Where have the spinally injured been left by Covid-19?

At a recent meeting of the All-Party Group on Spinal Cord Injury, attended by Minister of State (Minister for Care), Helen Whately, concerns were raised over the loss of specialist beds in the NHS for spinally injured claimants through Covid-19 and the risk that they will not be returned to spinal care. [1]

Are there consequences for insurers dealing with this sort of claim?

Keoghs have spoken to representatives in the health sector to take soundings on the current situation.  It is true to say that spinal beds were vacated and transferred to Covid-19 patient care as the first and second wave swept the UK. Many spinally injured claimants were discharged into the community much sooner than would ordinarily be the case, and before they had received the level of support and rehabilitation they needed. Within the midst of a pandemic, desperate times called for desperate measures but anyone dealing with spinally injured claims knows that delays in rehabilitation can carry a heavy price.

Recent experience shows that a bed shortage in spinal injury centres was already causing issues for spinally injured individuals who were being discharged far sooner than would ordinarily be the case.  Covid-19 has exacerbated this.

How might the current situation develop over the next few months and what impact might this have on claims handling? Here are some thoughts:

1. Delayed rehabilitation will have risked unnecessary deterioration and potentially chronic outcomes or, at the very least, conditions that are more resilient to rehabilitation. Transfer potential is unlikely to have been realised and bladder and bowel management programmes may not have been properly established. Reserving cases at day one will be more difficult for insurers as it will not be clear what potential individuals will have on discharge.

2. The psychological impact of a spinal cord injury is devastating, both for the individual but also for their loved ones. This will have been made far worse by Covid-19 visiting restrictions at hospitals meaning many individuals will have been left completely isolated at a time when they have needed their loved ones the most. Addressing this potential issue will be an important part of any rehabilitation put in place as part of the claim.

3. Save for the most simple surgical procedures such as bladder stone removal, more complex procedures (for example pressure sore treatment) will go back to the spinal unit for reasons of continuity of care; it may not be just a matter of “going private”. Delays here will undoubtedly cause stress and frustration for the injured individual.

4. With the backlog of spinally injured in the community awaiting treatment, the burden of long-Covid-19 in the community, and a finite resource of NHS rehab practitioners, it will take years, not months, to address these issues.

5. Ensuring that the claimant has access to appropriate accommodation upon discharge is key but there will be less time for this to be put in place with discharge often taking place with minimal notice. Now more than ever, claimant’s solicitors and insurers should adopt an open book approach to rehabilitation. Real-time updates from case managers to insurers can ensure that further delays to the claimant’s rehabilitation are minimised.

The message to insurers is likely to be that they have to embrace and even encourage private therapy; to sit back and leave the NHS to deliver will risk prolonging the life cycle, increase care costs and likely further entrench the claimant’s view of the compensator. Short term investment is more likely to prove money well spent in the long term.

This philosophy is not new and is one that insurers have always embraced in spinal claims; the problem post-Covid-19 is that the volume of cases that have stalled due to premature, sub-optimal discharge by the NHS will have exploded. 

For more information, please contact Emma Spencer, Partner and Head of the Spinal Group. 

[1] https://www.spinal.co.uk/news/minister-for-care-shines-spotlight-on-spinal-cord-injury-in-landmark-moment/