CASE MANAGMENT

EXPERT WITNESS

When Did a Client Become Part of a Case Manager’s Recruitment Package?

Posted by Dilara Rogers

6 August 2026

Last Sunday, I attended an assessment involving a client who had sustained a hypoxic brain injury. I sat with the client and their family and listened to them describe how one event had changed almost every aspect of their lives. Their independence, relationships, confidence, identity and plans for the future had all been affected.

These are not simply “cases”. They are people who have experienced catastrophic and life-changing injuries. Their families are trying to navigate an unfamiliar world of rehabilitation, litigation, care, funding and uncertain long-term needs.

This week I came across a recruitment advertisement for case managers posted publicly, open to anyone to see. Among the salary, hourly rates, car allowance and performance incentives was the following offer:

“£3,000 welcome bonus for Case Managers bringing existing cases.”

I would like all of my colleagues in the industry to pause and think about this. I personally found this deeply upsetting.

I fully understand that case managers should be properly remunerated for the expertise, responsibility and commitment their work requires, as should any other professional. That is not in question. What concerns me is the decision to attach a direct financial reward to a case manager “bringing” existing clients to a new company.

I felt compelled to speak out and ask all of my colleagues in the industry to reflect on this matter.

Clients are not commodities

Case managers are instructed through solicitors to support people who have sustained catastrophic injuries. Case managers are invited into clients’ homes and into the most private aspects of their lives. Case managers meet the clients’ partners, parents and children; learn about their vulnerabilities, fears, ambitions and frustrations; and become involved in decisions about rehabilitation, care, housing, education, employment, relationships and long-term quality of life.

Over time, a case manager builds a strong and lasting relationship with the client and family. That relationship exists because the client has placed trust in a professional who is expected to act independently and in their best interests.

The claimant is not a commercial commodity belonging to the case manager. The claimant is not a portable book of business, nor are they someone who should increase a candidate’s value to a prospective employer because they can generate immediate revenue.

A claimant does not belong to the case manager, the current case management company, the solicitor or the proposed new provider. The claimant remains a person exercising choice over their own life and services.

What is the claimant told?

I wonder if claimants are ever informed about these incentives. My guess is probably not. When a case manager discusses moving to another company, is the claimant told:

“I will receive a £3,000 payment if you transfer with me”?

Is the family told? Is the instructing solicitor told? Is the deputy, litigation friend or other representative told?

Are they told before the possibility of transfer is raised, or only after the client has already been encouraged to believe that moving is the natural or safest option?

The payment is not irrelevant background information. It is a direct financial interest in the outcome of the claimant’s decision. A claimant may believe that their case manager is recommending a transfer solely because it is in their best interests. Unless the financial incentive is disclosed, they may not know that the professional they trust will personally benefit if they agree to move.

How can that claimant make a genuinely informed decision without knowing this?

Continuity of care does not justify a financial incentive

There are circumstances in which a claimant may independently decide to follow a case manager who changes employer. Continuity is important. For someone with a brain injury, cognitive impairment, communication difficulty or psychological vulnerability, losing a trusted case manager may be distressing and potentially disruptive.

A client must remain free to express a preference to continue working with that person. However, there is a fundamental difference between:

a claimant independently choosing to maintain continuity with a trusted professional; and
a company financially rewarding that professional because the claimant transfers.

The first is client choice, the second is not. The second introduces a personal and commercial interest into a decision that should be based only on the claimant’s needs, wishes, best interests, continuity, cost and quality of service. A case manager may sincerely believe that the claimant would benefit from following them. But sincerity does not remove the conflict. One outcome produces a £3,000 personal benefit. The other does not. That conflict exists regardless of whether the case manager believes they would never consciously allow money to affect their judgement.

The unique position of trust held by a case manager

The power imbalance within this relationship cannot be ignored. A client who has sustained a brain injury may experience difficulties with memory, insight, communication, emotional regulation, confidence or decision-making. Capacity may be decision-specific and may fluctuate. Even where the client has full legal capacity, they may remain heavily reliant on the case manager’s professional opinion.

They may fear losing the relationship. They may feel loyalty or gratitude towards the case manager. They may believe that refusing to move with their case manager will mean losing access to the person who understands them best. Families may agree because they have been led to believe that continuity can only be maintained by changing company.

A professional has a responsibility to recognise and reduce the effect of that influence. They should not receive a payment determined by the decision of the person over whom they hold that influence.

This is, of course, my opinion and my firm belief. But do not just rely on my word. Let’s look at what the governing bodies say.

What do the HCPC standards say?

Many case managers are registered healthcare professionals. The Health and Care Professions Council requires registrants to promote and protect the interests of service users and carers, involve them in decisions, support informed decision-making and ensure that consent is voluntary and informed. The standards also require professionals to consider the power and trust attached to their position, maintain appropriate boundaries and ensure that professional decisions are not improperly affected by personal relationships.

Most significantly, HCPC Standard 1.12 states that a registrant must not abuse their professional position to pursue a financial relationship with a service user or carer. Registrants must also ensure that their conduct justifies public trust and confidence in them and their profession.

I am not suggesting that the existence of a recruitment advertisement alone proves that any individual registrant has breached an HCPC standard. I am saying that a payment conditional upon clients transferring creates a clear potential or perceived conflict which every HCPC-registered case manager should consider very seriously.

What does IRCM require?

The Institute of Registered Case Managers exists to protect the public by setting and maintaining standards for registered case managers.

IRCM’s guidance states that registered case managers and pre-registrants are expected to identify and appropriately manage conflicts of interest in order to protect service users, protect third parties and maintain public trust. Its guidance specifically addresses actual, possible and perceived conflicts and the responsibilities of case managers to recognise, disclose and manage them.

IRCM also requires case management services to be advertised and promoted with integrity and in accordance with relevant professional and advertising standards. https://ircm.org.uk/key-documents/

A bonus for “bringing existing cases” is not a remote or theoretical conflict. The case manager receives a financial benefit if the person they support makes one particular choice. That should be directly within the profession’s discussion about conflicts of interest, ethical marketing and public confidence.

What do the BABICM, CMSUK and VRA ethical standards say?

The joint Code of Ethics and Conduct in Case Management Practice provides particularly clear principles. It states that the client’s best interests must remain central to case management decisions.

It also states:

“The case manager will not abuse or exploit the relationship they have with their client, their family or others involved in their life, for any purpose including for sexual, emotional or financial gain.”

The Code further requires case managers to declare any actual or potential conflict of interest, whether personal, professional or financial.

Code of Ethics

Again, this does not mean that every claimant who follows a departing case manager has been exploited. The ethical concern arises because the payment deliberately creates an incentive that could encourage the professional relationship to be used for financial gain.

A responsible case management company should be designing systems that prevent such conflicts, not incorporating them into its recruitment package.

The position of the instructing solicitor

I am yet to meet a solicitor who chose to practise in personal injury or clinical negligence for any reason other than a genuine commitment to helping people whose lives have been changed through injury. Solicitors meet clients and families at the most difficult point in their lives. They carry responsibility not only for the litigation, but also for helping the claimant access rehabilitation, care and professional support while the claim is progressing. When a solicitor introduces a case management company or case manager, they do so on the understanding that the claimant will be supported independently, ethically and in their best interests.

They place significant trust in us.

They trust that the case manager will not use the relationship built with the claimant for personal gain. They trust that recommendations about care, rehabilitation and service provision will remain professionally objective. They trust that the case management company will provide proper governance and disclose anything that could compromise that independence.

A financial incentive for “bringing existing cases” risks undermining that trust.

The solicitor may have no knowledge of the recruitment arrangement. They may believe that a claimant’s proposed move has arisen solely from the claimant’s wishes or from a genuine concern about continuity. They may be asked to approve or facilitate the transfer without being told that the case manager stands to receive a payment if the claimant moves.

That places the solicitor in an unfair and potentially difficult position.

The SRA Code requires solicitors to act in their client’s best interests, preserve their independence and ensure that clients receive information material to their matter. It also requires informed consent where a client is referred, recommended or introduced to a separate business. Relevant financial interests and fee-sharing arrangements connected with referrals must be disclosed.

https://www.sra.org.uk/solicitors/standards-regulations/code-conduct-solicitors

The £3,000 payment described in the recruitment advertisement is not automatically a payment made or received by the solicitor, nor can it be assumed from the advertisement alone to constitute a prohibited referral fee. However, SRA guidance makes clear that substance matters more than the label attached to a payment. In personal injury claims, payments linked to referrals attract particular scrutiny, and where a payment appears to be for a referral, the person concerned may need to demonstrate that it was made for another genuine reason.

https://www.sra.org.uk/solicitors/guidance/prohibition-of-referral-fees-in-laspo-56-60

The wider issue is more fundamental.

Where a solicitor has trusted a case manager to act independently for a vulnerable claimant, they should not later discover that the case manager had a personal financial interest in moving that claimant to another provider.

The responsibility should not fall on the solicitor to uncover an incentive that has not been disclosed. The case manager and the incoming company should provide that information openly before any proposed transfer is discussed or acted upon.

Solicitors working in personal injury and clinical negligence should be able to rely on case management professionals without having to question whether trusted relationships with claimants are being used as part of a recruitment transaction.

The duty to be transparent rests first with the professional who will receive the benefit and with the company offering it. Is this being fulfilled?

What is the responsibility of the recruiter?

The recruitment company may not have created the incentive, but it has chosen to advertise it publicly. A recruiter operating within the catastrophic injury and rehabilitation sector should understand what “bringing existing cases” actually means.

“Cases” are not commodities to be traded. “Cases” are vulnerable people whose relationship with their case manager was formed through professional instruction and during an exceptionally difficult period in their lives.

The Recruitment and Employment Confederation’s (REC) Code of Professional Practice requires honesty and transparency, truth in advertising and respect for established work relationships. These requirements apply to REC members, rather than automatically to every recruiter.

A responsible recruiter should question whether it is appropriate to market a role by attaching a cash payment to the movement of vulnerable clients. Simply advertising the terms provided by the employer does not remove the ethical responsibility attached to publishing them.

Finally, what about the case management company?

I am a true believer that case management companies operating in this field have a direct and uncompromising responsibility to practise ethically.

A case management company has a legitimate commercial interest in recruiting skilled and experienced professionals. It may offer competitive salaries, professional development, supervision, flexible working and performance-related remuneration based on quality, compliance or leadership. But an organisation that pays a case manager specifically for bringing existing cases is not simply rewarding their experience. This is commoditisation of vulnerable people; ethical practice be damned.

The wording matters. A lot.

The advertisement did not say that the company would support continuity where a client independently requested it. It offered a payment to case managers who brought existing cases. That creates an obvious question about the company’s culture and governance.

It presents questions:

How does it reconcile this incentive with the assertion that the client’s best interests are paramount?
How does it ensure that the client is not approached, persuaded or emotionally influenced?
How is the conflict disclosed?
Who independently verifies that the proposed move is in the claimant’s interests?
Would the company still consider the case manager equally valuable if no clients followed them?

One can argue that disclosure is the minimum solution that needs to be put in place.Any financial benefit linked to a claimant’s transfer should, at the very least, be disclosed clearly and in writing. The claimant and relevant decision-makers have the right to know the details of the transaction and have the right to choose.

I argue that the most ethical and defensible safeguard is not simply to disclose these incentives. It is not to offer them.

Case managers will change employers. Clients may sometimes want to follow them. That can be managed properly without making the client’s decision part of the case manager’s remuneration. Perhaps practices of this kind have existed privately for some time. What affected me so strongly was seeing that the incentive is now advertised openly, as though bringing vulnerable clients into a new employment arrangement were an ordinary and acceptable recruitment benefit.

We should not allow this commoditisation to be normalised.

This commoditisation should concern case management companies that invest in ethical governance and professional supervision.

It should concern case managers whose credibility depends on their independence.

It should concern solicitors who rely on objective professional recommendations.

It should concern deputies and litigation friends responsible for protecting vulnerable people.

It should concern professional bodies whose standards explicitly address trust, conflicts, exploitation and financial gain.

Most importantly, it should concern clients and families.

They are entitled to know whether a decision affecting their rehabilitation and support is accompanied by a personal payment to the professional discussing that decision with them. The questions we should all be prepared to answer

Would we feel comfortable sitting in front of a client with a catastrophic brain injury and saying:

“If you move with me to my new company, I will receive £3,000”

Would we be equally comfortable saying it to their family?

Would we record it openly in our professional notes?

Would we expect the instructing solicitor to consider it irrelevant?

Would we still regard the arrangement as acceptable if the claimant had not been told?

If an incentive cannot withstand full and direct disclosure to the person whose decision triggers the payment, it should not exist.

Our clients have already experienced injuries that have fundamentally altered their lives. The relationships we build with them are based on trust, vulnerability and an expectation that we will act with integrity.

That trust is not ours to trade.

A claimant is not a commodity, a revenue stream or an enhancement to somebody’s recruitment package.