Darren’s case exemplifies the flexibility of BIRT’s continuum which allows people to have the degree of support they require whilst still on the journey towards independence.

The Brain Injury Rehabilitation Trust (BIRT) provides a range of services nationwide that are tailored to meet people's needs at every stage of their rehabilitation pathway. This pathway is accessible at any point following an acquired brain injury. People who have been through assessment and rehabilitation at a BIRT centre often go on to live in their own home or in one of our many community based services. In this way, the progress made during residential rehabilitation is continued once an individual returns to living in the community. Each individual has a person centred support plan which embraces their lifestyle choices whilst ensuring their individual rehabilitation needs are met.

Darren has experienced the range of BIRT services, including spending time at it’s independent hospital, York House and is now living in the community and hoping to go to college.


In 1980, when Darren was four years old, he was involved in a road traffic accident which changed his life forever. His brain injury left him with post-traumatic epilepsy and confined him to a wheelchair. Sixteen years later, he was assessed at Daniel Yorath House in Leeds and had a period of rehabilitation there. After a year he moved into a supported house within BIRT, with 24 hour support, but his impulsive behaviours and lack of insight meant that a decision was made to find him a safer environment.

The great benefit of BIRT’s community services is that when the ‘dips’ happen the staff teams are able to offer support in more structured services. It is always hoped that this will be for a short time but sometimes this isn’t the case. However the aim is always to move people on to the least restrictive environment.

Darren initially moved to BIRT’s independent hospital, York House, but within two months he transferred, still within BIRT, to Redford Court in Liverpool where they specialise in a slower stream rehabilitation programme.

After three years Darren went to live in a transitional, independent living flat within the grounds of Redford Court, where he had input from various members of the clinical team at Redford Court, including occupational therapy, physiotherapy, speech and language therapy and psychology. Darren was able to play a part in the management of his finances with the support of the ‘Bank’ at Redford Court and the centre’s Business Administrator.

He now lives in his own flat in Birkenhead, which is a BIRT supported living unit where Darren had one-to-one support to maintain his daily activities and domestic tasks. However, shortly after his move, his hours were cut significantly by the funding authority - this led to rapid deterioration in his well-being. Thanks to the work of the multi-disciplinary team, Darren was eventually re-allocated extra hours and there was a discernible change in his attitude and temperament, so that the original behavioural issues all but disappeared.


Darren is very well-liked by service users and staff alike and now always greets people with a smile. He has progressed substantially; using an iPad, enthusiastically doing his domestic chores, self-medicating, and managing his weekly finances independently, requiring minimal support. Darren is supported to take part in activities swimming, the gym and cycling. He loves going to watch Manchester United which the Wirral and Liverpool-based staff grin and bear!

He has a solicitor and case manager who have complimented the staff team, not only on Darren’s progress but also about the reduced time and input that that is now required; leading to substantially reduced costs.

The Brain Injury Rehabilitation Trust, known as BIRT, recently published some research showing significant clinical and cost benefits can be achieved by neurorehabilitation following an acquired brain injury.

The study shows a lifetime cost savings of between £0.57 million and £1.13 million for people admitted to rehabilitation within a year of acquiring their brain injury. Savings of between £0.19 million and £0.86 million were found for individuals admitted to rehabilitation more than a year after injury.

One example shows the annual costs of care before admission to neurorehabilitation were £60,000, yet after neurorehabilitation were just £19,000. The lifetime care cost calculations are made on the assumption that an individual would live an average life expectancy of 36 years after discharge.

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