Complex and multiple physical injuries and conditions in adults, including:
- Upper and lower limb amputations.
- Upper and lower limb injuries and joint replacements.
- Cauda Equina Syndrome.
- Internal injuries (bladder and bowel).
- Chronic pain.
- Visual/hearing loss or impairment.
- Bone infection and vascular impairments.
- Burns and plastics and scar management.
- Hand injuries.
- Arthritis, including Rheumatoid and Juvenile Idiopathic.
- Neurological conditions including stroke, MS, MND, Parkinson’s and dementia.
- Mild to moderate brain injury including post-concussion syndrome.
- Associated mental health.
Clinical Currency Statement
As at May 2022, I am engaged in the role of Case Manager for Rehab Without Walls for an average of 90 hours per month. I also work as an independent OT for an average of 5 hours per month
Specific Injuries Experience
Pam works with clients with complex orthopaedic and musculo-skeletal injuries, often resulting in the need for multiple surgeries which may include fasciectomy, joint replacement or amputation, across one or more limbs and joints.
In addition to the primary condition, Pam’s clients frequently have associated internal injuries, vascular impairments and infections including bone infections, and inevitably associated pain conditions such as phantom pain, chronic pain and Chronic Regional Pain Syndrome.
The complex nature of the clients Pam works with frequently results in there being a neurological component to the injury or condition, either as a result of a traumatic event or through an acquired brain injury. This commonly results in there being a significant psychological or psychiatric overlay, in addition to behavioural and mood disturbances, difficulties with executive functioning and cognitive deficits.
Pam has regularly worked with clients with Cauda Equina Syndrome, both in acute and community settings.
She also has substantial experience working with clients with sensory impairments, visual impairments in particular, both as a primary condition and as a consequence or complication of either brain injury, or rheumatological condition, such as temporal arteritis.
She has extensive experience of working with children and adults with burns and the resultant need for plastic surgery, both functional and cosmetic, rehabilitation and scar management. Pam’s role requires her to have
in-depth knowledge of the unique challenges that this client group face both in terms of physical rehabilitation and psychological support.
In all cases, Pam is responsible for identifying, co-ordinating and managing her clients’ care, equipment, rehabilitation and housing needs, across both statutory and private services, working towards achieving her client’s goals, maximising their independence and overall quality of life.
Pam has worked as an independent Care Expert Witness with Jacqueline Webb & Co Limited since 2012, completing detailed reports on claimant’s who have experienced catastrophic and life-changing injuries. Pam is experienced in attending Case Conferences and participating in Meetings of Experts, in addition to completing a wide range of other follow-up work as cases travel through the litigation process.
Pam currently works as an Occupational Therapist and Case Manager, primarily with clients with life changing physical and neurological conditions requiring medical and surgical intervention in addition to rehabilitation. Although Pam works autonomously, her caseload is highly varied and involves managing and working within multi-disciplinary care and therapy teams, to ensure the best outcome for each client.
Pam has extensive experience in assessing individual needs, working collaboratively with clients and their carers to maximise and maintain their potential in both the short and longer term. This includes co-ordinating and implementing bespoke packages of care, including therapy services within statutory and private services, to ensure creative and cost-effective solutions.
Given the chronic and degenerative nature of many of the clients Pam works with, she has gained extensive knowledge of joint protection and pacing principles, fatigue management and workplace ergonomic assessments which encompass predictions for future requirements in line with disease progression. She has also developed an in-depth understanding of the potential debilitating psychological implications of chronic and degenerative conditions and, the impact this may have on an individual’s day to day functioning.
Pam has a background in sensory impairment and has a caseload that includes clients with varying degrees of visual impairment, up to total visual loss.
Since qualifying as an Occupational Therapist in 2001, Pam has worked in in-patient and out-patient settings and has gained comprehensive experience, specialist skills and knowledge across a wide range of clinical areas. This has included hand therapy, burns and plastics, scar management for adults and children, neurological intensive care, orthopaedics, rheumatology, chronic pain and general medical conditions. Her roles and focus have been to assess individual needs and to design treatment and rehab packages that would achieve patients’ short- and long-term goals, whilst providing recommendations for the necessary care and equipment that would facilitate independence and maximise functional ability.
Qualifications and Membership
- BSc (Hons) Occupational Therapy Oxford Brookes University (2001).
- British Association of Hand Therapists (BAHT) Level 1 (2003).
- British Association of Occupational Therapists (BAOT).
- Health and Care Professions Council (HCPC).
- Specialist Seating Assessments (2016).
- RCOTSS Medico-Legal Forum Committee member (2016/2017).
- Best Interest Assessor (2017).
- British Association of Brain Injury and Complex Case Management (BABICM).
Care Expert Witness
Jacqueline Webb & Co Limited
Rehab Without Walls
Oxford Brookes University
Senior Occupational Therapist, Social Services
Oxfordshire County Council
Senior Occupational Therapist, Outreach and Rheumatology
Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Trust
Senior Occupational Therapist, Plastics
Oxford Radcliffe Hospitals Trust
Basic Grade Occupational Therapist, Hand Therapy and Plastics
Wexham Park Hospital
Teaching and Lecturing
- Oxford Brookes University – associate lecturer, delivering the upper limb module (2017, 2018).
- Oxford Brookes University – associate lecturer, Mental Capacity Act (2017, 2018, 2019).
- Oxford Brookes University – associate lecturer – anatomy (2019, 2020, 2021)
- Oxford Brookes University – Interviewing Occupational Therapy Students (2017-2018).
- Presentation on ‘Hand Function’ – In-service training programme, Nuffield Orthopaedic Centre (2016).
- School’s presentation scheme on ‘Bones and Muscles’ (2016).
- Presentation on ‘The Charcot Ankle’ – training programme to regional junior doctors (2015).
- Formal presentation, National Rheumatoid Arthritis Society on ‘Joint Protection Principles’ (NRAS) (2012).
- ‘Occupational Therapy for Rheumatology Patients’ – training programme presentation to regional junior doctors (2010).
- ‘Rheumatology Workshops’ for Oxford Brookes University Occupational Therapy BSc (Hons) course (2010).
- Presentation on ‘Anatomy of the Hand’ to course candidates – accredited British Association of Hand Therapists (BAHT) Level 1 course (2007).
- Article on Chronic Fatigue (2019).