinical and case management experience, and their likely approach to the client’s rehabilitation and care needs.

How important is the case manager in a serious injury claim?

Case managers have a key role in a serious injury claim. As our client’s ‘guides’ through their post-accident journey, their knowledge of suitable local care and rehabilitation providers is crucial in ensuring the right therapists are involved from the outset, and managed in the longer term. At Stewarts, we are always keen to work with talented and committed case managers and making new contacts is another benefit of the ‘meet & greet’ process.

When it comes to working with case managers, collaboration is crucial. Clients who have sustained life changing injuries need a huge amount of support and guidance in order to maximise the benefits of the rehabilitation and support package and regain as much independence as possible. The many ‘moving parts’ need attention and the solicitor can and should support the case manager if needed. Similarly, if funds are running low or there is an unexpected item of expenditure now on the horizon, the lawyer needs to know so that funds can be obtained before it is too late. It’s therefore essential that the case manager feels comfortable enough with the solicitor to pick up the phone and speak if needs be.

It can take time to obtain interim payments from insurance companies to fund the client’s care and rehabilitation package while the claim is running. Insurers often reasonably wish to understand what the funds are being spent on and feel confident that the funds will be used to to provide a real benefit to the injured party. Having the support from an experienced, knowledgeable and efficient case manager is often vital in securing the funds quickly.

Case managers are also important witnesses and I invariably take a witness statement from them to support the client’s claim. They have usually been involved with their client’s rehabilitation from the outset and have an intimate and detailed knowledge of our mutual client, their family and support network, rehabilitation and care needs, and how they have been met over the course of the legal claim.  Giving a statement on behalf of the client means it is likely the case manager will be called as a witness to give evidence at trial if settlement negotiations have failed and the issue of the damages, needed to meet the injured person’s lifetime needs, is determined. Fortunately such trials are relatively rare and most cases settle by negotiation.

It is also important that experts instructed by the parties to provide evidence to the court hear what the case manager has to say. These experts receive all of the relevant notes, records, reports and statements ahead of an assessment, but may only spend a few hours with the claimant before writing their reports setting out their expert opinion as to what a person’s needs are and what their long-term outcome is likely to be. The case manager should attend the expert meeting, or speak with the expert afterwards, to ensure nothing has been missed.

What are the pros and cons of the Rehabilitation Code 2015?

The Rehabilitation Code 2015 (“the Code”) provides a framework for the parties in a claim to work together outside of the litigation process to provide  rehabilitation and support to an injured person. The Code can be found here: Rehabilitation Code 2015

One of the biggest benefits of the Code to claimants is that payments that the other party’s insurer makes under the Code are paid on a 100% basis. Even if the claimant is subsequently found to be partly at fault for the accident, or even fully to blame, the insurers will have paid for the agreed items in full and cannot seek to recover the cost from the client.

One of the trade-offs is that the insurer receives simultaneous disclosure of the Immediate Needs Assessment (INA), the document produced by the case manager following our initial review of the injured person. This prevents the claimant’s solicitor having a first peek at the report and perhaps working with the case manager to emphasis certain parts of the INA for the claimant’s benefit. Other trade-offs are that;

  1. the case manager cannot be a witness in the claim, and
  2. the INA should fall outside the litigation and should not be referred to by the litigation experts.

In practice, the parties often agree to the contrary. That is my preference as case managers often make important and powerful witnesses. Experts also benefit from seeing the INA, as it is the very foundation of the care and rehabilitation package which will be subsequently commented upon by the litigation experts when they provide their reports to the court.

One issue that I do see arising, often after a case is transferred to Stewarts from another firm of solicitors, relates to ongoing simultaneous sharing of documents. Whilst the INA should be sent to the claimant and defendant’s representatives at the same time, all other notes and reports created during the subsequent case management process are covered by the usual legal principle in relation to disclosure of documents and medical records relating to the claimant, unless the parties agree otherwise. They should be sent to the claimant’s solicitor first; it is for the claimant’s solicitor to send them to the insurer or their representatives as the case progresses.

What does the perfect Case Manager’s file look like?

The claimant has a duty to disclose the case manager’s file notes and it is therefore essential that the file is prepared properly. Disclosure usually starts relatively early with the claimant agreeing to voluntary disclose documents on a rolling, often quarterly, basis.

When receiving documents from case managers, I expect to see all correspondence and telephone notes taking place over the relevant period. It is often also helpful to see notes containing the case manager’s thoughts and views at that time and any justifications for measures they have suggested, or input they consider appropriate. These contemporaneous records are often illuminating and helpful as, it has to be born in mind that memories fade and it may not be until some years later, when giving a witness statement or in trial, that the case manager is asked to explain why they chose to recommend a certain route to the claimant.  Documents can also be exhibited to a witness statement and are often helpful for the court.

Case management files are sometimes split into ‘privileged’ and ‘non privileged’ documents. This is helpful but case managers should not be too worried about getting this perfectly correct; it is the lawyer’s role to advise their client on which documents are privileged and should not be disclosed to the defendant’s insurer.

Carers daily records are also very important documents, which will be passed to the litigation care experts to comment upon. They need to be legible, thorough and informative. I often ask for ‘highs and lows’ to be recorded. Care is often one of the most contested area within damages, so good notes that justify the support and the benefit to the client are worth their weight in gold.

Having copies of all invoices evidencing the claimant’s expenditure allows their lawyer to keep an up-to-date Schedule of Loss, a document that it is necessary to provide if a court hearing to determine whether a further interim payment should be made is needed.

The least valuable document is a goal sheet that wallows without any update. If goals are not progressing, it’s best to explain why. This is something insurers will nearly always pick up on.

I always review the case manager’s notes and records as they give me another insight as to what is happening in my client’s life and rehabilitation. If there are particular issues that the claimant is struggling, the solicitor can often assist or bring in further support from the client’s barrister and/or experts who can work through any issues the claimant has.

When writing notes, it is best to always assume that the other party’s legal team and insurer, experts, barristers and judge may well read the document and that you could be questioned upon it.

It’s best not to refer to information contained in expert reports or recite the content of calls with lawyers of either side. Recordings of expert assessments should not be made unless asked by the parties’ lawyer and I would recommend that the case manager always check first with the expert before making a recording.

What are your five top tips for Case Managers?

  1. Talk to your solicitor; we should always be approachable and available to you. Sound us out on your thoughts for our mutual client’s rehabilitation and care. Ask us when funds are due in.
  2. Evidence your work. If it’s not recorded, then it (arguably) didn’t happen.
  3. Give us plenty of warning and lead in time. Often evidence is needed to justify interim payments and various steps may be needed before the request or application for funds can be made.
  4. Help out at expert appointments. You have so much useful information about your client’s care and rehabilitation needs that the court will benefit from hearing.
  5. Talk to your solicitor; it’s so important, it’s worth mentioning twice.

For further questions and queries contact:

Barry Lehane

RGN, LLM

Head of Case Management and Rehabilitation

barry.lehane@eucm.co.uk – 07928 511 071

Jenny Mitchell

BA (Hons), CMgr, MCMI

Head of Business Operations

jennifer.mitchell@eucm.co.uk – 07842 245 019

An electric wheelchair in an urban environment with an individual with complex needs

Complex Needs: What are these?

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The term complex needs has become an important term, referring to a mix of physical, mental, social, or environmental challenges affecting a person’s well-being. While lacking a universal definition, these needs are crucial to understand for developing effective care support systems. This article explores the various aspects of complex needs, highlighting the importance of a holistic and empathetic approach in addressing them.

Defining Complex Needs

Complex needs refer to the combination of multiple and linked challenges some individuals experience simultaneously. People with complex needs often have requirements that span their physical health, mental health, wellbeing, education, and employment. Individuals who fall under this umbrella often require a higher level of support and intervention.

Understanding the Complexity

It is important to recognise the various factors that contribute to an individual’s requirements and their complex needs. People with complex needs often face a combination of physical, psychological, and social difficulties that can include:

  1. Physical health conditions: Individuals may have chronic illnesses, disabilities, or complex medical conditions that require ongoing medical treatments and interventions. These conditions can significantly affect their daily functioning and quality of life.
  2. Mental health issues: Mental health problems such as anxiety, depression, bipolar disorder, or personality disorders can contribute to the complexity of an individual’s needs. These issues require appropriate diagnosis, management, and support from mental health professionals.
  3. Learning disabilities: Learning disabilities can affect an individual’s ability to acquire and apply knowledge, leading to challenges in education, employment, and daily living. Specialised support and interventions are necessary to address these needs effectively.
  4. Trauma and adverse life experiences: Individuals who have experienced trauma or adverse life events may have complex psychological needs. These experiences can include abuse, neglect, violence, loss, or significant disruptions in their lives.
  5. Substance abuse and addiction: Substance abuse and addiction can present complex needs that require specialised interventions. Treating the addiction while addressing any underlying mental health issues is essential for successful recovery.

The Importance of Addressing Complex Needs

Ensuring a person receives the appropriate support and resources is necessary to improve their well-being and functioning. Our highly trained and specialist care team work to understand a person’s needs and provide the best possible care for the individual.

By working to provide a comprehensive and integrated package of care, those with complex needs experience positive outcomes including:

  • Improved physical and mental health
  • Enhance social connections
  • An increased quality of life
  • Better education outcomes
  • Greater employment opportunities

How the Empowering U team work to support individuals with Complex Needs

Complex needs require a comprehensive, adaptable, and person-centred approach to address the challenges presented. Empowering U has a team of highly trained and multi-disciplined care managers, support staff, registered nurses, and nursing associates. This team provides the important know-how to design a client-specific package of long-term holistic care.

Working in line with NICE guideline (NG216), some key strategies and approaches that we employ to provide effective support include:

  1. Person-centred planning: Focuses on the person’s goals, aspirations, and strengths while involving them in decision-making processes. It empowers individuals to take an active role in managing their complex needs and promotes autonomy and self-determination.
  2. Care team collaboration: Collaboration between different care team members, such as registered nurses, mental health specialists, and physiotherapists is crucial to ensure coordinated and holistic care. Sharing information and their expertise allows for a more comprehensive understanding of needs, enabling tailored and effective support.
  3. Early intervention and prevention: Identifying and addressing early on can prevent further deterioration and improve outcomes. Early intervention and preventive measures can support individuals who may be at risk of aggravating their needs further.
  4. Continuous evaluation and improvement: Regular monitoring and evaluation of support interventions are essential to identify gaps and areas for improvement. This enables our care team to adapt and refine their approaches to meet the evolving needs of individuals.

Complex needs require a comprehensive and person-centred approach to address the challenges faced by individuals with complex needs. By fostering an attitude of collaboration, person-centred care, and collaborative support, our complex care team effectively supports and empowers each other to improve the well-being and quality of life of the individual with complex needs.

UKABIF Summit 2023 Reflection

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Monday 6th November played host to the UKABIF (United Kingdom Acquired Brain Injury Forum) Summit 2023. This event brought together key parties involved in the rehabilitation and care of individuals with ABI (Acquired Brain Injury).  

Barry Lehane RGN, LLM (Head of Case Management and Rehabilitation), Jennifer Mitchell BA (Hons), CMgr MCMI (Head of Business Operations), and Andrew Williams CMgr FCMI (Divisional Director) provide a UKABIF Summit 2023 Reflection. 

Hosted in Manchester, the UKABIF Summit 2023 had a feature rich programme consisting of 14 speakers and provided valuable insights into the latest research, treatment approaches, and support systems for those affect by a brain injury. Industry leading specialists and organisations to exchange ideas and insights into the brain injury sector. Attendees represented legal firms, case managers, rehabilitation providers, and professors. 

UKABIF Summit 2023 

A standout speaker slot was the “Experts by Experience” talk, in which three young adults shared their inspiring and triumphant stories of returning to education following a brain injury. Their victories extend beyond the physical and cognitive challenges of brain injuries; they have also confronted the demanding task of resuming their education.  

Hearing their accounts first-hand, reaffirmed the nature of the work all in audience undertake daily to support the neurorehabilitation, physical rehabilitation, and the confidence of those with brain injuries. Individuals with a brain injury are a testament to the human sprit’s capacity to overcome adversity; an underscoring of the truth that every setback bears the potential for an even greater comeback. 

Meeting various firms and individuals who represent through litigation proceedings, support an individual through rehabilitation, and support those with brain injuries was a great tool to share ideas and inspirational stories to support others. These insights and experiences offer an incredibly valuable perspective into the possibilities that lie in the present and future of rehabilitation and reintegration after catastrophic injuries, especially for younger individuals who are working towards the sake of their future. 

Looking ahead 

This unique opportunity to share a space with like-minded individuals and firms allows Empowering U Case Management (EUCM) to think about our clients’ journeys; a reaffirmation of the EUCM aim to guide our clients on a rehabilitation journey that facilitates a return to an active, satisfying life. The speakers and networking opportunities throughout the event motivated the entire EUCM team to further our mission and highlighted the importance of continued client support through their journey of recovery. A valuable perspective was the possibilities and the future of rehabilitation and reintegration of individuals following a catastrophic injury, especially for younger individuals who are working towards the fate of their future.  

Events like these are incredibly important in sharing the latest within ABI and BI rehabilitation. Empowering U greatly appreciate the opportunity to be able to attend and exhibit, listen to important topics from brilliant speakers, and meet fellow industry professionals. We have brought a lot of things back with us that we intend to implement throughout the business going forward. 

Looking into 2024, Empowering U are keen to attend this brilliant platform again. Thank you UKABIF for an amazing summit! 

The Synergy between Complex Care and Case Management

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The Empowering U umbrella encompasses Empowering U Complex Care (EUCC) and Empowering U Case Management (EUCM) in which both teams work in conjunction with one another to ensure a client with complex care needs receives the specialist care and support that they need in both the home and the community. 

Empowering U Complex Care was launched in 2014 by the Jakhu family who have over 30 years’ experience owning and operating care providers in the UK. Originally based in the West Midlands, Empowering U have gone from strength to strength and now provide complex care services nationwide through a network of tightly knit, specialist and dedicated teams of complex carers.  

Empowering U understood that to ensure the highest calibre of care and support to those with complex care needs, they needed to create a second strand to the business – Empowering U Case Management, which they launched in early 2023. The two interdependent halves of the business ensure a seamless integration of complex care and case management. 

The Role of Empowering U Complex Care 

Empowering U Complex Care takes a truly holistic approach; engineering and implementing a multifaceted package of personalised care that is constantly monitored to ensure the client is receiving appropriate support.  

Our complex care team work in tandem with one another, from the highly trained members of management to the support staff who have the skills and knowledge, this allows us to not focus on ‘what we can’t do’ but instead focus on what a client wants to achieve to enable them to lead a fulfilling life.  

Empowering U Complex Care understand the need to provide a range of services to suit all of client’s needs: 

Nurse-led Care

Our team create bespoke support plans which capture the wishes and needs of a client. For example, if a client is an in-patient, our team will work closely with the discharge team to ensure a personalised care plan is ready to go upon discharge. Through one-to-one or two-to-one support and the assignment of ‘key workers’, we ensure that a client’s needs and rights are always upheld. Knowing there is always a safe, trustworthy team to rely on, means our clients feel empowered to communicate with us easily and freely. Our nurse-led care services are provided by a specialist team and include: 

  • Catheter, Bowel & Stoma care 
  • Complex Bowel Management 
  • Tracheostomy & Ventilated care 
  • PEG (Percutaneous endoscopic gastrostomy) and JEJ (Jejunostomy) Acquired Brain Injury support 
  • Suctioning Oral and Tracheal 
  • Oxygen Therapy 
  • Epilepsy Rescue Medication – Buccal Midazolam & Rectal Diazepam 
  • NG (Nasogastric) 
  • Ileostomy (Stoma / Colostomy) 
  • Cough Assist and Assisted Cough 
  • CPAP (Continuous Positive Airway Pressure) 
  • BPAP (Bilevel Positive Airway Pressure) 
  • NIPPY (Non-Invasive Positive Pressure Ventilation) 

Our nursing team also provide Complex Care support in a household setting – all our clients are assigned key workers and are specialist providers of tailor-made care packages. We provide support for individuals with learning disabilities, mental health problems, Autistic-spectrum conditions, personality disorders, complex medical needs, and behaviours that challenge.

Personal Care Support

Personal care provides an intimate and physical care package to ensures a client is supported by a care worker with activities such as washing, dressing, general hygiene assistance, or just being there to offer reassurance and guidance if required. Our care workers aid with the following: 

  • Bathing / Showering 
  • Washing & Drying Hair 
  • Bed baths 
  • Continence & Incontinence care 
  • Toilet and Bathroom assistance 
  • Oral Hygiene 
  • Shaving, Hair & Beard Care 

Learning Disabilities and Behaviours that Challenge

We understand the importance of inclusion and belonging within the community, and for clients with learning disabilities we fully embrace the vision of social inclusion. Working closely with relevant learning disability providers, current care providers, and other professionals to ensure we align our service to the exact needs.  

  •  A client with a behaviour that challenges is supported through encouraging positive risk taking and we implement positive behaviour management strategies with individually tailored re-enablement packages. As a licenced Maybo provider with accredited in-house trainers, our staff learn conflict and de-escalation techniques that also enhance the provision for clients with challenging behaviours. 

Transition Services

We can help to guide the young person, their family and all professionals involved with current care to ensure that the progression from childhood to adulthood is as smooth and trouble free as possible. Clarity during this time is vital, therefore, we will always be on hand to discuss any concerns or fears you may have and can offer support, guidance and direction to the correct sources of information.

Reablement

A short-term care package that allows a client to regain the ability to carry out day-to-day tasks or activities independently; ranging from daily domestic tasks to personal hygiene routines. Our specialist support staff have very intention to get a client back on thier feet. They will thoroughly assess the situation, needs and requirements, and work closely with the client or family members & friends to develop a detailed objective driven plan that aims to be achievable yet realistically tailored to your a client’s individual needs.

Respite and Occasion Care

We ensure that loved ones are being taken care of at the highest standard, which provides you with the reassurance that you need to allow yourself to take a break. Occasion care is the support and care required to enable you, or a loved one, to attend that special event. It doesn’t matter the event; Empowering U will provide trained and experienced care professionals to enable you to attend the event safely and in comfort.

Empowering U Case Management 

Empowering U Case Management have a team of 10 experienced case managers who provide clinical support and practical help to clients and their family whilst they navigate the litigation process. Our Case Managers are based throughout the country, and clients are matched with Case Managers based on proximity and specialist skillset. As a member of the British Association of Brain Injury and complex Case Management (BABICM), Empowering U supports both claimant and defendant parties through their litigation process and as such, have become a trusted partner for many Personal Injury Solicitors, Financial Deputies, and healthcare professionals throughout the UK. 

All of our Case Managers are registered with their own individual professional bodies and work to the code of conduct as specified by BABICM and Case Management Society UK (CMSUK), also following the Rehabilitation Code (2015). As part of Empowering U Case Management’s approach, our Case Managers will meet with a client, on a free no-obligation basis, to ensure both parties are the right fit with each other.  

The synergy between Empowering U Complex Care and EUCM elevates our capacity to provide exceptional, compassionate, and personalised care and case management for those with complex health needs” notes Jennifer Mitchell CMgr MCMI, Head of Operations.

Barry Lehane, RGN, LLM, Head of Case Management and Rehabilitation adds, “Empowering U is comparable to a tree – everything is under the one “tree” with all the branches leading back to the trunk. It means Empowering U Complex Care and Empowering U Case Management can work hand-in-glove to optimise the client’s journey, rehabilitation and quality life.

Empowering U Case Managers function as intermediaries, bridging the gap between clients and healthcare providers, facilitating access to the appropriate services and resources. Moreover, they serve as staunch advocates, ensuring that patients receive care that is both judicious and cost-effective. The purview of case management extends beyond healthcare, encompassing social services, mental health support, and even legal advocacy, contingent upon the unique needs of the client. 

The Symbiosis of EUCC and EUCM 

      1.    Comprehensive Assessment: The collaboration commences with a meticulous assessment of the client’s needs. Complex care teams understand the medical and psychological requirements, while case managers involve themselves into the broader social determinants of a client’s rehabilitation needs, including working with architects and contractors for housing, finding suitable transportation, and encouraging financial stability. This all-encompassing evaluation provides the bedrock for the creation of a meticulously tailored holistic care programme. 

      2.    Care Coordination: Complex care teams work with case managers to align medical treatment regimens with the broader social and emotional support. This ensures that the client’s rehabilitation journey remains unencumbered, transcending the constraints of medical appointments to encompass the acquisition of essential social services. 

      3.    Communication and Advocacy: Case managers function as the client’s unwavering advocates, transcending the complexities of medical terminology to ensure that clients and their families possess a thorough understanding of their rehabilitation. Case managers liaise with healthcare providers to guarantee that the client’s preferences and needs are upheld and respected. 

      4.    Preventive Measures: In concert, complex care and case management place a significant emphasis on preventive care. By skilfully addressing not only immediate health concerns but also the social determinants of health, they aim to mitigate the exacerbation of chronic conditions and reduce in-patient instances. 

      5.    Continuity of Care: The partnership between complex care and case management fosters a continuous trajectory in the client’s rehabilitation journey. 

From the client’s point of view, this symbiotic in-house relationship offers a myriad of advantages. It translates into a personalised programme, where their multifaceted care requisites are sensitively addressed. Furthermore, a client’s family is brought into the loop with every step of the journey, enabling all parties involved the chance to input on the rehabilitation of a client. 

How do Case Managers Reduce the Stress of a Client and Family?

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Overview

According to the Mental Health Foundation, at some point last year, 74% in the UK noted that they felt stressed and unable to cope. At the most basic level, stress is the body’s responses to pressures in life or situations and this varies greatly from person to person; it could be a breakdown in a relationship or a traumatic life-changing injury.

Stress Awareness Day 2023 takes place on 1st November. In this article we explore the crucial role that case managers play in reducing the stress and anxiety of all parties involved in a clinical negligence or personal injury claim, acting as intermediaries and an important representative. They not only represent the client and their wishes but liaise with lawyers, during litigation proceedings, through to healthcare providers, and architects.

Case Managers are introduced into a client’s journey from the outset of litigation, coordinating with defendant or claimant parties to ensure the right care and support is found for the client. From initial contact, a case manager will work with the other health and social care professionals to ensure the smooth running and co-ordination of a multi-disciplinary team, allowing a client’s needs to be met whilst supporting the family at the same time.

Managing stress in the early stages of an injury claim

A true appreciation of the client’s difficulties is crucial for a case manager in the initial stages. As many of the cases they are involved in are complex, their expertise is essential in linking the most suitable and cost-effective resources and services to a client, maximising their quality of life, and meeting their needs.

These initial stages are the most important for a client and their family and often the most stressful. Not only are they having to deal with the legal aspects of their case but also the emotional and life-changing side of it. Depending on how long the duration of a case is, the stress of the situation can be overwhelming, therefore, it is crucial the case worker has a rapport with the client, family, and legal team. They can help ease the burden through understanding of the case and by proposing a suitable rehabilitation plan.

Case Managers Role in Client Rehabilitation

Within 21 days of starting the claims process, an appointed case manager will assess the client, their needs, the wishes of the family, whilst following the Rehabilitation Code 2015. Through a thorough assessment, the case manager will construct a rehabilitation plan that encourages the most suitable medical, social, occupational, psychological, and physical recovery.

Once this plan is in place and agreed, it can be implemented. Just as each client and their needs are unique, so too is their rehabilitation plan; one client requiring hydrotherapy sessions, whilst another may require an assessment for a prosthesis.

A sturdy rehabilitation plan and a hardy case manager promotes a sense of calm throughout all involved within the case. Their comprehensive knowledge encourages a supportive atmosphere, something the Mental Health Foundation Research Report notes; a strong network of supportive individuals promotes practical advice that supports the reduction of stress. Case managers will be with the client and family throughout the litigation process and rehabilitation journey and in having a close-knit connection, a case manager can be the shoulder to lean on when things get hard, they can be the key-factor in saving a familial relationship after a traumatic incident, and they are often regarded as a friendly face when things get tough – in some cases a life saver.

How Case Managers can reduce their own Stress

It is essential that an understanding of the stress that we go through as individuals differs immensely with the stress families and individuals go through following a catastrophic injury” comments Barry Lehane, RGN, LLM (Head of Case Management and Rehabilitation).

Barry continues, “As an organisation, we support our case managers to understand and contextualise this stress and embrace the concept of ‘a problem solved is a problem halved’. We achieve this through regular supervision and ongoing contact with our case managers.

Everyone knows the correct pathway for broken bones – reset the bone, fit a cast, wait some time, and on to physiotherapy. However, mental health does not have a rulebook to fixing and healing; akin to case management, every person is different. Case Management is not an easy job. The empathetic and challenging work they do in supporting others often leads to an inattention of their own wellbeing and this is especially important when it is not just one case they are working on; it is often multiple – higher caseloads often equates to higher stress levels.

I’ve learned the importance of maintaining a healthy work-life balance to manage and reduce stress. Unlike in my earlier roles, where I would work for extended hours without taking breaks, I now ensure to combine my workload with much-needed pauses. If a task is getting too stressful, stepping away from the computer for a few moments allows me to regather my thoughts and return to work feeling refreshed” mentions Jenny Mitchell, BA (Hons) CMgr MCMI.

She continues, “Aside from these personal practices, I’ve completed a Level 2 certificate course in understanding mental health first aid and workplace mental health advocacy. This training has not only equipped me with the knowledge to recognise signs of stress in myself but has also enabled me to support and guide my colleagues through their stress handling mechanisms. This comprehensive approach towards managing stress has been effective for my mental well-being, making me feel more balanced and in control”.

There are multiple ways a case manager can implement methods to help reduce their stress level:

  • Understand the source of the stress – Stress comes in many forms, and it is always easier said than done to consider a trigger, however, understanding the cause of stress is often the best remedy and can help to alleviate this. Some factors that can trigger stress are organisational, interpersonal, personal, environmental.
  • Practicing self-care – This is essential for any individual working in an environment where there is a lot of pressure such as case management. Working to maintain the physical, mental, and emotional health through exercises such as eating well, sleeping enough, exercising regularly, and doing hobbies work towards reducing stress levels. Self-care also involves setting boundaries, delegating tasks, regular breaks, and saying no.
  • Seeking support and supervision – Seeking out the support from colleagues, mentors, managers, and peers can provide feedback, advice, and validation. These not only help to reduce stress levels through socialisation, but they can also provide vital support when working through complex cases.
  • Celebrating achievements – Case managers will often focus on the problems and difficulties of their clients and their role, sometimes leading to frustration and discouragement. However, it is important to celebrate successes and achievements. Acknowledging your efforts and consequently rewarding yourself for these, sharing stories, and receiving feedback are all good ways to improve self-esteem and in-turn reduce stress levels

The list is not exhaustive but offers methods to help reduce stress levels.