Question time with Bob Butler, rehabilitation case manager, registered nurse and paediatric and clinical negligence specialist

Bob’s mission at HCML is to help make it the go-to company for children’s catastrophic rehabilitation case management.  He was lead clinician at the famous Children’s Trust Tadworth, helping to pioneer the UKs first children’s residential rehabilitation service and make it a centre of excellence.

Hundreds of children, young people and families have been entrusted to his care in the last 30 years, where he has treated and developed pathways for acquired, birth-related and traumatic brain injuries, while honing his expertise in clinical negligence.

Having returned to front-line care at HCML, he explains what fires him up to give his best, day after day, and why he sees his job as being like an aviator.

Q1. What does a typical working day/week/month look like for you?

There is never a dull moment in my Monday to Friday 9-5 work.  I’m supporting some very interesting, complex cases, each needing varying degrees of input at any one time.

Day to day I’m using HCMLs case management integrated care records system, to plan my clients’ rehabilitation plans and treatment interventions. I work from home but rarely in isolation as I frequently communicate with the wide interdisciplinary team and with HCMLs network of rehabilitation case managers. I’m also visiting clients in Wales, Birmingham and the South of England. Each rehab client is different and every clinician brings something interesting to the table.

Q2. Do you have a personal mission that fires you up each day to deliver your best?

My personal mission is to get the very best outcome for the children and young people I support, as quickly as possible and in a manner that brings least inconvenience to them and their families’ daily lives.  I’m always thinking how I can best deliver truly child and family centred care, building positive rapports, having fun, going the extra mile and bringing a sense of calm and order to the chaos a catastrophic injury brings.

Q3. What do you consider to be your main achievement in the last year?

Getting some fantastic feedback from my rehabilitation clients, their families and stakeholders. Customer satisfaction goes a long way to evidence that you are doing something right and I’m pleased that I haven’t had one negative comment.

Q4. Who is at the heart of what you do?

The children, young people and families are at the forefront, closely followed by the stakeholders that commission my input.

My approach is underpinned by a strong sense of professionalism, inquisitiveness and evidence-based practice and this makes it easy to have open, constructive and sometimes challenging conversations about the best rehabilitation route. Constructing a really good rehabilitation plan from the sum of the parts is always extremely satisfying.

Q5. When you see a barrier to getting things done, how do you typically respond?

It’s like ‘going on a bear hunt’, but in my case, who says you can’t go around it, over it, under it or through it. There’s always a way. I think this is where my entrepreneurial spirit comes to the fore.

Q6. When you talk about your work as a case manager, what surprises people who don’t know the profession?

 Initially I think it’s a perception that in some respects it’s linked to a murky world of finance, legality and compensation claims. No win no fee – what’s the case manager making out of this?  My priority has always been the best outcomes for the client and/or their recovery to previous level of functioning. I did a very similar role throughout my career in the NHS and charity sector, coordinating interdisciplinary teams and facilitating high quality rehab programs. It just wasn’t labelled as case management but when I explain what I do to people that know me, they are surprised at the similarities.

Q7. What do you do outside of work?

I drink tequila and party with some great HCML colleagues.  I escape to nature, go fly-fishing in the beautiful English countryside, get out on my mountain bike when I can haul my butt off the sofa and, most enjoyably, spend time with my three grown-up kids, who have all but flown the nest temporarily at Uni, but keep returning home with bags of washing.


Q8. Which label best sums up your role as case manager: trouble-shooter, project manager or navigator?

Aviator captures the concept best. Flying between many diverse and often intricate clinical conundrums. Leading the way with many stakeholders reliant on your competencies throughout the journey. Carrying the responsibility of delivering speedy outcomes safely. Pilot and co-pilot to a vast network of clinicians and professional groups.

Q9. What do you say to clinicians thinking of becoming a case manager?

If you are competent in clinical practice, if you like helping make a difference to others and working in a team then go for it. It’s the most rewarding and satisfying job I’ve had in a very long time. I couldn’t say what it’s like working for another company but at HCML I’ve found a fit which I appreciate. I intend to stay for as long as they’ll have me.

Q10. Do you have a role model or hero, that inspires you in your day-to-day work? 

I’m inspired by a collection of many fantastic frontline clinician colleagues from over the years.  However, my truly inspirational heroes are the hundreds of children that have suffered ABI and their families who I’ve worked closely with over the years who, with help and support, dust themselves off and make the most of life. It’s really shaped my perception of what really is important. It’s helped me to recognise the minor challenges that life throws us daily as not being that important. I’m now kind of a glass half-full guy (especially if it’s a good Shiraz).

Q11. What do think will make your proudest, in years to come, about your work?

If I can support HCML in being recognised as the go-to company for children’s catastrophic rehabilitation case management then I will have achieved something purely by continuing to do what I know best and supporting others to do likewise.

Q12. How is HCML different?

It puts the rehabilitation clients at the forefront and centre of its business. It supports interaction between its rehabilitation case managers who are encouraged regularly through social and academic opportunities to meet, interact, consult and exchange ideas. This, in turn, has built a highly dedicated and knowledgeable team of professionals.

Although HCML is growing, it retains a family feel, where everybody is recognised for their contribution and nobody is too aloof to support others when needed. There is no pomp and ceremony but rather straight talking with the right balance of support and challenge. Most of all it’s a fun place to work and I like the people I work with.