Case management

The new body created to hold a publicly-accessible register of case managers  - the Institute for Registered Case Managers (IRCM) - is aiming to open registration for case managers later this year, in a major stride forward for the profession. 

The IRCM has developed strongly since its inception almost two years ago, with significant time and effort invested from its leadership team and the case management community in helping to shape its future. The body is being established to focus on standards for case managers, bringing new levels of accountability and endorsement to the profession, for the protection of clients and assurance of their families, authorities and commissioners. 
And now, the IRCM - created jointly by the British Association of Brain Injury and Complex Case Management (BABICM),
the Case Management Society of the UK (CMSUK) and the Vocational Rehabilitation Association (VRA) - is looking to open registration for case managers soon, with the target of accreditation  by the Professional Standards Association (PSA) remaining on track for 2023. 
It is also building a supporter community, which now comprises stakeholders from across case management and associated sectors, with the IRCM particularly keen to add the support of more personal injury lawyers, law firms and Insurers. 
While its public profile continues to grow, work continues in the background to ensure its application to the PSA is as comprehensive as possible before submission. Once registered, the IRCM will develop a voluntary register of registered case managers, endorsing their capability to practice.
Angela Kerr, chair of IRCM, said the hard work and co-operation of individuals and organisations from across the sector has enabled it to progress at the rate it has.
“We have a very clear plan and that is what we are all working to deliver, and I must say it is going really well,” she said. 
“A big part of it has been getting the right team in place, which extends through our sub-groups and all of our volunteers and
those who have shared feedback and insight,

and we’ve had fantastic support for which we are very grateful and extend our thanks.
“People have been so engaged and our supporter community, which is growing all the time, have been excellent. The engagement from the start has been brilliant. 
“We are hoping registration will open in by the end of this year , which is really not long, and that we will submit the application to the PSA towards the end of this year also . We’re working hard on that behind the scenes. 
“But what is so important to us in what we are creating is that the public and commissioners are aware of IRCM, our goals and our reasons for doing what we’re doing. 
“This has been a huge task, probably bigger than I envisaged it would be, but the fact we have such a great team of people with us on this journey is wonderful.”
The IRCM is seen as a huge step forward in the professionalisation of case management and its greater recognition - but awareness among those who need to know is fundamental, says Angela.
“What we really need to do is make sure the public and commissioners are aware of the work we’re doing and what being a  registered   case manager means ,” she says. 
“That’s probably our next challenge, to make sure all of those people who need to know about the IRCM, do know about us. 
“By the process of registration, case managers demonstrate competence against case manager specific standards and their commitment to providing quality case management , which gives a greater level of assurance. There has never been this level of accountability within case management, so it’s a very big step forward. 
“A very small percentage of the population will encounter a case manager, but for those who do, we want them to know the stringent standards they are working to as a registered case manager. That is very important in giving protection to clients and reassurance to commissioners. 
“A big part of this awareness is growing our supporter community further and encouraging more of those who commission our services to be part of what we are creating.”

Belonging and allyship -
how can you achieve this?

A sense of belonging is vital to a person’s psychological health and to the function of our society as a whole. But why does this so often not happen? What can we do to play our role in achieving this, and supporting those who do not feel that sense of belonging and allyship?

Dr Shabnam Berry-Khan, clinical psychologist, case manager and director of PsychWorks Associates, discusses this hugely important topic, which continues to adversely affect so many minorities in the UK and around the world.
October is Black History Month here in the UK. In this month, we are reminded to promote and celebrate Black contributions to our British society and to foster an understanding of the impact of Black history on the UK today. 
While this month originates from Negro History Month in the US from as far back as the 1920s, Black History is not just an American thing. You do not need to dig too far to learn that British history also has a significant part to play in slavery and the poor treatment of Black people since.

You also do not need to think too hard to appreciate that this month is not the only month in which we can reflect on Black history. Indeed, Black history plays a part in modern Britain every day. With recent acknowledgments about unconscious bias, institutional racism, disparities in health and justice service treatment and outcomes for the worst, and modern policies that have seen people sent "home" (aka Windrush), the Black experience is not really historical so much as current. In fact, this Black History Month’s theme is ‘Time for change: Action not words’. Perhaps this statement can be seen as a clue about the state of play today.
However, this article is not meant to be about Black History Month per se, but it does provide a convenient backdrop for the real topic that I want to raise here: belonging. Fitting in. Feeling like a member of a group. An affinity for a place or situation. A secure bond. A safe place.
Let's do a little thought experiment: imagine the last time you went on holiday abroad to a country where people looked different to you, ate different foods, wore different clothes, where you had to learn how to navigate a new area, and they spoke to you in a language that you didn't fully understand and they didn't speak your mother tongue. How did you feel? 
Hold that thought.  As I'm writing this, I am fully aware that some of us will have to use our imagination because English is a first language and a lot of the world can speak some English. What a privilege. 

Breakthrough - paving the future of case management 

As a forward-thinking new business in the sector, Breakthrough Case Management is a driver for change. Here, Breakthrough discusses its commitment to innovation and best practice, while never making change for change’s sake

When you are looking for a case management company, you need a safe pair of hands.
Do they have the right specialist expertise and an ability to deliver what you need – when you need it? At the same time, you also want a case management company that is innovative. Do they explore new approaches or just stick to the same outdated technology, tools and ways of doing things?
The reasons for seeking a case management company are varied. You or a family member might need guidance and support following a life-changing injury. You might be looking for a job as a case manager to start or progress your career. Or you might be a solicitor requiring a case management company to support your clients.
Whatever your motivation for seeking a case management company, with Breakthrough you can be confident we have the knowledge and experience you need. But equally, we are trailblazers.

Everything we do is focused on getting results for our clients, our partners and our team – whether it’s ground breaking rehabilitation technology, the latest case management and care software, inventive in-house training programs, or inter-disciplinary knowledge sharing.

Building trust in case management
Trust is fundamental in the relationship between a case manager and a family who has experienced a traumatic injury. There needs to be complete certainty we have our client’s best interests at heart and we’ve got their back. Experience and the backing of an established case management company is the foundation this trust is built on.
The co-founders and directors of Breakthrough Case Management and Breakthrough Care, Annabelle Lofthouse and Catrin May, are registered nurses with significant experience spanning over 30 years in healthcare. 
In addition, they have both spent over a decade in complex case management and complex care support. Annabelle and Catrin work with a team of experienced case managers from a wide variety of clinical disciplines, supported by an operations team that ensures everything happens how and when it should do.
We are a relatively new company with a highly experienced team. Our clients can be confident they receive the best possible case management, rehabilitation, care and therapy.

Building trust in case management
Trust is fundamental in the relationship between a case manager and a family who has experienced a traumatic injury. There needs to be complete certainty we have our client’s best interests at heart and we’ve got their back. Experience and the backing of an established case management company is the foundation this trust is built on.
The co-founders and directors of Breakthrough Case Management and Breakthrough Care, Annabelle Lofthouse and Catrin May, are registered nurses with significant experience spanning over 30 years in healthcare. 
In addition, they have both spent over a decade in complex case management and complex care support. Annabelle and Catrin work with a team of experienced case managers from a wide variety of clinical disciplines, supported by an operations team that ensures everything happens how and when it should do.

We are a relatively new company with a highly experienced team. Our clients can be confident they receive the best possible case management, rehabilitation, care and therapy.

Innovative approaches to case management
With a long-established business, there is a risk of complacency and resistance to change. Recent history shows it is often the young businesses that bring new and innovative ideas to a sector. 
Apple, Google and Facebook were all early adopters, launching previously inconceivable new products and ways of working into the tech space. Mobile-only banking innovators, such as Monzo and Starling, have changed financial services forever. They all paved the way for other companies to follow.
As industry leaders, we adopt a similar mindset to get the best for our clients. We are always looking for opportunities and
ways to improve. Big or small. Constantly asking the ‘what if?’ questions with an unrelenting focus on results. 
This includes:
> Bringing our staff training in-house and recruiting a new head of clinical training
> Fostering cross pollination of best practice across the different disciplines involved in case management
> Championing a pioneering approach to rehabilitation-focused care, where functional rehabilitation occurs every day
> Adopting secure cloud-based software to create a more seamless journey for our case management and care clients and support all the professionals involved.

Supporting and growing our team
This firm foundation and people-first approach, coupled with a mindset that supports innovation and growth, doesn’t only benefit our clients. It benefits the entire Breakthrough team.
Having a head of clinical training and dedicated Continuing Professional Development trainers to deliver in-house learning is a different approach to many others in the sector. It means we offer our team the best possible opportunities to grow and progress – and deliver the safest and best possible services to
our clients.
Case managers often work remotely and operating in silos can mean best practice and new innovations aren’t shared. Not at Breakthrough. We ensure all the different disciplines and roles involved regularly communicate and discuss ideas.
This includes a comprehensive mentor scheme that matches new case managers with more experienced team members – often across disciplines.
We also invest in technology that makes the team’s job easier. For example, our care management software makes it easy to document daily notes and medical charts on a simple app. As well as providing a tool to track and monitor rehabilitation progress.

Building partnerships and leading the industry
Technology also supports our partnerships with solicitors, insurers and other medico-legal professionals. Our case management software captures all the information needed to progress a case as efficiently and effectively as possible. Reports and updates are saved securely and made immediately available to everyone involved in a case.
As a company we are developing tech partnerships that enhance the suite of services we provide and deliver innovations to market. We are disrupting complex care support by reimagining traditional service modes and bringing our expertise as case managers into service delivery.
However, while we strive to be trailblazers and lead the case management industry, we never take risks. Compliance and safety are fundamental to good case management and care. We conduct regular audits, staff appraisals and client questionnaires to uncover any potential issues and identify areas for improvement.
We are proud that the high standards we hold ourselves to are reflected in our (literally) outstanding results:
> Outstanding rating from the Care Quality Commission (CQC) on our very first inspection
> Outstanding rating of our service by 100 per cent of case management clients and families
> Outstanding or good rating of our service by 100% of law firms and referred professionals.

Better case management and care
Of course, for every Apple or Google, there’s a Theranos or WeWork. Companies that had an idea but didn’t follow through with delivery. Sometimes change isn’t the right thing to do and the established ways of doing things work well. 
At Breakthrough, we don’t change just for the sake of it. Our top priority is to do things right – and then we look to see how we could do things better.

Life-changing trips and exhilarating adventures
In a unique approach to rehabilitation and in showing what is possible, Community Case Management Services has become known far and wide for the adventure trips it arranges for clients. 
Surfing trips are commonplace - four will run this year - as are trips to the Community Case Management Services house in Normandy, France. Two trips to safari in Africa, where participants will also help in an orphanage, are planned for next year. While the trips have run for several years, but were forced to pause during COVID, happily they are now back with a vengeance. 
Throughout her career as a nurse, Maggie has passionately believed in giving people living with brain injury and other disabilities the opportunities to thrive, to live their lives - and, crucially, to feel ‘normal’ again. This is something that runs throughout Community Case Management Services - and their trips are a prime example of this.
For the client on the ventilator, whose dreams of becoming a ski instructor were cruelly dashed by spinal cord injury, skiing was something he never imagined he would ever do again. 
But for Maggie, the ‘impossible’ is very rarely that, and sure enough, she and the team found a way. 
“We want to prove within this organisation that anything can be done,” she says. 
“This young man really wanted to go, so we found a way. He didn't have a claim, so my daughter ran a marathon to get money and we persuaded some solicitors to help sponsor the trip. 
“We took the team of nurses, he had a spare ventilator, we did it all properly. The most important thing was to maintain his breathing and everything was fine. It was all possible.
And he had the most wonderful time. He was up before me every morning, it was exhausting! He was the first man on the mountain and the last one off.”
Such life-changing experiences are precious for the client, their family, and for the Community Case Management Services team too, says Maggie. 
“They are the best moments - they’re certainly my best moments,” she says. 
“But it’s about more than the trip, more than the experiences. The point for us is to show that anyone can move forward if you give them goals. They need their own individual dreams. Seeing them smile is everything.”
Inclusion is hugely important to Maggie, and enabling people to rediscover the joy of life after injury or disability. 
“What we want to do is to give them another life,” she says.
“They love having the opportunity of meeting other people and of getting a life back. A lot of people we work with have lost their network. They may be very disabled, they may have communication problems - but they need to live and have dreams and aspirations.
“They need every year to think, as we all do, ‘What’s the aim? What do we want?’ When we get to January, it’s good to plan a holiday or activities, and that’s what we do. It’s not just
the humdrum - we want to give people something to really look forward to. 
“In the early stages, it’s about coming out of hospital, it's about getting your therapy, and the therapy needs continue. But they move out into the community, and what then? How can you boost their serotonin levels? How can you get more from them?
“And that’s why we do the trips. We don't make any money, they’re not commercial trips. There isn't a profit margin on it. We want to be able to take anyone, I won't do any trips that
are not wheelchair accessible, because everyone has to be able to go, if that is what they want to do
“But for us, we do need to hold our nerve - it’s a big undertaking to do these trips. You’re arriving at the airport with 12 wheelchairs, you’re first on the plane and have already upset everyone because they’ve got to wait for you and we’re an hour late taking off. But the camaraderie between us when we’re first on the plane is great.” 
The roots of the trips can be traced back to Maggie establishing the Oxford and Bristol group of the Silverlining Charity, which proved to be a hugely effective way of bringing people together in activities and enjoying life. 
“There was a client who I wanted to go to London, but he wouldn’t go. So I thought ‘Well if he won’t go there, we’ll bring the Silverlining to him’. And we set up the group. He is now so proud of being the founder member. Previously he didn’t do anything and was very, very lonely. But the impact of him being part of this group has been huge for him,” says Maggie. 
“It was a very good way of getting people to socialise and enjoy a normal life. We’ve done art, fashion shows, all things that people might want to do with their lives.
“You've got to do as much as you possibly can. I think people often don’t realise how much untapped potential there is out there. We’ve got people writing songs, painting pictures, doing very creative activities. It can be very hard for people to motivate themselves after an injury, but that is where we as a team can really help.”

Leading the development of case management
As the founder of one of the UK’s first case management businesses, Maggie has been at the forefront of the vast progress of the sector from the very beginning. 
Using her background as a nurse, she took inspiration from the work being done in case management in the United States to drive forward the creation of a new profession - and with it new levels of support nationally for people living with brain injury and other conditions and disabilities. 

“We weren’t a nursing agency - we were much more than that. We saw the need for our role in discharge planning, future care planning, making provision for people’s future. We were people who were interested in making sure there was provision for proper brain injury rehab.”
Having laid the foundations of case management, others were keen to follow Maggie’s lead, with many of today’s best-known and respected case managers and case management businesses being supported by her and Community Case Management Services at early stages of their development. 
“I couldn't do it all on my own, at first there was only me doing my bit with a couple of other case managers, and obviously we've grown over the years. Both as Community Case Management Services, but importantly collectively in case management,” says Maggie. 
“Case management has changed completely. I think it's a fantastic service which has developed its clinical roots, which has come through having CQC registration and is probably one of the most important things to happen.
“The way we work has moved on a lot. For example, in the very early days it was frowned upon that you would get your clients together, which might sound rather strange now. But thinking and practice moves on, and we now have regulation and standards.
“I think the litmus test of a case manager could be: ‘Do you have their mobile number? Can you contact them 24 hours a day?’ It was always meant to be a 24-hour service, with the kind of clients we deal with, it’s not a Monday to Friday role at all.”
Maggie was also fundamental to the creation and growth of the British Association of Brain Injury and Complex Case Management (BABCIM), and has played a role in its ongoing development - and that of case management - ever since. Recently, she returned to be part of its Council. 
“We needed BABICM and I helped to set up the first steering groups. I was at the BABICM table from the very beginning and am one of the very few that are left as a sole owner of a company that is still a family company doing case management,” she says. 
“Thirty years later, I’m back on Council because of the fact that I still believe so passionately that we're doing the right thing. There have been a lot of changes in case management, a lot of the family firms have disappeared. And I feel very strongly that we have to fight for the standards. 
“I don't want to see any reduction in stance, I think BABICM standards are brilliant. We now have proper systems in place, we are regulated, and there’s a wide range of case management too. 
“There have been so many changes in case management that I’m glad we have BABICM. We were always worried that the market for case management would change, and people would see it as an opportunity to make money, there can be a tendency for people to look at financial targets rather than clinical ones - but clinical governance is very important to me, and I think BABICM has a very important role to play in ensuring this remains the priority.”