Written evidence provided by:	Headway – the brain injury association
Submission to:	Health, Social Care and Sport Committee, Welsh Parliament
Title of inquiry:	Inquiry into the Covid-19 outbreak on health and social care in Wales

Background

Headway is a UK-wide charity working to improve life after acquired brain injury (ABI).

Every 90 seconds someone is admitted to hospital in the UK with an ABI-related diagnosis, such as trauma, stroke, tumour and neurological illness. In Wales, over 17,000 people a year are admitted to hospital with an ABI.

Of those who survive, many will require some form of support or rehabilitation; for some, this will be a life-long need.

Headway works to improve life after ABI through providing services, support and information at every stage of the care pathway. Headway UK provides support and guidance to a network of over 120 locally-run groups and branches across the UK and Channel Islands.

Groups and branches offer a wide range of services, including brain injury rehabilitation programmes, carer support, social re-integration, community outreach and respite care. Frontline UK-wide services include a nurse-led helpline, which answers over 11,000 enquiries each year; an Emergency Fund to assist people in coping with the financial impact of sudden catastrophic brain injury; and a range of free to access award-winning publications.

Headway UK has worked in partnership with the Welsh Government over a number of years to set up a network of branches to support people living with ABI. These branches have been established in some of the most isolated areas in Wales with funding provided by the Welsh Government, which came to an end earlier this financial year. However, despite this funding coming to an end, Headway UK remain committed to supporting brain injury survivors in these remote communities to ensure they do not have to cope with the effects of their injuries alone.

Funding implications for Headway UK

Headway UK has diverse income streams and a mixed economy of funding; not just grants and donations but also trade, via its network of 30 charity shops.

Our trading, like most other charities, has ceased entirely as a result of our retail premises being closed and staff being furloughed. However, all 30 shops are still incurring significant costs to the charity despite bringing in no income.

Headway provides training to a range of professionals including those working in supporting adults with a brain injury, through to solicitors who deal with brain injury cases. These training sessions, alongside our regular events and conferences have had to be cancelled in light of the pandemic.

Similarly, the traditional fundraising methods employed by Headway and other charities require people to come together. Social distancing guidelines mean this is no longer possible.  Therefore, the vast majority of our community fundraising initiatives have had to be stopped losing the charity vital income.

We welcome the government’s efforts to lessen the financial impact of the current public health crisis, however, the losses we stand to incur will still be substantial. Nevertheless, we are working hard to limit the impact on our services.

Headway is forecasting its 2020 income to be approximately £1.3m below budget. This represents in excess of 25% of the charity’s annual turnover of around £5 million. We also expect it to take a considerable time for our income to return to their pre-crisis levels and anticipate the impact lasting until the end of 2021.

This drop in income may require the charity to make very difficult decisions. The vital services we provide may need to be scaled back or even stopped in some cases. We will do our upmost to continue to support brain injury survivors and their families in Wales.

We want to continue to provide these services and ensure that people in Wales do not need to seek help from more costly state-funded services.

Welsh Government Third Sector COVID-19 Response Fund

Headway welcomes the announcement of the Welsh Government to allocate £24 million to help the charitable sector through this crisis.

It is imperative that the application process for this fund is not only swift but is also not overly complex to complete. Many charities are now working with a skeleton staff and simply do not have the capacity to fill out lengthy forms whilst also trying to maintain the services they provide.

We recognise the need for funds to be directed towards those charities who are directly supporting the Coronavirus effort; however, consideration must also be given to other charities. Many charities, like Headway, support some of the most vulnerable people in society who have been hit hardest by the impact of the pandemic.

Headway provides services to people with life-long disabling conditions who will require permanent support. If these local groups were to stop providing these services, there would be a significant impact on the social care sector in Wales.

Headway groups and branches in Wales

Thirteen Headway groups and branches provide support to brain injury survivors and their families in Wales. This support varies depending on local needs and resources but is invaluable to those who receive it. The most recent survey results demonstrated that over 1600 individuals are supported by Headway in Wales.

Headway Cardiff and South East Wales is an autonomous local charity that is affiliated to the UK-wide body.  They work with their local authorities and Local Health Boards to provide a variety of specialist rehabilitation and social support services to brain injury survivors and their families. Doing so helps individuals rebuild their lives and regain a degree of independence thus making them less reliant on more costly state-funded services and reducing the pressure on the health and social care system.

The other branches across Wales, run by volunteers, provide invaluable support services to people living with ABI and their families.

Like Headway UK, local Headway groups and branches are funded in a variety of ways. However, those who provide physical spaces for sessions and places to meet have been forced to close their doors. They have developed new, innovative ways of delivering support to their service users and will continue to do so.

Feedback from Headway Cardiff and South East Wales suggests that some of their most severely disabled service users have had care hours cut. This is having an impact on the immediate family and Headway staff and volunteers are being asked to provide that support.

Staff and volunteers are supporting service users with collecting shopping and medical supplies. Some service users will only accept support from the staff they have built up relationships with and therefore trust. Without this provision they would be unable to access the things they need.

Conclusion

Whilst the Third Sector Resilience fund is welcome and support is being made available in the short-term, there needs to be consideration of the long-term implications of this crisis. The ‘stabilise’ element of the fund to cover immediate costs in the first three months is essential and the ‘sustain and recover’ element is welcome, but only covers the following nine months where 25% of the grant can be used.

The local Headway group fear that the impact on their organisation will be significant over a much longer period and support may be required beyond this point.

It is imperative for the local group and branches in Wales, that support is provided to organisations not involved directly supporting the response to COVID 19. Otherwise there is a fear that they will not be in operation to support individuals and their families in Wales, long after this crisis is over.