CPIMS provide case management services to individuals who have suffered an injury or illness including specialist rehabilitation services for individuals who have suffered a catastrophic neurological injury. Rehabilitation is a process of assessment, treatment and management with ongoing evaluation by which the individual (and their family/carers) are supported to achieve their maximum potential for physical, cognitive, social and psychological function, participation in society and quality of living.
Key aspects of rehabilitation care include multidisciplinary assessment, identification of functional difficulties and their measurement, treatment planning through goal setting, delivery of interventions which may either effect change or support the person in managing persisting change, and evaluation of effectiveness . Supported by our clinical governance framework, our case managers utilise the latest evidence base to safely achieve the best possible outcomes providing individual care for individual people.
CPIMS use a proactive multidisciplinary approach, underpinned by evidence based and outcome focused goals and strategies. We ensure that national standards and care regulations are met, providing clear structured support for individuals, their family and significant others. The purpose of rehabilitation is to restore some or all of the patient’s physical, sensory, and mental capabilities that were lost due to an injury, illness, or disease. Rehabilitation includes assisting the patient to compensate for deficits that cannot be reversed medically. Rehabilitation is effective for many types of injury, illness, or disease, including amputations, neurological problems, orthopaedic injuries, spinal cord injuries and traumatic brain injuries.
Rehabilitation case management integrates injury and claims management in a clinician-led, multi-disciplinary approach in delivering a safe, robust recovery and return to work and a collaborative approach is key to ensuring effective outcomes. Rehabilitation can reverse many disabling conditions or can help patients cope with deficits that cannot be reversed by medical care alone. Rehabilitation addresses the patient’s physical, psychological, vocational and environmental needs; it’s an holistic approach that puts the individual at the centre of the process. It is achieved by restoring the individual’s physical functions and/or modifying their physical and social environment. The main types of rehabilitation are physical, occupational, and speech therapy. Each rehabilitation program is tailored to the individual patient’s needs and can include one or more types of therapy.
The case manager usually coordinates the efforts of the rehabilitation team, which can include physical, occupational, speech, or other therapists; nurses; occupational therapists; physiotherapists; housing needs specialists; psychologists; orthotists; prosthetists (makes artificial limbs or protheses); and vocational counsellors. Family members are actively involved in the patient’s rehabilitation program.
The Rehabilitation Code provides an approved framework for personal injury claims within which the claimant’s representatives and compensators can work together. Whilst the Code is voluntary, the Personal Injury Preaction Protocol provides that its use should be considered for all types of personal injury claims. The objective is to ensure that injured people receive the rehabilitation they need to restore quality of life and earning capacity as soon as possible and as much as possible.
The important features of the Code are:
- The claimant is put at the centre of the process.
- The claimant’s lawyer and the compensator work on a collaborative basis to address the claimant’s needs, from first early notification of the claim and through early exchange of information.
- The need for rehabilitation is addressed as a priority. Time-frames are set out in the Code.
- Rehabilitation needs are assessed by independent professionals with appropriate qualifications, skills and experience.
- Initial rehabilitation assessments can be conducted by telephone or personal interview, according to the type of case. The resulting report should deal with matters specified in the Code.
- The parties may consider whether joint instruction of rehabilitation assessor and provider would aid collaborative working and be in the claimant’s best interests.
- The claimant has the ultimate say in choice of case manager, and is not obliged to undergo treatment or intervention that is considered unreasonable. A guide to appointing and working with case managers accompanies this Code, but is not part of it.
- The case manager should seek proactively to co-operate with treating NHS clinicians.
- The compensator will pay for any agreed assessment of rehabilitation needs, and must justify a refusal to follow any of the rehabilitation recommendations.
- Initial assessment (including the Triage Report for lower value injuries) is outside the litigation process .
- Where rehabilitation has been provided under the Code, the compensator will not seek to recoup its cost if the claim later fails unless fraud or fundamental dishonesty can be proven.
- The Code recognises that lower value claims (typically < £25k) have different dynamics, and that there will sometimes be a medical need for claimant solicitors to arrange treatment before getting agreement from the compensator. In these circumstances, the compensator is not obliged to pay for treatment that is unnecessary, disproportionate or unduly expensive.
- In the interests of streamlining the process, most lower value claims will require a Triage Report only.
- It is the intention that the parties adopt the principles of the Code beyond the Immediate
The rehabilitation process will provide a clear understanding of:
- The assessed needs of the client
- The goals or outcomes to be achieved, with clear understanding of same between all stakeholders
- The proposed interventions and strategies to address identified barriers to recovery and return to work
- Clearly identified roles and responsibilities of the key stakeholders in supporting recovery and return to work best outlook
- Transparent and realistic timeframes for achievement
- Periodic review, evaluation and reporting on the progress and on-going effectiveness of case management for each case
- Transparent and accurate costs, focusing on quality case management
Plans are developed through a collaborative approach and agreed by all parties e.g., the injured person, the treating medical practitioner, the employer and the insurer. This ensures that all parties are working towards the same outcome and have a clear understanding of the actions required to achieve that outcome.
CPIMS case managers have specialist training and a wider understanding of working with individuals with complex care needs. As advanced practitioners, our case managers are proficient at collaborating and formulating multidisciplinary programmes through a partnership approach including allied healthcare agencies and the NHS. Our experienced practitioners coordinate a wide range of medical opinions to formulate a person centred and cohesive rehabilitation programme.
1. Specialist neuro-rehabilitation services: providing for patients with complex rehabilitation needs. London: British Society of Rehabilitation Medicine. 2010.
2. NICE guidelines [CG162] Published date: June 2013
3. BSRM NUMBER 10: Long-term neurological conditions: management at the interface between neurology, rehabilitation and palliative care
NATIONAL GUIDELINE 2008
4. NHS England commissioning guidance for rehabilitation 2016
5. The 2015 Rehabilitation Code