When you are taken to the hospital after a catastrophic injury, you will receive urgent intervention and surgery. This is called acute care.
When your condition stabilises, the hospital will then start to plan your rehabilitation and, in time, look to discharge you to either step-down care or back home.
How to access rehabilitation services?
You may be able to access rehabilitation through the NHS. There are several statutory services available that may support your rehabilitation after discharge. Your treating clinical team should make you aware of the available services and the next steps.
However, there are often significant waiting times for specific types of rehabilitation services, and the services available to you on the NHS may not equal what can be obtained privately.
Private rehabilitation under the Rehabilitation Code
Everyone agrees that early rehabilitation can make a significant difference to your long-term outcome, both in your recovery from the injury and in what you can do.
If you are making a personal injury claim, then your legal team should use the Rehabilitation Code 2015 to maximise your rehabilitation. This code is designed to allow claimants to access rehabilitation, funded entirely by your opponent, outside of the claim process.
If the opponent agrees to do this, the first step is to instruct a case manager.
What is a case manager?
The case manager works for you. They are usually clinically trained, often a nurse, physiotherapist or occupational therapist. They will review your medical records and see you to complete an initial needs assessment (INA).
The initial needs assessment is an assessment of your current situation; it will highlight any gaps in NHS provision and your priorities for rehabilitation. This initial needs assessment meeting with you will usually last a few hours, after which the case manager will write up your assessment. The initial needs assessment will also provide the estimated costs of the recommendations.
The initial needs assessment will then be presented to your legal team and your opponent's representative. Your lawyer will send it to you to check that you agree with it and want to proceed with the suggested rehabilitation. If you do, your legal team will then liaise with the opponent to secure funding from them for the recommendations.
If funding is secured, your case manager will coordinate your support based on their recommendations and liaise with the relevant clinicians involved in your support. Your case manager will develop plans with you and will monitor progress against the recommendations, reporting back to the legal teams involved.
Your case manager may request some other assessments for your ongoing rehabilitation. These could include:
Physiotherapy
A physiotherapist will work with you to assess movement and function, and your priorities. They will design exercise programmes to support your ongoing goals.
Occupational therapy
An occupational therapist will support you to manage your daily living goals; these could be returning to work or simply managing in the home. An occupational therapist may support with equipment, aids or adaptations to help you with your rehabilitation.
Speech and language therapy
A speech and language therapist can support you with regaining your speech and language skills. They can also help improve swallowing function to prevent the risk of choking.
Funding options if the Rehabilitation Code is not agreed
The Rehabilitation Code is voluntary, and there is no means of forcing an opponent to agree to fund a case manager to prepare an INA or to pay for their recommendations. Sometimes an opponent will have legitimate reasons to take such a stance, although not always.
When faced with this scenario, an opponent may sometimes prefer to release an interim payment in the claim, which you can then choose to use to fund a case manager and your rehabilitation. Alternatively, at Higgs LLP, we can provide you with access to funding options that will allow you to instruct a case manager and implement some rehabilitation.
This information is for guidance purposes only and does not constitute legal advice. We recommend you seek legal advice before acting on any information given.
