Independent Nurse Led Triage answer for Whiplash Claims

Independent Nurse Led Triage for Whiplash Claims

In his autumn statement the Chancellor announced that he planned to raise the small claims limit to 5k and abolish compensation for whiplash claims in an attempt to reduce fraud. He has said that any savings should be passed down to each tax paying driver reducing their premiums by approximately £50 per annum.

Following his announcement there have been numerous articles focusing on fraud exposer, arguments regarding rights for access to justice and concerns whether the costs will actually be passed on to the tax payer. Their hasn’t been any real focus on how if implemented properly this would be beneficial to those who have genuinely been injured.

Since its infancy rehabilitation has been a hot potato in personal injury with many of those implementing it struggling to fully understand the concept for which it was intended, i.e putting the injured person back in to, or as near as possible the position they were in prior to an accident happening.

If asked most genuine claimant’s given the choice would rather not have had the accident in the first instance or having had the accident would prefer to have the treatment they need so they can recover and get back to normal as quickly as possible. Waiting for a doctor’s appointments, not being able to work whilst having a mortgage to pay, speaking to solicitors and attending medical examinations for compensation for some can be as stressful as the actual accident.










I have lost count of the number of people who have told me they have been involved in an accident that was over 2 years down ago and who are still waiting for medical reports before funding for their treatment will be made available, whilst others say they have received their compensation but are continuing to have problems with the site they injured.

In society when someone is taken ill or has been injured, their first port of call is a health centre, whether this is a walk in centre, a GP’s practice or Accident and Emergency. On admission they are usually assessed by an independent triage nurse, who has studied for at least 3 years at university and in clincal settings, then has worked for a minimum of 6 months in the NHS. The nurse uses their skills and knowledge to make an informed decision about the patients needs for treatment and then refers them on if appropriate, to the most suitable expert for their needs, whether this is a physiotherapist or a doctor. This nurse then steps aside leaving the treatment to those suitable qualified.

Whiplash in most cases can be treated with analgesia and advice as it is usually short lived and self-limiting so their is no need for further intervention as it gets better on its own and the individual can return to their pre-accident lifestyle. However in a small number of cases the symptoms persist and physiotherapy intervention is needed.

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Whilst in personal injury the needs of the injured person should always be at the forefront of any claim, if the assessment of a client’s needs is not carried out by an independent organisation, the financial implications that surround compensation may cloud their judgement when considering rehabilitation.

Therefore it seems obvious that the solution for personal injury fraud is to replicate the National Health Service’s tried and tested model using independent nurse led triage for all clients. Surely this would guarantee that all claimant’s were being assessed holistically by an appropriately skilled person from day one and treatment given only to those who need it.

Whilst triage has been recognised as they way forward in the 2015 Rehabilitation Code the code is not mandatory,  so perhaps the Chancellor needs to review the code and work with experts who in this field to make it a mandatory part of the pre action protocols?

Fast Assess is Hiring

FastAssess is hiring  – With the Rehab Code 2015 due to kick off on 1st December 2015, we are looking for Registered Health Professionals to join us.

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For any further information  please e-mail


Rehab stalwarts launch FastAssess

Our lovely friends at Post Mag have been kind enough to do a press release on our new product FastAssess.

I think I should have popped to the hairdressers before the photo shoot!








Rehabilitation experts from Accident Rehab & former Managing Director of HCML have joined forces to launch a service designed to make the rehab process more efficient.

Helen Merfield, founder of HCML,pictured left, and Helen Spillards, director of Accident Rehab, pictured right, have launched Fast Assess, which is billed as providing high level telephonic triage and assessments at a lower cost than other market players, while providing consistency and independence for solicitors and insurers.

Commenting on the launch of the service, which coincides with an updated version of the rehab code, Spillards said: “Just over two years ago when the Jackson reforms came in to play there was a noticeable change, and it became apparent that many of those who needed rehabilitation weren’t being assessed properly and as a result weren’t getting the treatment for their injuries until it was too late – leaving their conditions to become chronic.”

Merfield added: “With the recent release of the rehab code, the timing couldn’t be better for delivering a fast, lower cost, medically-led, independent triage/assessment report. Which is exactly what Helen has done. Helping insurers and solicitors meet the 1 December deadline for adopting the new code”

Merfield and Spillards have more than 30 years’ experience in the personal injury sector, have run their own independent case management companies and have been board members of the CMSUK.

Both started their careers in the personal injury market at AIG. Merfield went onto set up HCML and was most recently involved in the review of the rehab code.

Spillards set up her own independent case management company and was involved in the development of the first master degree in case management in the UK.

For more information on FastAssess email us at or call us on 0151 348 7000

What makes the 2015 Rehab Code different?

It has been 8 years since the Rehab Code was updated. Since then we’ve seen the Jackson reforms in 2013 and the introduction of Medco earlier this year, not forgetting changes to the Health Service and Welfare Reforms leaving many to believe that the rehab code was no longer fit for purpose.

Whilst the concept of the rehab code hasn’t changed and still actively encourages a collaborative process between both claimant and defendant, the 2015 rehab code is more detailed with clearer guidelines on the expectations for both sides and will make things more ethical and better for the injured person.

So what makes the 2015 rehab code different?

Firstly and probably the biggest difference is the attention that has been given to lower value claims. The 2015 rehab code is significantly more detailed and has been written jointly by members of ABI, APIL, CMSUK, FOIL, IUA, MASS and PIBA. Mark Bayliss, chair of the International Underwriting Association admitted to Post Magazine that creating the updated code had been a challenge for all involved as everyone has a different view on rehabilitation ‘but we got there in the end.’










The 2015 rehab code identifies that the claimant and their rehabilitation should be at the forefront of any personal injury claim regardless of its value. It recognises that injuries don’t always need to be catastrophic to require rehabilitation, that not all lower value cases need treatment and those that do may need more than just a course of therapy.

The onus has been put on to the importance of early identification of injuries and early intervention of rehabilitation, which will prevent conditions becoming chronic, thus enabling claims to be settled more swiftly and accurately.

The code continues to advocate the need for an appropriately qualified health practitioner to assess the injured person and identify their needs, whether it be a triage on a lower value case or an immediate needs assessment on a catastrophic. What is interesting about is this is that one of initial findings considered as appalling health care in the Mid Staffordshire NHS inquiry in 2010  was that triage in A&E had been undertaken by untrained staff, something that could perhaps be related to the current rehabilitation market.  There are other issues that may also be comparable which I plan to write about in a later blog.

The code advocates independence from the medico-legal process something that has become an issue since the Jackson reforms and has been argued is a conflict of interest.

The 2015 rehab code is focused on 10 markers that need to be taken into consideration when structuring a rehabilitation plan.

1. Age ( particularly children/elderly);
2. Pre-existing physical and psycho-social co morbidities;
3. Return-to-work/education issues;
4. Dependants living at home;
5. Geographic location;
6. Mental capacity;
7. Activities of daily living in the short- and long term;
8. Realistic goals, aspirations, attainments;
9. Fatalities/those who witness major incidence of trauma within the same accident;
10. Length of time post-accident.
As an addition to the code there is a supplement guide on the requirement and expectations of a case manager.

Many who have worked in the industry for a long time and understand it would probably agree that the 2015 rehab code is guidelines for going back to basic’s !

To coincide with the 2015 rehab code Accident Rehab has launched FastAssess which is our online independent rehabilitation triage reporting system, which will give an early accurate assessment of  a client rehabilation needs for lower- mid value cases. For more information, please contact us on 0151 348 7000 or e-mail




Rugby Injuries

Despite the number of injuries to the Welsh team they were still able to beat 28- 25 to England at Twickenham at the weekend.

With the English, (myself included) still licking our wounds, I thought I would write a brief blog about the most common rugby injuries.

As many as 1 in 4 rugby player’s are injured each season with a 57% of those injuries occuring during a match rather than training, more often than not these injuries occur in the second half of the game.

The chances of getting an injury on a rugby pitch are 3 times higher than on the playing field and research has suggested that in the UK one in every 100,000 players is likely to sustain a significant injury.

According to QBE the top five injuries are

  1. Concussion
  2. Hamstring Injury
  3. Thigh Haematoma
  4. Calf Muscle Injury
  5. Medial Collateral ligament (MCL) injury

Whilst Physio Works estimate that over 40% rugby injuries are muscular strains and bruising, 30%  are sprains followed by dislocations, fractures, lacerations and overuse injuries, whilst 44% of  head injuries are concussion.

The Australian Rugby Union state that 31.2% of injuries occur as a result of tackling whilst only 2.4% happen in the scrum and the body part that is most likely to be injured is the shoulder.

In an early study by Hattingh in 2003  it was identifed says that the eighth man is the position most at risk of injury, followed by the flank, hooker and lock, whilst the scrum half least at risk.

With the Rugby World Cup entering it’s 3rd week and the likes of Leigh Halfpenny, Scott Williams and Hallam Amos already ruled out due to injury, let’s hope future injuries are kept to a minimum so that we are able to enjoy the rest of the tornament!












PTSD Rehabilitation for witnesses of Tunisian Shootings!

Just over 2 weeks ago, I was sitting on the beach in Sousse soaking up the sunshine only metres away from where the Tunisan attacks took place last Friday.

With clear blue skies, crystal waters and white sands, this is an idyllic place to get away from the hustle and bustle of everyday life.

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Going on holiday is meant to be a time for enjoyment and relaxation, so the idea of someone with a Kalashnikov assault rifle running across the sands and openly firiing at holidaymakers is simply terrifying. There is no doubt that many of those who witnessed the attacks and the aftermath are going to experience an element of post traumatic stress disorder ( PTSD).

Whilst it is normal to experience upsetting and confusing thoughts after a traumatic event, for most people these feeling will improve naturally over a few weeks.  However,  some people  suffer with extreme symptoms that usually  present themselves in the first 4 weeks post incident, these can include flashbacks, experiencing and reliving the trauma over and over again, physical symptoms such as sweating and a racing heartbeat,  avoidance behaviour fear of going back to where the event happened and hyperarousal symptoms.

It is possible that those working and holidaying in and around the Imperial Marhaba are going to have difficulties coming to terms with what they have experienced and if their symptoms have not resolved within a month, then it is likely that they will benefit from a course of cognitive behavioural therapy, (CBT).

CBT is a treatment that helps people to change the way they think and behave, so that they are able to deal with their problems and change negative thought patterns into more positive experiences.  The treatment is usually carried out by a Psychologist. It can be arranged by a GP on the NHS  for no charge, or it can arranged on a private basis for a cost of between £40-£120 per session. If arragned privately the paitent doesn’t not need a referral letter from a GP. Therapists can be found on the BABCP website or on the directory of chartered psychologists.

If you would like more information or help, please contact us on 0151 348 7000 or e-mail us at and will be happy to help.





Rehabilitation & Compensation!

I stumbled across an article in the Daily Mail this morning about the horrendous accident at Alton Towers last week where 14 people were injured, 4 of them seriously.

We now know that Leah Washington a 17 year old girl on a first date,  was one of the more seriously injured sustaining an above knee amputation whilst her boyfriend Jo Pugh has been left with injuries to both knees and his hand.

There is no doubt that the rest of those on the ride will have an element of psychological trauma & possibly a form of whiplash.

Whilst Alton Towers have already accepted  full liability, I was astonished that the article was focusing on the millions of pounds of compensation expected to be paid out, rather than on the recovery & rehabilitation of the poor passengers on the ride whose lives have been turned upside down.

It wasn’t until I received a link to a further article with a single sentence was I made aware HCML had been asked to get involved & support those injured in the ride.

Whilst there is no doubt these individual’s will get the compensation they deserve, it reminded me of the question that is always at the forefront of my mind when promoting the services of rehabilitation & case manager’s.

Given the choice would you rather have your leg or million pounds?

Whilst accidents can’t be prevented, getting an injured person the best treatment & services, so they can make the best recovery & regain their independence & quality of life should be the priority in any personal injury claim.



The Rehab Code 2015

Last week I attended the market brief on the revised Rehabilitation Code ( Rehab Code)  and Case Manager’s Guide.

The Rehabilitation Code was first published in 1999 and was last updated in 2007. Since then there have been many significant changes in the industry, most importantly the Jackson reforms in 2013, which left many people in the industry stating that the code was no longer fit for purpose.

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After serveral months of discussion amongst the members of the IUA’s Rehab Working Party which includes members of the ABI, APIL, CMSUK, BABICM and FOIL the new rehab code is now in it’s final stages and plans are being made for it’s release over the summer.

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The rehab code will be aimed at implementing a more collaborative process between both sides in the personal injury claims process and will be divided in to two sections, lower value cases under £25k  and medium, severe & catastrophic cases for those about 25k. There is also a set of guidelines on what to look for and expect when choosing and using a case manager.

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For more information please contact us on 0151 348 7000 or e-mail us at

Accident Rehab Triage Product Makes the News

Last week we made the news with our online line portal and fast track triage product. Thanks to our friends at Claims Magazine

After months of working with our colleagues at Livepoint Solutions we have been able to utilise their skills and combine them with our knowledge and create an online referral portal for our fast track rehabilitation triage product.

With changes in the way medical reporting is being processed and the revised rehab code due for release in June the rehabilitation industry has never been so exciting.

If you would like to register for our online portal, please complete the form below.

Portal Registration

If you would like to make a referral for an INA or triage assessment please complete the form below to register for our online portal