There should be tight deadlines on all parties to an injury claim – solicitors, insurers and rehabilitation providers – to ensure that rehabilitation achieves as much as it can, according to one well-known rehabilitation case management company.
HCML said the IUA-ABI rehabilitation working party has a one-off chance to make the “dysfunctional” Rehabilitation Code fit for purpose.
HCML chief executive Keith Bushnell said he wanted the working party to tackle round two of consultation on the voluntary code with a mission to cut delays over assessments, treatment and care – he said fewer than a quarter of those out of action for more than six months ever return to work.
“The point of the code is to allow early intervention even when liability is unclear. Yet time after time we see necessary rehabilitation held up by delays in agreeing liability.
“The code needs a mechanism for the injured person to get care when it is needed, and when liability cannot be agreed promptly, the only mechanism currently is single instruction for the most serious injuries.” The code also needed to address treatment for mental health issues, he added.
Mr Bushnell said there should be a 14-day deadline for responses to assessment and recommendations for all parties – insurers, solicitor and rehab providers.
“While integration with NHS and state social care provision should be the default position for rehab intervention, delays at key points of recovery sometimes make private care the best choice to accelerate recovery. A stop-start approach to client care does more than delay recovery. It can reverse progress to recovery.”
While welcoming plans that create separate arrangements for fast-track cases and all other cases – including catastrophic injury – Mr Bushnell said the concept of immediate needs assessments should be reserved just for catastrophic injury, where there is a clear difference between immediate needs and ongoing, long-term care and where outcomes are much less predictable at the outset.
“In all other cases, the expectation should be that treatment, care and return to work support will naturally follow on from the assessment.
“In fast-track cases rehab should proceed through accredited providers with immediate medical assessments by qualified clinicians taking a stepped-care approach with the number of treatments decided on solely clinical need allowing early intervention to proceed smoothly.
“Car repair and hire is agreed immediately in these cases – rehab should be no different. A high proportion of cases can be effectively resolved through well managed self-help programmes.”
He added that HCML supports moves to introduce compulsory standards for accredited case managers, overseen by the appropriate professional bodies.