Page 14 - PIC-Magazine-Issue23-Autumn-Winter-24

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Case Law Judgements Impact on Case Management Practice
A Lesson Noted from CCC vs Sheffield Teaching Hospitals NHS Foundation Trust 2023
ase managers need to be fully cognisant of the legal context within which they operate and are obliged to maintain
knowledge of sector developments (IRCM, 2024, CMSUK, 2009, BABICM, CMSUK, and VRA, 2020). This extends to how case law judgements directly,
or indirectly, impact case management practice. On 12th July 2023, Mr Justice Ritchie handed down a judgement in the case of CCC vs Sheffield Teaching Hospitals NHS Foundation Trust (Royal Courts of Justice, 2023) which has relevance for case managers. This article will briefly highlight one aspect of his findings. Reading the full judgement is recommended.
A case manager ensures that their client’s health, social care, and educational or employment needs are readily identified and improved where possible following accident or injury. They promote quality, cost effective outcomes for the client, regardless
of who may be providing funding (CMSUK, 2009, IRCM, 2024). They
also establish which services will help to return them, as far as is reasonably possible, to the position they would have been absent the event. Case managers may be called to present their evidence. If so, they should expect robust and detailed cross-examination and be prepared to justify their decisions (Cottrell, 2013). At all times the case manager should ensure the availability of clear, well-documented justifications for their clinical reasoning and actions (IRCM, 2024).
The background to the case is of a young girl (referred to as CCC) successfully suing the Defendant for negligent treatment at birth. Her resulting severe spastic quadriplegia, very severe brain damage, and complex needs require
a maximum severity care package
REFERENCES
BABICM, CMSUK, VRA. (2020) Code of Ethics and Conduct in Case Management Practice. Available at: Code of Ethics - BABICM
BABICM. (2022) A Perfect Storm. Available at: Perfect Storm Survey results - BABICM CMSUK. (2009) Standards of Practice and Best Practice Guidelines.
Available at: www.cmsuk.org
CMSUK. (2024) Case Management. Available at: UK Business Case Management | Case Management Society UK (cmsuk.org).
Cottrell, S. (2013) ‘Caveat Case Manager’, Journal of Personal Injury Law, 4, pp. 224 – 233.
IRCM. (2024) Standards of Proficiency. Available at: Microsoft Word - Case_Management_Framework_Final_Conference.docx (ircm.org.uk).
Royal Courts of Justice (2023) CCC vs Sheffield Teaching Hospitals NHS Foundation Trust, Citation no. EWHC 1770.
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consisting of two carers to assist with all activities of daily living whenever she is awake. Mr Justice Ritchie identified the quantification of the care, case management, accommodation, transport and equipment costs as the main issues. We will consider care.
On discharge home, CCC’s mother (referred to as M), became her sole carer until some contribution from
the local authority was instigated,
and an interim payment allowed for commencement of case management services. Additional care was appointed but during the COVID-19 pandemic, retaining care workers became extraordinarily difficult.
It is in relation to commercial care that there lies a salutary warning. It was Mr Justice Ritchie’s judgement that due to the case manager’s inexperience and lack of qualifications, ‘unreasonable decisions’ were made to engage commercial care using a nursing agency at high cost. As such, past care was awarded with a significant deduction of 80% of the nursing agency fees incurred up to the commencement of COVID-19 restrictions.
Worth noting is that even whilst the Claimant’s care expert’s evidence and rates were preferred, Mr Justice Ritchie stated that these undervalued the care provided by M. He provides a very moving description of the care M gives to CCC, her daughter. He pinpoints the struggles that she endured, alone, for many years and even with commercial care available, to the point of her experiencing physical exhaustion
and psychiatric symptomatology. It is beholden on all of us working in this sector to re-acquaint ourselves with the reality of the parental burden and personal sacrifice made in caring for a severely disabled child (Royal Courts of Justice, 2023, Point 147).
At some stage, a newly appointed
case manager ‘hit the road running’ and prioritised the reorganisation
of care and therapy. Despite the
sector pressures, which have been
well documented (BABICM, 2022),
she quickly built a team of directly employed staff on a fairly negotiated rate of remuneration, with no reliance on agency staff and a reduced care burden on M. Additionally, her meticulous records established precisely the client’s care needs and provided the evidence to secure an adequate award for CCC’s future requirements. Once in Court her verbal evidence was ‘impressive’ and her work recommended by the judge.
Keystone Case Management (KCM) considers that a rigorous recruitment process is vital to facilitate the migration of highly skilled professionals into a case management role. We implement a structured training programme and a supervision model
to ensure the thorough development of the skills required for case managing people with complex disabilities and needs. A feature in this case
was a frequent change of
case manager. This was
not, according to the judge, ‘objectively reasonable in a
case of maximum severity’. It
can deliver an unsatisfactory
outcome for all parties. At
KCM we work hard to match
our case managers with our
clients to obtain longevity of relationship and maximise
outcomes. We abide by,
and welcome, regulation
by sector specific and
professional bodies which
ensure an excellent and safe
service is delivered.
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