Written evidence submitted by Headway – the brain injury association

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. 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.

Funding implications for Headway UK

Headway 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 brining in no income.

Headway provides training to a range a 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 will stand to incur will still be substantial but 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. Many local Headway charities may not survive this crisis without additional support, meaning brain injury survivors and their families may need to seek help from more costly state-funded services.

Emergency Coronavirus charity funding

Headway welcomes the announcement of the Chancellor to allocate £750 million to help the sector through this crisis.

Whilst this is a step in the right direction, the support package will only cover a small proportion of the expected losses. It falls short of the £330 billion promised to businesses and is in fact, around just 1% of what has been provided to businesses. Neither does it come close to matching the £4 billion it is estimated that the charitable sector as a whole will lose in the coming months. 

It remains unclear how government departments will identify priority recipients of the £360 million pot available from departments. Similarly, there is no indication as to when the National Lottery Community grant pot will become operational. There is, as yet, no guidance on eligibility criteria or how applications can be made. This needs urgent attention as even a short delay could lead to smaller charities, such as local autonomous local Headway charities, folding in the intervening period.

It is imperative that this application process 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.

Headway groups and branches

Over 120 Headway groups and branches provide local support to brain injury survivors and their families. This support varies depending on local needs and resources but is invaluable to those who receive it.

Approximately two thirds of the network are autonomous charities that are affiliated to the UK-wide body.  These local charities work with their local authorities and CCGs 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 state-funded services and reducing the pressure on the health and social care system.

Like Headway UK, local Headway groups 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.

Many Headway groups have had assurances that the funding they receive from local authorities and CCGs will continue in the short term but have no indication about the medium to long term. All their regular fundraising activities have had to stop and the financial situation for many of these is groups is dire.

There is concern that if these groups were no longer operational the individuals who use them would have seek care and support elsewhere, leading to even more pressure on an already overstretched social care sector.

Conclusion and recommendations

Whilst these government schemes and funding pots are welcome, some urgent elements of clarification are needed.

Additionally, Headway agrees with the calls of the Chair of this Committee, Julian Knight MP, in his letter to the Chancellor of 7 April, that a stabilisation fund is needed to enable charities to keep operating over the coming months.