But broadly speaking, most case managers in the UK at the moment are working with people after traumatic injuries. And we are there to help coordinate whatever it is that is going to improve the rehabilitation and recovery journey for people. And at the end of it, which I work, which is the more catastrophic and complex end, and often working with brain injury, spinal cord injury, life changing injuries, it extends into how people wish to live their lives, what sort of lifestyle choices they want to make, and just working alongside them very often to figure out what is the best approach to that, what kind of support do they need, what sort of choices might make life easier, more fun, more enjoyable. It goes far further than health and social care are able to go, or it can do.

It all depends on how much people want, how much they need and the funding of it.

There's a Criminal Injuries Compensation Authority, there are medical negligence cases, there is a military system that the government has for injured service personnel and so on. So in answer to when do we come into it, that can really depend on when that person takes a claim forward and it can depend on the particulars of that individual circumstance, the claim, the type of claim as to when it is possible to get a case manager involved. The earlier the better, I would say, and often we are one of the earliest parts of what might be funded over and above what the state provides for that person.

So again, it's trying to hit that sweet spot of being in everyone's interest to get us involved.

So in any capped system, what you used to be able to do with it, if it hasn't moved forward to match life and the rising costs of everything, we can do a little less. But then there's just the pressure to be perhaps a little more creative and think how we do that with less. So we are always aware of trying to get the best value for our clients.

And to a certain extent, it's our job to flag up what they need and other people decide whether that's affordable.

Or would you sort of work in partnership with deputies and people like that to deliver?

So we work closely in partnership with Court of Protection deputies on cases like that, where they have the money, but they need us to help figure out what actually this person needs and what's a reasonable price to pay for that. Are there three options? And if so, which is the right one for the person?

But their job is to think about, is that actually affordable? How much does this person have for the rest of their life for these, a vehicle, for example, an adapted vehicle? And is the one that's most suitable something that's affordable in the grand scheme of managing this person's money, if they can't do that for themselves?

If you're case managing a person, your duty is to them and you are doing the day-to-day case management work. There's a whole system of people called expert witnesses who report on that same person, but their job is to report to the court about what they need. I have done that role as a physio and there are people who do that role as a case manager as well.

You'd never do it for somebody who are actively case managing. But that's really how it is established in the first place, what somebody's needs will be long term. And it is an educated guess, if you like, but based on lots of experience of what for this person are likely to be their needs for the rest of their life, what of those might be met by the states, but what of those will need to get life back to as near where it should have been had that not happened, what will be needed and then translate that into pounds, shillings and pence.

So it's a very overseen system as well, which means that then when I'm working as a case manager, I don't have to do all the things the experts said, but there should be a reasonably well thought out plan that has ended up with the sort of resources that I can then think about using alongside perhaps that court of protection deputy to further what that individual and that family need and want.

But I also would suggest that most of us who've worked with brain injuries, brain injured needs don't fall into neat categories very often at all. And there are often things where you think to yourself when you're in a rehab team, for example, well, it's not exactly my job, but this thing isn't really anyone else's on the teams either. And if somebody doesn't sort this thing out, pick up the phone, make a call, send an email, organise something for somebody maybe, then maybe the rest of it's all going to fall apart a bit.

And that's case management, so one part of it. So I often say to people, you know, we've probably all done some. It's a coordinating role.

It's almost like project management at times, thinking about timing of things, the right thing, getting everyone communicating, sorting out problems along the way, except it's not a grand design property. It's a person and their life at the centre of this.

They're going to change. Everybody's lives change, have new chapters. You think differently about what you might want next week, next year, five years time.

Then when you get there, maybe it wasn't what you thought. So we're taking those journeys alongside people and trying to really deeply understand that person and how we can support and help them toward that life that they want or to experiment with that life maybe and figure out what they do want. So when I trained as a physio in my early days, I was taught to work with people from the earliest point of saying, what are your short, medium and long term goals?

And I now think particularly long term, that was a bit mad at the very beginnings, while somebody was maybe still in hospital, having had something suddenly happened to them, because my experience has been that for most people, you need to get back into living life. And maybe maybe that's about getting back home into community or whatever to kind of figure out what this might mean and what you might want. And even then it might change because we all change.

One of my colleagues often says, it's like the client is sort of maybe on a roller coaster often. And sometimes we're sitting next and taking the journey observing sometimes we're jumping off to find the brake or or the speed pedal. Sometimes we're not on the journey with we're kind of watching from afar, because that's what is right for the client and what they want.

It all depends on where the roller coaster is going, what it's doing at any point in time is very individual.

So it isn't what I think. It's what my client thinks, and wants, and then trying to kind of figure out, and sometimes challenge that too. I think that's a very healthy part to it. But always starting with that person, and almost going in with no, no real idea of what it might be that you might be doing, which is one of the things I do like about it.

It depends on what's happening in someone's life. What's the next stage? So significant moments of transition when people move home or have a new relationship, get married, a parent who is a carer dies, people have children or the children leave home and suddenly life is different.

Again, these are all transitions in all of our lives, but they can really have a bigger impact in the lives of our clients. So sometimes those are moments when we find ourselves needing to think again, some new fresh thinking and perhaps scaffold in some more support for people.

And it's also very helpful to have that support. So I don't know. Could it be that there are two to three thousand people doing it?

And then what we often get asked when people come for an interview is what's a caseload? How big would a caseload be?

But that means that a caseload, if you've got extremely complex folk who need more of your time, you'll have fewer cases. So you might, a full time case manager might have maybe six, seven, or maybe they've got a larger number of some cases that need a little less. So in terms of figuring out if we said maybe there are two to three thousand people doing the job, how many do they, what's an average caseload?

But are they all full time? Probably not. I don't think I want to guess, actually.

So, you know, those are expensive things. So that there is a lot of resource within the UK around these clients to help them have as fulfilling and good a life as possible.

How's life? What do you want? Trying to give an idea of what maybe we could do, because case management for clients and families, they've no idea.

It's often kind of presented as a, we’ll, get you a case manager, they'll sort out everything. But what does that actually mean? And only by working with someone do you really often find that over time, as you develop that relationship, you also develop understanding between you, hours of who this person is and what they really want.

And is it fulfilment or is it something else? Don't know. There's of what can we do?

And there aren't that many, there are some edges to what we do, but it is extraordinary how diverse it can be. And I think for people who can't access case management, you know, question might be, well, what happens for those people? And they have to figure it out themselves.

And I think family members very often is what we see. Family members are putting their lives on hold quite often in order to figure out how to support this person, how to support the journey towards some sort of fulfilment, meaningful life. And I guess I would hope with case management, we decrease that for families as well.

So families can spend more time being family, because some of those things take a lot of time and knowledge and we can we can fill those gaps.