Hi Sarah, thanks for joining in the chat.

So they directly support adults with brain injury and family members in that way. But the majority of the face-to-face support work on the ground, so to speak, is done via a network of local Headway groups, of which Headway Cambridge and Peterborough is one. And we're all independent charities in our own right.

So whilst we form a network and we're affiliated with Headway UK, we're all very independent. And consequently, whilst there are some similarities in unity, and we do work quite closely with those in the eastern region, for example, there are also quite a lot of differences. So we always say to people when they approach Headway, particularly if they live on a border county, for example, it's always worth reaching out to your two most local Headway groups because they won't necessarily provide the same service.

So one might suit your needs better than another, for example.

And that was a long time ago. Is that still the sort of thing you do? So do you have members of staff sort of in hospital meeting patients and families at that kind of early stage?

And we do just that really. And no one case is the same. No one individual is the same.

But we're there to sort of provide that emotional support and guidance, but also practical advice around claiming benefits or employment return to work. We also have specialist counsellors who can support with any sort of adjustment, both for the individual who's been injured, but also their loved ones. So we do offer the hospital based support.

It's incredibly important part of what we do. And then also we offer support in the community as well. Yeah.

And that's when we do our outreach work, where we do one to one support in the community, people that are looking to sort of improve their independence skills. Or we also have a trainer who goes out and supports people in the gym, for example, if they've got the physical and strength and mobility goals. So yeah, it's a five day a week service.

But also we do quizzes, we do strategy games, and we also do a range of art, clay therapies, gardening therapies, music, singing therapies. So what we do is we look at what the individual is looking to get out of coming to Headway. And then we will build the support around that through these groups.

And the clients get a lot out of it as well, because we exclusively support people with an acquired brain injury. And as we know, often it's described as an invisible or a hidden injury for many. And there's a lack of understanding in the general community around the impact of brain injury.

So when we speak to the clients about what benefit they get from their attendance, it's not just about, you know, attending these group sessions and working on their cognition. But it's that social element as well. It's being around other people with shared and similar experiences.

So we do have a making connections programme and that's a volunteer led programme. So we have a group that meets in Peterborough, which again is run by a volunteer. And I think they just meet for lunch and just generally chat about their shared experiences.

At the moment, we encourage family members to attend our neuro hubs and there is always a quiet space and time for them as well. So the expectation is they don't have to stay with their loved one, but often we find that they do. And part of the support that we offer, in addition to the emotional support, is that practical advice and guidance.

So often the family members report that they've got real benefit out of just observing how we perhaps interact with their loved one or how if they're perhaps losing attention, how we can deflect and bring back. So a good part of it, both for paid carers as well as family members, is that they get to learn something as well as the respite, which is essential.

And for those people, we've got a number of clients that have been with us for several decades, but we celebrate the small wins. So whilst we're not expecting at that stage for it to be monumental changes, what we're doing is maintenance and prevention there, really, and giving people the best quality of life possible.

Same with Hub. So on our Neurohubs, when we've got clients that maybe have decided to move on and have got the support, they can come and, you know, help and support in the Hub. So yeah, that's lovely.

And that's the whole sort of holistic family approach of being able to utilise the skills that they've learned to benefit others.

But are any of the things that you do, are they kind of commissioned? It's a complex sort of ecosystem, the health and social care service isn’t it? But I know there are some areas where essentially the NHS buy services from organisations like you to support people because it's things that they're not giving themselves. How does it work in your area?

So a block contract is where the health authority or the ICB fund a provision, a service. And a spot contract, which is what we have, the funding attaches to the individual. So they have their own budget.

And then the social worker or the health worker will then assign a part of that budget to attend Headway. But it's a real, real challenge because I think what we offer is a psychosocial model of support like we alluded to earlier. It's equally cognitive strategies and working at quite a complex level at times to get people, you know, back to where they want to be.

But equally, there is a huge social element. So consequently, you will have adult social care not recognising the health and the more cognitive, complex elements of what you do, but recognising you as a social or a daycare service. So will fund that.

And then Health on the other side, because you're non-clinical, don't necessarily see it as a health benefit, where the reality is probably with brain injury, it sits, stop, bang in the middle. So there is an element of health and clinical expertise that inevitably has to come in. But of equal importance is that social element.

So I think certainly this is something Headway UK are looking at at the moment in terms of lobbying and commissioning and campaigning is really where does brain injury sit within that commissioning framework? And I would argue it sits, stop, bang in the middle and ought to be jointly funded.

You know, if there is an NHS waiting list, rather than having somebody sat at home without any support, that's where we can help. So it's a case of having those conversations with the commissioners and recognising where we fall in that client journey and that pathway, really.

So I'm really trying to advocate for psychosocial group model to form part of that multidisciplinary team and being seen as of equal importance as all of the clinical therapies, really. So my hope is that with all of these changes, this will be the time to maybe bring that about and advocate for that.

So here's a chance, perhaps, to use that national network of Headways to say, what are we doing really well and can we kind of spread that around, take this opportunity, as you say, to kind of develop new things to support people on their journeys?

So now we know where the Integrated Care Boards are going to be geographically placed. Those Headways are now starting to have conversations around joint working and alignment so that we're not duplicating those conversations.