The largest annual periodical payment for a client

Recently, our team have been involved with a client where his legal team secured the largest ever annual periodical payment for a client, after he was severely injured in a road collision.

JF, then 33 and living in his own flat, was cycling to his work at a supermarket in 2018 when he was knocked off his bike by a stolen vehicle being driven on the wrong side of the road. His injuries were devastating: he suffered a cardiac arrest at the scene and was later diagnosed with a form of cerebral palsy affecting all four limbs. He continues to be fitted with a tracheostomy and feeding tube and needs full support with mobility. One of the goals in his care was to get JF moved into his own home, rather than living in a care home for the rest of his life.

JF’s Case Manager, Tania Brown Ltd’s very own Nicola Ewell, worked on the case in order to help him achieve this goal, and secure him stability and quality of life he deserved.

TBL Case Manager, Nicola Ewell
TBL Case Manager, Nicola Ewell

Nicola said, “It has been a real privilege to have worked on this case. Initially, it was believed that the client had very limited potential for rehabilitation and would not ever be in a position to eventually live at home.

It was very evident that my client was showing signs of engagement and I felt determined that it would be possible for him to move back home with the appropriate level of support and care in place, and as a Case Manager, it’s really important to stick to what you believe and achieving the best outcomes possible. My focus is always client comes first.

Through a huge team effort, including the TBL admin team, medical professionals, Stewarts Law, ongoing supervision with my clinical lead, and so many other people, it has been a joy to see our client going home to be with his supportive, amazing family. The moment we saw him get to go home was so emotional and rewarding.

Thank you to everyone who worked on this case with me and will continue to do so moving forward.”

The team at Stewarts Law represented JF, and achieved a total settlement figure of £30m. There have been many people involved in securing this outcome, with a special thank you to Ben Townsend of Stewarts Law, for leading the legal team on the case.

Janette Wynn, Managing Director for Active Care Group’s Case Management Division, said, “We are so proud of Nicola Ewell for her involvement and determination in JF’s case, and so pleased with the outcome, it truly is a privilege to work with such amazing case managers’’.


Introducing Rachel Treanor – Clinical Case Manager

Rachel has recently joined Tania Brown Ltd as a Clinical Case Manager. Rachel graduated as a Registered General Nurse in 2000 at Walsgrave Hospital, Coventry, with a Diploma in Higher Education. She began her nursing career as a staff nurse working in acute respiratory medicine in Yorkshire.

In 2014 Rachel began working as an independent consultant and currently is a bank Specialist Advisor for the Care Quality Commission (CQC). She also advised on palliative care and best practice for the patient.

In 2017 Rachel joined a legal team offering support and assistance towards people who have been subjected to medical negligence, i.e pressure ulcers.

We are extremely thrilled to have Rachel as part of our team.


Acquired Brain Injury: The lived experience of relatives and friends.

BABICM carried out a survey entitled  Acquired Brain Injury: The lived experience of relatives & friends.  This has been paraphrased as below:-

Family members are themselves affected by the impact of Acquired Brain Injury
(ABI) upon their relatives and they play an important role in the rehabilitation and
long term support required. The study aimed to understand how families are
impacted and their views on the formal and informal support received directly or
indirectly as a consequence of the ABI. To date there has been very little research
undertaken by social workers in relation to ABI and/or the experience of family

A mixed methods research design was employed to capture the lived experience of
family members of people with ABI. The results of the quantitative and qualitative
data were triangulated against the literature. An online survey was completed by 110
relatives of people with an ABI, seeking their experience of the condition, its impact
upon their lives and their views of services. The results of the survey were collated
and organised in SPSS (version 24). Non-¬‐parametric Spearman’s Rho Correlations
(non-¬‐parametric test) were performed upon the results.

The research identified that family members’ experience is complex and enduring,
encompassing most aspects of life, and is affected by the context in which it occurs
as well as by formal and informal support structures. The particular nature of the
grief and loss experienced by families is ambiguous and develops over time.

Quantitative data identified that Brain Injury Case Managers were the most
positively reported upon service, followed by Neuropsychologists and the charity
Headway. The least positively reported upon service was Social Work. Greater
understanding of the complex lived experience of family members may support
more effective responses to both them and the individual with ABI, integrating
services and families to improve quality-¬of-¬life. As ABI is a process with changes to
functioning developing over time, the information and knowledge required by
loving and supportive relatives needs to be created with them, being person, family,
injury and context-specific.

To read the full article please follow the link

[button url=”” new_tab=”” download_btn=”” button_style=”default” button_size=””] BABICM Article [/button]



Osseo-integration, prosthetics, orthotics and rehabilitation

The TBL staff received a training session on osseo-integration, prosthetics, orthotics and rehabilitation from the team at Mint Rehab. The team take a very functional approach setting tasks in context of the client’s day to day life, rather than doing “therapy” tasks. They detailed the approach to osseo-integration, latest research and any contra-indications.

See document here.


Depression following Traumatic Brain Injury: Impact on post-hospital residential rehabilitation outcomes

Depression following traumatic brain injury: Impact on post-hospital residential rehabilitation outcomes.

The following research has been carried out and a need exists to better understand the impact of depression on functional outcomes following TBI.

A similar effect might be anticipated in community rehabilitation packages and we at Tania Brown Limited monitor levels of depression using the HADS to ensure our clients get the best outcomes from their rehab?


To evaluate the prevalence and severity of depression among a large group of chronic TBI adults; to determine the impact of depression on outcomes of post-hospital residential rehabilitation programs; and to assess effectiveness of post-hospital residential rehabilitation programs in treating depression.


820 adults with moderate to severe traumatic brain injury (TBI) were assigned to one of four groups based on MPAI- 4 depression ratings: (1) Not Depressed, (2) Mildly Depressed, (3) Moderately Depressed, and (4) Severely Depressed. Functional status was assessed at admission and discharge with the MPAI-4 Participation Index. Differences among groups were evaluated using conventional parametric tests. Rasch analysis established reliability and validity of MPAI-4 data.


Rasch analysis demonstrated satisfactory construct validity and internal consistency (Person reliability = 0.89-0.92, Item reliability = 0.99). Of the 820 subjects, 39% presented with moderate to severe depressive symptoms at admission, These subjects demonstrated significantly higher MPAI-4 Participation scores than the mild and not depressed groups. Depressed groups realized significant improvement in symptoms, but, those remaining depressed at discharge had significantly greater disability than those who improved.


Depressive symptoms had a deleterious impact on outcome. Remediation of symptoms during rehabilitation significantly improved outcomes.



Anna Watkiss – Guest Speaker, Digby Brown Head Injury Information Day, Edinburgh

The Head Injury Information Day run by Digby Brown took place during Head Injury Awareness Week. Anna Watkiss was asked to present on the broad subject of relationships after brain injury. Her talk aimed to challenge health professionals working with individuals with acquired brain injury to consider the goal that many clients want to work on; that of forming a new relationship or being supported to maintain an existing relationship. Anna presented a whistle stop tour of how clients and health professionals supporting them, might work to maintain relationships, establish new relationships, support a client’s right to a sexual relationship and the use of dating apps/websites within the confines of capacity and supporting clients safely.