How has Case Management changed?

Circle Case Management spoke to Emma Way Associates and asked "What changes has your team seen in Case Management, Personal Injury and Clinical Negligence in the last 10 years?" 
We asked the team Emma Way Associates, who offer bespoke case management and expert witness services for those who have sustained a spinal cord injury, amputation or other severe orthopaedic injuries, to centre their answers based on a catastrophic injury perspective, not including ABI, therefore limited involvement with deputies or those without capacity.

In the last 10 years, what changes in Case Management have you noticed?

Continued growth of the industry as a whole with, initially, a huge growth of new companies and independent case managers. I feel that this is beginning to settle with some very large, established case management companies, who were the leaders approximately 30 years ago. These have all now been taken over and tend to follow a different business model. Then there is the development of mid-sized companies whilst the amount of individual case managers is reducing. I believe this is due to the increased regulations and bureaucracy that is involved.  Increase in case managers being used for lower end litigation cases and for vocational return.

There have been the development of case management frameworks and advanced qualifications. The role has become more defined with the Institute of Registered Case Managers in the pipeline to provide some regulation to the industry and the expectation that case managers should become CQC registered.

Less and less available via statutory services (even less since Covid-19) and increased growth in private provision of options. However, knowing appropriateness and ability of private services (and case management) is difficult to determine but it is very important that the services are relevant, they do truly have the specialist expertise required and their involvement is monitored.

In the last 10 years, what changes in Personal Injury and Negligence have you seen that have impacted Case Management?

The role of the case manager has become fully recognised in medico legal cases.  Most lawyers understand the role better and know what they should expect from good provision.

Quite rightly, we have become better at estimating costs and providing justification and records of spending so that we remain reasonable and interventions are measurable. I’d say that, overall accountability has improved.

The timing of input has altered – I think overall case management is being put in earlier than before and I believe this must be due to the introduction of, and more solicitors signing up to, the rehabilitation code which has opened access to services for more individuals, not just for those with confirmed litigation underway and interim payments secured.

What has been the biggest achievement working in Case Management?

The development of EWA which has maintained it’s specialist, niche and client centred focus as well as extremely high standards.

Being instrumental in improving clients lives from soon after they sustain a catastrophic, life changing injury to them achieving as near independence as possible with minimal intervention from therapies, medical teams and case managers.

What has been your most profound case and why?

There are so many. One which involved having a client sustaining a spinal cord injury on top of an amputation and establishing their bespoke rehabilitation and living needs, unpicking pre-and post injury needs with the related complex costs and issues for the litigation team and how to put in appropriate assistance and interventions.

A case where the client struggled to adjust and engage but, following years of self-destructive behaviour and being the last professional involved, finally they reached peace and were able to accept and move on to self-manage their own situation.

Do you have any predictions for Case Management / Negligence / Personal Injury for the next 10 years?

I think there will be less and less individual case managers with individuals opting to work within companies and more aware of CQC registration and the demands this involves.

The increased litigation world will cause continued growth, particularly of the lower end cases. The differing roles, and costs, of case management, depending on the extent of injury will become more clearly defined.

With the above in mind, I fear that more and more companies will be taken over and lose the clinical leadership and expertise and follow more of a corporate model which, in my experience, does not provide the very best expertise and client focused intervention.

Find out more about Emma Way Associates by visiting: Emma Way Associates - Case Management and Expert Witness Services