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BIWSG Response to the delay to the introduction of Liberty Protection Safeguards

BIWSG Response to the delay to the introduction of Liberty Protection Safeguards

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The Brain Injury Social Work Group (BISWG) is disappointed to hear that the introduction of the Liberty Protection Safeguards (LPS) has been further delayed by the UK Government, and BISWG supports the British Association of Social Workers’ response to this decision.

For people with an acquired brain injury (ABI), their families and the staff that support them, difficulties with the implementation of the Mental Capacity Act (MCA) and the associated Deprivation of Liberty Safeguards (DoLS) were very clearly identified in the House of Lords review of the MCA which was published 9 years ago.

Despite their Lordships very clear report, that sought evidence from across England and Wales, individuals with an ABI continue to be placed at risk of MCA assessments, Best Interests and DoLS decisions that are not informed by professional staff who are knowledgeable about the condition and how it affects functioning. There is increasing academic evidence of the harms caused by a system that fails to take account of post ABI difficulties and how these manifest in assessments versus in real world settings.

The further delay to the implementation of the LPS is not supportive of improvements to the application of the MCA for people with a brain injury. It is therefore imperative that due consideration is given to this decision and the consequences, with a view to possible revision, as further delay might not only adversely impact practice but also service provision for people affected by ABI.

Further delay in the implementation of LPS’s will continue to adversely affect people with ABI and their families.

Complex Decision-Making in Mental Capacity Practice

Complex Decision-Making in Mental Capacity Practice

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The Brain Injury Social Work Group (BISWG) worked with the British Psychological Society (Division of Neuropsychology) and the University of Essex to present a free conference in April 2022, which addressed the complexities of decision making in mental capacity practice.

The sessions are now available to access free of charge. They are delivered by social workers, those with lived experience, psychologists, psychiatrists and legal professionals.

The event was held in memory of Dr Melanie George whose work in this area has led to better understanding of the frontal lobe paradox in acquired brain injury. You can read the paper published by Dr George and Dr Gilbert here:

The recordings from the day are accessible via a moodle site (open.essex) which also allows networking and discussion in a closed social media discussion forum. Signing up is free – follow the link to “self enrol” – “continue” -> “create a new account” (this asks you for your age and country*) ->proceed.


Call for Evidence launched for national brain injury strategy

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The Brain Injury Social Work Group is delighted to that the government’s Acquired Brain Injury Panel has launched a Call for Evidence to inform the Acquired Brain Injury national strategy.

The Minister of State for Care and Mental Health, Gillian Keegan and Chris Bryant MP hosted the launch which was attended by campaigning organisations, MPs, government officials as well as clinicians and those with lived experience. Chris Bryant, Chair of the All-Party Parliamentary Group on Acquired Brain Injury, secured the ABI strategy at the end of 2021 and he and Gillian Keegan co-chair the ABI strategy programme board which first met earlier this year.

Jackie Burt, Chair of BISWG said: “We are so pleased the government is giving acquired brain injury the attention it deserves with the ABI Strategy.

“The call for evidence will give people the opportunity to share their experiences and state what they feel the government needs to prioritise. So we really need people to participate and share this information. This will give the panel information to develop their work.”

Minister of State for Care and Mental Health, Gillian Keegan, said: “It is absolutely essential people living with acquired brain injury get the best possible care and treatment and that we take steps to prevent these injuries wherever possible.

“Together the cross-government programme board and the call for evidence will allow us to deliver a strategy to address issues that matter most to those with acquired brain injuries and other neurological conditions.

Chris Bryant MP said: “I’m delighted that the government is starting to pull together a cross government strategy on acquired brain injury.

“We need people to come forward with ideas and suggestions based on their experience of brain injury as practitioners, patients or family members so we can get this strategy right.

“I urge everyone to take part if they think they have an insight to offer.”

To have your say in the Call for Evidence, complete the survey. If you require further information, contact

Strategy for Acquired Brain Injury to be developed in 2022

Strategy for Acquired Brain Injury to be developed in 2022

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The Brain Injury Social Work Group (BISWG) is delighted that the Government has announced it will implement a cross departmental strategy for Acquired Brain Injury (ABI).

Gillian Keegan, Minister of State for Care and Mental Health released the statement following a Prime Ministers Question posed by Chris Bryant, MP on 24th November which asked Boris Johnson whether the Government would develop a strategy for acquired brain injury.

Chris Bryant is the Chair of the All-Party Parliamentary Group on Acquired Brain Injury, he said: “The Government has announced it will be creating a Panel Board in the New Year with officials from several departments to start devising a whole-Government strategy on ABI. In other words, the Government is doing precisely what my Acquired Brain Injury Private Members’ Bill is calling for.

“A huge thank you to all the acquired brain injury charities, MPs and other campaigners who have been supporting my Bill and the campaign.”

Chris Bryant and Gillian Keegan will co-chair the programme board which will begin by launching a call for evidence in early 2022.

Jackie Burt, Chair of BISWG said: “The Government’s announcement that they will be implementing a full ABI strategy is hugely welcome news. Working on the social care side of things we are acutely aware of how much joint work is needed and what a difference it will make to better supporting people with an acquired brain injury.

Many organisations, charities, clinicians, service users and MPs have campaigned to push for the strategy. There is much work to do in the New Year BISWG will contribute to the call for evidence and any further work required.

You can read a full copy of the statement here

The Importance of Considering Functional Outcome and Self-awareness in the Assessment of Care Needs

The Importance of Considering Functional Outcome and Self-awareness in the Assessment of Care Needs: Initial Evaluation of the Brain Injury Needs Indicator

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A recent study published in the British Journal of Social work explores the relationship between the insight brain injury survivors have into their own condition and the problems associated with it.

The authors from The Disabilities Trust used the BINI (Brain Injury Needs Indicator) to monitor both the level of recovery after brain injury and the survivors insight into their condition. This provided a better estimate of overall risks and care needs than considering recovery or insight in isolation. Those with lower levels of insight scored higher on risk than those with higher insight, even when the level of recovery was comparable.

In practice, this means that self-report interviews and assessment tools may not always be appropriate to fully assess support needs in people with brain injury, and that seeking the views of someone who knows the person well may uncover hidden needs.

The BINI was originally designed to support social workers and other assessors in their social care assessments of people recovering from an acquired brain injury, and to help them determine what social care support they might need. It is referenced in the Care Act Guidance (point 6.43) as a tool that can be used as part of the assessment to help identify deficits in people with a suspected or diagnosed brain injury.

The published study evidences the validity of the tool as a robust indicator of risk and care need.

The full article can be accessed here.

Registered professionals can request access to the BINI here.

Improved brain injury knowledge needed by social workers

Improved brain injury knowledge needed by social workers

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The Brain Injury Social Work Group (BISWG) are supporting the call made by The United Kingdom Acquired Brain Injury Forum for social workers to be trained and informed around acquired brain injuries following a review into the death of a Brighton man.

A review into the death of 42 year old Brighton man ‘James’, who had an acquired brain injury (ABI), has found the current safeguarding system to be insufficient and a lack of expert knowledge in brain injury among the agencies working to protect him.

Now, UKABIF (UK Acquired Brain Injury Forum) has written to Social Work England and the Secretary of State for Health, gathering more than 100 signatures from experts across health, social work and law in support of their call for improved training for social workers.

James died in July 2019 and his death led to a Safeguarding Adult Review (SAR) looking at the involvement of Brighton & Hove Health and Adult Social Care, Brighton & Hove CCG/Sussex NHS Commissioners, Sussex Police, Brighton and Sussex University Hospitals Trust, Brighton & Hove Housing Department, Money Advice Plus and Brighton and Hove Safer Communities Team.

The Review looked at the period from December 2016, around the time the local authority began a formal safeguarding enquiry, until James’ death. During this period, there was multi agency involvement with concerns around James’ substance misuse, vulnerability and ability to live independently.

His acquired brain injury was not taken into account by the professionals involved in James’ care and the review concluded ‘the assessments undertaken of James’ needs did not take sufficient account of his ABI and in particular the absence of capacity assessments informed by expertise in brain injury meant the care provided to him was ineffective.”

The review stated: “…the safeguarding system within Brighton & Hove is insufficiently developed to enable people with acquired brain injury to be safe.”

Chloe Hayward, UKABIF Executive Director, said: “Sadly, the issues raised by this SAR are not unique to James or to Brighton & Hove. It identified significant failings and a complete failure to assess mental capacity. Underpinning all of this is an acknowledged absence of ABI knowledge by social workers. We believe social workers play a vital role in supporting individuals and families affected by ABI but cannot do so effectively without the knowledge they need to practice to the best of their abilities. We want to work with Social Work England and look at how social worker training can take into account the needs of people with brain injury.”

The Coroner issued a Regulation 28 report following the case which gives all the authorities involved 56 days to produce a future plan.

Dr Mark Holloway, Trustee of BISWG, who is a social worker and brain injury case manager, was an expert witness for the Coroner leading the case into James’s death. He added: “Acknowledged and serious failings in James’ support and treatment are a personal tragedy for him and his family. However, these failings are representative of a systemic issue based in an absence of training and of knowledge by social workers of the impact of ABI upon an individual’s functioning and behaviour.

“Experience from across the country demonstrates that a lack of basic knowledge (and lack of interdisciplinary working) leads to recognisable and often preventable harm. Presently social workers are not being given the tools they require to carry out their vital role. Until they are, more harm will be caused and statutory duties will remain unmet. Individuals and families affected by ABI need the best support possible, knowledgeable social workers, equipped to carry out their roles, play a significant part in that process.”

Tracy, one of James’ sisters, said: “As the SAR into our brother’s life and death has shown, the services that were supposed to help and protect him could not do so because they did not understand his brain injury and how this affected him.

“He needed guidance and support in every aspect of his life and most importantly he needed safeguarding, to protect him from others who took advantage of his vulnerability and exploited him in every way possible. He was left unprotected and unsafe – he could have been helped instead. As a family we hope that the lessons learnt from his death can help others, so other families do not have to go through what we have, and that people with a brain injury can be supported and given hope.”

UKABIF raises awareness of acquired brain injury and works to ensure that people with ABI have early access to local, specialist neurorehabilitation and follow up services in the community.

The full Safeguarding Adult Review can be found here.

A copy of letter to SW England can be found on the UKABIF website here

If you require any further information, please contact Emma Chesworth on 07952 158926

In Memory of Dr Melanie George

In Memory of Dr Melanie George

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It was with great sadness that the BISWG trustees learned about the recent death of Dr Melanie George .

Melanie’s extensive work in the field of Acquired Brain Injury is renown and has been beneficial to those of us working in this area and to affected clients and families.

We are fortunate that Melanie was able to work with BISWG in attending Parliamentary meetings and in producing her templates to assist assessments.

The many publications that Melanie and her colleagues have produced have been influential in affecting the need for change. In particular the report ”Mental Capacity Act assessments : Why everyone needs to know about the frontal lobe paradox’’ produced in conjunction with Sam Gilbert.

Melanie was very keen that her work would be used by BISWG to inform practice and we were more than happy to agree to this.

We aim to ensure that this work will form part of our training agenda to encourage the skills and practices of the social work profession in the hope that this will be a fitting legacy in Melanie’s memory

Brain Injury Social Worker, Jackie Burt, listed in New Year's Honours

Brain Injury Social Worker, Jackie Burt, listed in New Year’s Honours

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Jackie Burt, the Chair of the Brain Injury Social Work Group has been awarded an MBE in the New Year’s Honours for her work with people with brain injuries.

Jackie qualified as a Social Worker in 1985 and began her career with the Mental Health team in Moorhaven Hospital near Plymouth. She later joined the Neurology Team at Derriford Hospital where a strong multi disciplinary approach was important when working with people diagnosed with neurological conditions such as Multiple Sclerosis, Motor Neurone Disease, Brain Tumours, Parkinson’s Disease, Huntington’s Disease, Epilepsy and Acquired Brain Injury of all kinds.

Over the years Jackie has worked extensively with OT’s Physios, Speech and Language Therapists, Psychologists, Doctors and Commissioners. She has extensive experience of Local Authority Social Work in a Neuro Rehabilitation setting, involving arranging complex discharge packages for patients who have experienced life changing events and supporting families.

Having developed a special interest in Acquired Brain Injury Jackie joined the BISWG committee in 2007 and when BISWG gained charity status in 2009 she became a Trustee.

Jackie set up and runs the South West ABI Forum for professionals working in the field. She now works as a Case Manager in the South West and remains committed to raising the profile of the needs and concerns of those living with Brain Injury.

Jackie said “I am so surprised and delighted to receive this award. I have been very lucky to have worked with brilliant people over the years and happily have been able to help many people with brain injuries. There is a huge lack of education and understanding within the social work profession about brain injury and this is what the Brain Injury Social Work Group is trying to address through publications, training and education.”

Spotting the signs of acquired brain injury (ABI) in adults: top tips

Spotting the signs of acquired brain injury (ABI) in adults: top tips

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In August 2019 Community Care published an article on acquired brain injury, written by BISWG Trustee Andy Mantell. A shortened version is publicly available here.

There is a full Community Care Inform Guide for Inform Subscribers which provides detailed case examples, scenarios, and practice tips covering the basics of ABI.

Andy will be presenting a session on Acquired Brain Injury in Adults and how to recognise this condition and respond to it at Community Care Live in London on 16th October 2019 alongside the Dr Sue Copstick from the Brain Injury Research Trust.

You can find out more about attending the seminar which is free of charge here.

BISWG Trustee Dr Mark Holloway is co-author of a new book Family Experience of Brain Injury: Surviving, Coping, Adjusting (from the After Brain Injury: Survivor Stories series)

BISWG Trustee Dr Mark Holloway is co-author of a new book Family Experience of Brain Injury: Surviving, Coping, Adjusting (from the After Brain Injury: Survivor Stories series)

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The book is a collaboration between family members of people affected by brain injury and professionals who have worked in the field, alongside family, for many years. The intention is to provide an opportunity for those hidden and marginalised voices of family members who are in for the long haul, often dismissed by services and sometimes left to cope in isolation.

It is hoped the book is helpful for professionals and families affected by brain injury and that you can also utilise it to help explain the family experience to professionals who are often lacking in knowledge of brain injury and the impact it has upon family.

This is the link to the publisher’s site.

This is the link via Amazon.