Posted 1st June 2010
Kevin Purvis has recently joined the CMSUK Board of Directors as a co-opted Board Member, and we have kindly been provided with his biography, and a very useful introduction into Paediatric Case Management. We would like to thank Kevin for committing his time to the CMSUK.
Kevin Purvis has recently joined the CMSUK Board of Directors as a co-opted Board Member and will be standing for election to a full Board position at the CMSUK Annual Board Meeting 2010. He is Managing Director of K Purvis and Associates who specialise in case management for children and younger people. He is duel qualified general and sick children's nurse and holds extensive clinical working experience (26 years), in the specialist care of neonates, infants and older children requiring care and treatments for Hydrocephalus, Acquired Brain Injury, Spinal and other bony injuries, multi-trauma and preparing children and families for home ventilation. He is currently undertaking a diploma in Child Development.
After leaving the NHS and before setting up his own company he worked in the field of rehabilitation as Director of UK Services for an International Rehabilitation Charity providing care, housing, vocational training, sheltered workshops and vocational rehabilitation for people with learning difficulties and residential slow stream rehabilitation for people with acquired brain injury and high spinal injuries.
Kevin spent two years working within a Genitourinary Medicine at a premier HIV and AIDS treatment and research centre which provided specialist services for minority and excluded groups. Services included clinical screening and treatment, inpatient care, end of life care, rehabilitation to work, support at work and benefits advice.
Most recently before setting up his own Case Management Company, Kevin worked as General Manager in an Insurance owned Case Management Company. He worked as part of the senior management team to provide Case Management and Occupational Health Services. He also undertook case management and immediate needs assessment for complex adult and child cases.
In all his posts he has retained hands on service provision.
Kevin and his company are based in the South West between Exeter and Plymouth. The work of the company includes immediate needs assessments, case management and longitudinal assessments. The work is focused on children and younger people who have sustained moderate to severe/complex injuries.
Some basic points for consideration when undertaking Paediatric Case Management:
A one size fits all approach does not work when undertaking Paediatric assessments. The approach will differ across the age ranges. Assessing an infant's immediate needs is a very different prospect from assessing a younger person who may be ready to leave school and begin working life.
Working with children means that you are working with their close family. It is very important to ensure you set professional working boundaries and that the family know the extent of the service you are able to provide as close family members can become very attached/reliant on case managers for personal support. This is especially true where there may be a single isolated parent.
It is important that you never find yourself in a position where you are left alone with a child as this could potentially expose you to a whole host of problems.
Working in the field of paediatric case management it is important to ensure the children and younger person's voice is always heard and that any arrangements put in place reflects their wishes. This can be a hard task when there is a combination of immaturity and complex injury. Inclusion of the main carers is very important in beginning to understand care needs and desired outcomes from any case management package.
A child consenting to treatments is a complex area. If a child refuses to undergo a treatment and is of an age when they are deemed competent to understand the outcomes then it may be necessary to seek other advice on the way forward.
All too often we see children who have sustained significant injuries two or three years earlier and have received limited rehabilitation guidance and no long term rehabilitation. We see children whose behaviour, as a result of their injuries, is disruptive at home and school. Other siblings can be directly affected by the changed behaviour. One parent described it as having a distant relative suddenly turn up on your doorstep: "you vaguely recognise them but do not really know them and they are totally disruptive to any normal family life we once knew." In assessing these children it is important to take a wider view of family dynamics as the consequence of a child with disturbed behaviour may reflect across the whole family. Respite may be an option to consider allowing the rest of the family some time to recuperate.
Specialist children's rehabilitation centres such as the Children's Trust, Tadworth, may be an option for providing a multi-professional rehabilitation based assessment and long term rehabilitation planning. However these specialist services are limited to the number of children they can accept at any one time.
Return to school following a major injury is not always a problem and some children are able to fit back into school with minimal support, for example; reduced school hours for a couple of weeks, or providing a facility where they can rest for an hour if they get tired. Where a child has returned to school and has had problems such as disrupting classes, falling behind in learning or has not been able to return to school then obtaining an ‘Educational Statement' (a process of pulling together educational, psychological, social care and health experts to assess and plan for the best learning environment) may be required. Learning can be re-established at school, alternative establishments or in the home. Obtaining a ‘statement' does not mean that the recommendations will be executed and this can lead to very frustrating times for all concerned. The child can end up potentially isolated from school and school friends.
Working with injured children requires specialist knowledge to ensure that assessments are accurate and include appropriate outcome measures. It also requires the ability to gain the confidence of the child and family at a very early stage and be absolutely honest about the outcomes you can potentially help affect.
If you would like more information about how we work or to contact us to discuss a case, please do not hesitate to contact Kevin through the CMSUK Website.
Some useful contact addresses:
Advisory Centre For Education
1c Aberdeen Studios
22 Highbury Grove
0808 800 5793 - general advice line: Monday-Friday 2-5pm (free phone)
Association of Brain Damaged Children
3 St Paul 's Road
024 7666 5450
British Institute of Brain Injured Children
01278 684 060
01279 685 573
Child Accident Prevention Trust
4th Floor, Cloister Court
22-26 Farringdon Lane
Tel: 020 7608 3828
Fax: 020 7608 3674
Child Brain Injury Trust
The Radcliffe Infirmary
Tele: 0845 601 4939
The Children's Trust Tadworth Court Tadworth Surrey KT20 5RU Tele: 01737 365 000
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