Select Committee on Health Appendices to the Minutes of Evidence


APPENDIX 2

Memorandum by Headway Cardiff (H4)

  While the health Select Committee relates to England we feel that changes in England often pave the way for those in Wales. We feel that our experiences of statutory services reflect those in the rest of the United Kingdom.

SUMMARY OF POINTS COVERED

  1.  Background to Headway Cardiff

  2.  Preservation of life over quality

  3.  Delay in discharge

  4.  Health v Social Service responsibility

  5.  Lack of ongoing community health provisions

  6.  Proposals for new community brain injury service

  7.  Lack of Social Service recognition of the needs of people with acquired brain injury

  8.  Suggested reading.

1.  BACKGROUND TO HEADWAY CARDIFF

  Headway Cardiff was established in 1985 by therapists in Rookwood Hospital as a support group for survivors of acquired brain injury. Over the years it has evolved to breach the gap in statutory services. It is now a Ltd company and charity providing services to people with acquired brain injury from South East Wales. These services include a day centre twice a week, an information and helpline and counselling service. We employ two staff who are supported by a team of volunteers. We have received lottery funding and are presently funded by charitable trusts. We receive spot contracts from Social Services for eight of our 30 clients. These pay for the attenders with the most severe physical disabilities. The local health trust allows us free use of the premises from which we run our service.

2.  PRESERVATION OF LIFE OVER QUALITY

  Many resources are spent on preserving life but an ethical debate needs to be entered into, exploring quality of life in relation to preservation.

3.  DELAY IN DISCHARGE

  There is often an unnecessary delay in discharge while adaptations in the home take place, suitable accommodation is found or care plans are implemented by social services.

4.  HEALTH V SOCIAL SERVICE RESPONSIBILITY

  This is because of unnecessary bureaucracy and lack of community provision such as appropriately adapted or supported housing.

  Often people with brain injury and their families are caught between social service and health authority departments while each argues that it is the other's responsibility to provide support.

5.  LACK OF ONGOING COMMUNITY HEALTH PROVISIONS

  While survivors of brain injury receive a great deal of input while in hospital, community services are very limited, with one specialist brain injury nurse covering the whole of South Wales. It is very difficult to access therapies such as physiotherapy as there is no separate community service. Our clients are in direct competition with the patients at the local hospital. Similar problems are experienced accessing psychological and occupational therapy. Other than hospital therapists, there is only one part-time speech therapist available as an aspect of the day service provided by the local psychiatric hospital.

6.  PROPOSALS FOR NEW COMMUNITY BRAIN INJURY SERVICE

  After the damming report on "Severe Head Injuries Rehabilitation" published by the Welsh Affairs Committee in 1995, Bro Taf Health Authority Head Injury Working Party responded with "Putting our Heads Together—a rehabilitation service for people with severe head injury". This proposal put forward a design for an acquired brain injury multi-disciplinary community team of therapists. This was published in 1996 and we are still awaiting a practical implementation of the proposal although recently there has been a commitment by the health authority of £100,000 to fund this service. This will in no way fully meet the recommendations.

7.  LACK OF SOCIAL SERVICE RECOGNITION OF THE NEEDS OF PEOPLE WITH ACQUIRED BRAIN INJURY

  Social Services do not recognise brain injury as a separate category within their Social Care plan so only those with the most severe phsyical or mental disabilities receive support. Those with more subtle, but equally disabling problems, such as memory loss or organisational problems receive no input. This can result in people struggling to live independently and experiencing family, financial or mental health problems. The eventual outcome of this can be families splitting up, people gaining criminal convictions or being sectioned.

8.  SUGGESTED READING

  Severe Head Injuries: Rehabilitation—Welsh Affairs Committee, 1995.

  Putting our Heads Together—a rehabilitation service for people with severe head injury. Bro Taf Health Authority Head Injury Working Party 1996.

January 2001


 
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