08:45 - 09:15 Registration, tea/coffee, networking & exhibition stands

09:15 - 09:20 Welcome from the sponsor

09:20 – 09:25 Welcome from the conference Chair Christopher Wilson Smith KC, Outer Temple Chambers

09:25 – 09:45 Managing crisis takes a village, our data is our predictor

Predict the unpredictability, today is acknowledging that we all play a part in predicting what our clients are likely to need and the associated costs for the rest of their lives. We are now 30 years young with case management in the UK, and we are finally starting to see new trends and opportunity to gather data on what works, what’s new, and what we missed or what we would never have predicted. Drivers such as evidence-based practice, clinical excellence and reflective practice are ensuring that we are able to identify crises related and high risks, lifestyle choices, decisions and exposures for our clients. Managing crisis takes a village………we now have the privilege of hindsight, let’s not waste it!

Maggie Sargent, Founder of CCMS & Catastrophic Injury Case Manager and Nikki Hopkins, Operations Manager & Case Manager, CCMS

09:45 – 10:30 Hitting the Milestones The specialists said at the hospital “I am sorry Mrs D, your son will never independently walk or talk again from this injury” In the presentation Dr Dimitrios Sampanis will explore a client’s journey post injury, reaching various milestones despite the obstacles faced, and will give delegates insight into approaching rehabilitation in a meaningful way led by the client.

Dr Dimitrios Sampanis, Clinical Director, Home Rehab Therapists Ltd & Highly Specialist Neuro Physiotherapist, Associate Professor, St Mary’s University

10:30 – 11:00 Hydrotherapy?? But M has a tracheostomy!!

By sharing case studies including tracheostomy and PEG fed patients and using national guidelines this session will discuss a number of different patient journeys with water-based activities. The cost for hydrotherapy intervention, hydro pools and ongoing intervention costs. Looking for a checklist to support hydrotherapy for your clients? What to consider, how to risk assess the impact on the client? Then this is not to be missed!

Sarah Cox, Chartered Physiotherapist, Fresh Physio

11:00 – 11:30 Tea/coffee, networking & exhibition stands 11:30 – 11:50 Managing Relationship Risk in the Community

This talk will highlight the significant dimension of relationships with others (friends, family, romantic partners) and the impact of such on community activities and rehabilitation goals. I will present a case of an adult survivor of childhood brain injury, whose relationship patterns have been historically characterised by risk of exploitation and harm. These patterns were mapped out with the client and then shared with her family and team to support her in negotiating new relationships and widen opportunities for enriching community participation.

Dr Giles Yeates, Consultant Clinical Neuropsychologist & Couples Therapist, Rippling Minds

11:50 – 12:20 Parenting after brain injury: challenges & (missed) opportunities?

Becoming a parent is one of the most valued societal roles, yet people with brain injuries often face huge challenges navigating this aspect of life. The presenter will discuss the issues that brain injured people face when they want to become parents, the types of intervention they require and how rehabilitation teams, case managers and legal teams can work together to support them.

Speaker TBC

12:20 – 12:45 Lessons learned from 25 years of litigation: Reflections from the courtroom
William Latimer-Sayer KC, Cloisters

12:45 – 13:45 Lunch, networking & exhibition stands 13:45 - 13:50 Welcome back from the Chair
Chris Melton KC, Byrom Street Chambers

13:50 – 14:35 “To Travel is to Live"
The presentation will focus on a case study of a complex spinal cord injured patient with category 4 pressure ulceration. Prior to his injury, he travelled regularly across Europe to his second home in Portugal where he is from and where he still has lots of family. The session will focus on how this aspect of his life was of the utmost importance to him and how he could and should be enabled to continue to pursue this aspect of his life despite his life-changing injuries and a chronic category 4 pressure ulcer.

Cathie Bree-Aslan, Independent Tissue Viability Nurse & Expert Witness, Director & Head of Clinical Services at Wound Consultancy Ltd and Nurse Expert Witness Ltd

14:35 – 15:15 The Litmus Test

Travelling promotes independence, how do we as case managers support our clients on holidays and predict the unpredictability?

Nicola Cale, Practitioner Case Manager, CCMS

15:15 – 15:45 Tea/coffee, networking & exhibition stands 15:45 – 16:30 Borderline Personality Disorder and brain injury: the hidden challenge

A not so hidden disorder and the impact on clients with brain injury. There is a growing realisation and increasing data to show a correlation between marked emotional reactivity, severe difficulties maintaining interpersonal relationships and substantial costs to the individual, their family, and society.

Dr Alan Gray, Consultant Clinical Psychologist, Headwise

16:30 – 17:05 Counting the cost: Litigation and deputyship

Tracy will expand on the key areas and themes of the day, and tie this in with the challenges the Deputy faces when meeting clients’ needs over a lifetime, especially those who are more than 10-, 20- or 30-years post injury. Tracy will detail what the Deputy needs of the case manager, MDT and provide an overview on how we make this work now with reducing funds, or a very tight budget, and what we could be thinking about much earlier on within the litigation stage of intervention to meet much longer term needs of our clients.

Tracy Norris Evans, Partner, RWK Goodman

17:05 – 17:15 Conference close

This session will bring together the themes from the day and look to what is next? We will explore what funding is available in order to action the ideas discussed today. This session is also an opportunity for reflection based on evidence.

Maggie Sargent, Founder of CCMS & Catastrophic Injury Case Manager

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‘Level inequality in dementia diagnosis rates’

Over half of local authorities in England are falling short of the national dementia diagnosis target, leaving hundreds of thousands of people without a vital diagnosis, a new inquiry has revealed. 

The findings from the All-Party Parliamentary Group (APPG) on Dementia revealed where you live has a ‘massive impact’ on whether you will get a timely, accurate and high-quality dementia diagnosis.

The group of cross-party MPs, alongside dementia charity Alzheimer’s Society, is calling for a levelling up of diagnosis rates – as well as an urgent improvement in the speed and accuracy of dementia diagnosis, particularly in rural and ethnically-diverse areas.

For example, in Swindon, one of the lowest performing areas with a rate of 49.7 per cent, 766 people are missing out on a diagnosis.

Although dementia is the UK’s biggest killer, over 250,000 people with dementia in England are estimated to be living without a diagnosis, leaving them unable to unlock vital treatments, care and support.

While there is currently no cure, there are treatments available, and new drugs coming down the line which could delay progression of the condition.

However, future drugs will require people to get a diagnosis of the disease causing dementia, but latest data shows that Alzheimer’s disease and vascular dementia are still under-diagnosed compared to known prevalence rates.

This month’s NHS figures show over a 40-percentage point difference in diagnosis rates between the highest and lowest areas in England.

The inquiry, led by Labour MP Debbie Abrahams and Conservative Peer Baroness Angela Browning, reveals a complex picture of why there is such a disparity, and calls for better data to understand how factors including the availability of brain scanners, transport access, deprivation, rurality and ethnicity are playing a part.

The report, which includes findings from a survey of over 2,100 people affected by dementia in England, suggests transport is a major barrier to diagnosis.

One in four people reported being unable to make appointments because of travel problems, with 78 per cent relying on other people for transport. To combat this, the report proposes that every Integrated Care System (ICS) in England increases service provision to ensure that people can get a diagnosis closer to home.

Ethnicity was also shown to impact the chance of someone getting a timely dementia diagnosis, with people struggling to access diagnostic assessments in their own language, and with cultural references relevant to them, alongside stigma in communities stopping people coming forward with symptoms.

Dr Karan Jutlla, Alzheimer’s Society ambassador and dementia lead for the University of Wolverhampton, who gave evidence at the inquiry, said: “When we’re trying to understand the challenges ethnic communities face getting a dementia diagnosis, we need to look behind the headline figures.

“Wolverhampton has a relatively high dementia diagnosis rate, but this is disguising challenges of the 35.5 per cent of the population who are from ethnic communities.

“From my work I know very, very, very few people from these communities are presenting themselves to services. To be able to quantify this we need to start recording the ethnicity of people who do come forward.”

Encouragingly, the inquiry found that ICSs with the right healthcare systems in place can overcome factors like deprivation and rurality.

For instance, in rural Somerset, which has traditionally had low dementia diagnosis rates, there has been a 30 per cent increase in referrals per month since a new service was adopted last year, doubling the number of Dementia Support Workers in the county.

Also encouragingly the local health service in Swindon has recently committed to increasing rates through improving capacity in memory assessment services, including building ‘Rapid Assessment Diagnosis’ clinics.

APPG on Dementia co-chair Debbie Abrahams MP, who led the inquiry alongside Conservative Peer Baroness Browning, said: “All of the evidence shows that timely diagnosis is crucial for people with dementia, particularly in increasing access to drugs like donanemab, a new potential treatment for Alzheimer’s Disease.

“But this report shows that at the moment diagnosis rates are simply a postcode lottery.

“It could not be more clear now that we need Integrated Care Boards to introduce strategic local plans to increase access to diagnostic services. Likewise, the Government must significantly increase scanning capacity and workforce.”

Fiona Carragher, director of research and influencing at Alzheimer’s Society, said: “Dementia is a devastating disease, and delays in diagnosis can lead to crisis. We know one in four people with dementia battle symptoms for over two years before seeking a diagnosis, and a third of these people have an accident before looking for help.

“This inquiry lays bare the stark inequalities that still exist in getting a diagnosis – it’s unacceptable that your postcode, your mobility, or your support network can all be factors determining your chance of getting the diagnosis you deserve.

“Today, hundreds of thousands of people are facing dementia alone, unable to access the vital help and support that a diagnosis can bring.

“Breakthrough drugs like lecanemab and donanemab are coming round the corner, and everyone should have equal access if the drugs reach the clinic. This means giving people a timely, accurate and specific diagnosis of which type of dementia they have – so we can get drugs to the people who are able to benefit, and fast.

“Today’s report shows pockets of excellence in diagnosis, and areas bucking the trend through innovation. Improvement is possible, but we need more tailored services across the country, and better local planning by Integrated Care Systems to help bridge the gap and reach underserved communities.

“There’s more to understand in terms of why diagnosis rates vary so dramatically – Alzheimer’s Society is calling on the Government and NHS to gather the data that’s needed to find the root cause of these inequalities across the country.”