Select Committee on Health Appendices to the Minutes of Evidence


Memorandum by the Association of Serious Injury Solicitors (H36)

  1.  The Association of Serious Injury Solicitors is a regional group of Personal Injury Solicitors. The writer of this memorandum has a special interest in acquired brain injury (ABI). This memorandum has been prepared following research into resources available in the East Anglian Region. For this purpose we considered the resources available in Bedfordshire, Cambridgeshire, Essex, Hertfordshire, Norfolk and Suffolk.


  There are two Headway Units in Bedfordshire. There is a neuro-rehabilitation team dedicated to dealing with individuals with acquired brain injury in the county. North Wing Hospital has a community rehabilitation team. The team offers no long term support. There is one social worker within the physical disability team in Bedford who is dedicated to working with individuals with ABI. He was not available at the time that we made our enquiries. Where private funding is not available there is no long term support.


  There is a Headway Unit in Cambridge. The surrounds of Cambridge, however, are poorly served.

  There is no Headway Unit in Peterborough. It was disbanded in 1999. There is a neuro-rehabilitation team in Peterborough consisting of clinical psychologist, occupational, physio, speech and language therapists. The team does not provide any social supports. They are only concerned with intermediate rehabilitation and offer no long term support. The only form of social support identified for Peterborough was one social worker but it was not clear how one contacted her.

  There are also the post-acute rehabilitation providers at Oliver Zangwill Neuro-Rehabilitation Centre at Ely, St Andrew's Centre and the Lewin Rehabilitation Unit at Addenbrooke's Hospital. Where private funding is not available there is no long term support.


  Essex has three Headway houses, Colchester, Romford and Southend. There is a neuro-rehabilitation team based in Colchester General Hospital. The team provides support for all neurological disorders but again long term support is not available. Rehabilitation is no longer available at the Princess Alexandra Hospital in Romford and Chelmsford's Broomfield Hospital offers minimal rehabilitation. There are the private organisations of Elm Park, Tree Tops and a home in Dovercourt. Where private funding is not available long term support was limited. Headway in Essex (Colchester) provides a community support service but this is limited to information and advice.


  We were unable to contact anyone in Hertfordshire. The named contact on the Headway web site was no longer available.


  There are three Headway Houses in Norfolk. The co-ordinator of Headway in Great Yarmouth confirmed that there was little available in his area, Norfolk and Suffolk. Once medically stabilised the patient was sent home to families or lived in the community with carers' support. There is a head injury social work team based in James Paget Hospital and we understand that Social Services in this area are very helpful with funding. It was found that there was a lack of occupational, physio and speech therapy programmes and appropriate housing. We found that one Headway member in his 40s lives in an old person's home as there are no alternatives available.

  There is no day centre at Headway Norwich. Headway Norwich meets once a month for two hours in the evenings.

  Colman Hospital Rehabilitation Unit and Oak Farm Physical Rehabilitation Unit provide inpatient rehabilitation for those with ABI. There is no long term support. There is a neurological rehabilitation team based at St James' Clinic in King's Lynn providing brain injury rehabilitation. There is no long term support.


  There are two Headway Houses in Suffolk and it was found that the resources available here were a little more outreaching. There is no neuro-rehabilitation team in Suffolk but it was found that Icanhoe—the Suffolk Brain Injury Rehabilitation Centre, provides a comprehensive range of services including social work, vocational rehabilitation and care and support. A Case Manager based in Suffolk stated that there is an issue of long term needs for those referred to Icanhoe. The mid-Suffolk area is further supported by a voluntary organisation called Rethink Disability. They have a dedicated support housing unit as well as an outreach service providing specialist support workers to work with those with ABI in their own homes. It was found, however, that the therapies required by a person suffering from ABI were sadly inadequate.


  (3i)  The six counties referred to above are identified by National Headway as the Eastern Region. It was noted that there was a serious problem finding appropriate support for sufferers from ABI who cannot be maintained in their homes. There were problem finding accommodation. It was found that there were only three Headway Residential Units which were run by Housing Associations. The standards in these three units varied. One Case Manager reported that a 57 year old man suffering from ABI had no alternative but to be admitted into an old person's residential unit. A 32 year old girl, who was heavily dependent, was placed in a home where the average age of the residents was 65. She had no occupational therapy and had one session of physiotherapy a week. Incidents of sexual abuse were reported. One Case Manager reported that a girl suffering from PVS (persistent vegetative state) became pregnant whilst in a Young Disabled Unit.

  (3ii)  It was found that there was no uniformity of standards in the care of patients with ABI. There was a problem in terms of quality assurance. There was no way of protecting from abuse.

  (3iii)  There were no quality standards.

  (3iv)  The service available was found to be patchy and inconsistent. There are a significant number of agencies providing post-acute medical rehabilitation. With few exceptions, social rehabilitation and long term support failed to be addressed. The supply of information and advice was frequently left to the voluntary organisations.

  (3v)  Save where compensation claims arose and private funding was available long term support was scarce.

  (3vi)  It is recommended that there should be a statutory need to review individuals with ABI in residential homes. Reviews are not regular and only occur on complaint.

  (3vii)  It is recommended that the need for an independent person to stand in the shoes of a guardian ad litem should be addressed urgently.

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