Rehabilitation Brain injury cases
The Major Trauma Pathway was launched in 2010 with the recommendation that rehabilitation was a key concern. “Every patient admitted to a Major Trauma Centre should have their rehabilitation needs assessed and documented through a Rehabilitation Prescription”.
The background to this development was that the Clinical Advisory Group on Major Trauma, headed by Derek Wade, produced a report of September 2010 recommending the use of a Rehabilitation Prescription, In fact, what was envisaged was more a set of standards rather than an actual prescription. What was clear, however, was the need to ensure a cohesive focus on the patient’s longer term recovery.
Fantastic early NHS intervention needed to be followed through in the rehabilitation phase, and the best way to do that is to have a strategic and cohesive focus of the individual patient and their particular needs. Having such a document or list of recommendations would be tremendously beneficial to GP’s to inform them and their patients.
This was clearly a very welcome development and offered the chance of truly focus on the rehabilitation needs to the patient, and so too their long-term recovery. The purpose of a Rehabilitation Prescription was to make recommendation as to how the patient’s needs should be met following discharge from acute trauma services. Those with complex needs should have a more specialist Rehabilitation Prescription; in particular, those having highly complex needs, which require further specialist in-patient rehabilitation.
This idea was certainly a very helpful development for those patients coming out of the designated major Trauma Centres. For those with litigation, a client discharged from such a hospital or indeed in hospital but being moved to a different facility could refer to this Rehabilitation Prescription when considering support from a defendant insurer. This would provide and objective analysis of those needs, which would surely assist in establishing care and other therapy needs for those with complex and major traumas.
The idea of having one comprehensive document put together by specialist clinicians who were independent of any litigation process could therefore be a very positive one.
Obtaining an immediate need assessment report is clearly the aim of every PI lawyer at the start of any catastrophic injury case, but if there are no funds available to meet the cost, then the Rehabilitation Prescription may be one way forward, at least in those very early stages. Such Rehabilitation Prescriptions are unlikely to be seen to be used instead of immediate needs assessment, but could be objectively important and could potentially help to satisfy an insurer of that claimant’s needs.
Difficulties
There are problems, however. The United Kingdom Acquired Brain Injury Forum (UKABIF) recently requested information as to the use of Rehabilitation Prescriptions for patients discharged with an acquired brain injury in five Clinical Commissioning Groups (CCGs). The response rate was relatively low, and there were reports that Rehabilitation Prescriptions are rarely copied to patients and their GPs.
There have been concerns raised that the Rehabilitation Prescriptions are not monitored or followed up, and the suggestion is that CCGs themselves need to be educated as to patient pathway for rehabilitation. When funds are so short, as was clearly evidenced in the news recently, it is clearly a need that can prove more difficult to find funding for.
If possible, the Rehabilitation Prescriptions ought to be extended to all those who do have an acquired brain injury, as well as other catastrophic injuries; and not just those who have been through a Major Trauma Centre. The needs of those will be no different, and the more widespread the Rehabilitation Prescription is, the more change is likely to happen.
There are also concerns that the Rehabilitation Prescription is not being transferred between services. Nor is there a reliable way of tracking patients that have moved through the pathway, and without a central notifying system of administration, tracking this is difficult.
It is, however, a useful document for personal injury practitioners to know about. Patients in Major Trauma Centres should be asking for their Rehabilitation Prescription. That, at the very least, will assist in persuading defendant insurers as to the severity of the injury, and at least some rehabilitation that those particular patients require.
That could move insurers to agree to such rehabilitation which, even if not available within the NHS, would, of course, be available privately.
Speak to a solicitor about making a claim.
