By Pankaj Madan, Barrister, 12 King’s Bench Walk London and Exchange Chambers.
Spending a full day listening to, speaking at and chairing, this series of lectures brought home how far serious injury practice has moved on. What used to be a largely medical and legal exercise is now a much broader endeavour, drawing on neuroscience, education, rehabilitation science, emerging technologies and public law. The common thread throughout the day was the need for a more integrated, realistic and humane approach to our clients’ lives, both within and beyond the litigation process.
AI, neurotechnology and brain injury litigation
The opening session on AI, quantitative EEG and neurofeedback was a useful corrective to any lingering notion that these techniques are fringe or speculative. The speakers started from first principles, reminding us that the brain is a dynamic, constantly adapting neuroplastic organ, rather than a fixed structure as we used to think. Against that background, it is scarcely surprising that static snapshots, whether from imaging or one off testing, can fail to capture the true picture of a client’s functioning.
The iMedicSync wave helmet was presented as a practical tool, not a futuristic curiosity. Using AI to process large volumes of EEG data, it can highlight subtle patterns of dysregulation which might otherwise go unnoticed. For lawyers, the value lies in the potential to track change over time in a way that is both objective and clinically meaningful. One case study, involving a cyclist many years post injury, illustrated how targeted neurofeedback informed by qEEG could produce marked improvement in symptoms that had previously appeared entrenched. This was set, quite deliberately, within the context of a strong therapeutic relationship, rather than as a stand-alone technological fix.
Ben Marram’s session on neurorehabilitation in an AI driven era built on this theme. He addressed the familiar difficulty of clients who perform adequately on cognitive tests yet cannot manage in daily life. The frontal lobe paradox was used to demonstrate how conventional assessments can mislead if they are treated as the last word on capacity and function. He also gave a clear overview of emerging tools such as blood biomarkers and digital assessments, together with their limitations in real world practice.
What emerged strongly was the importance of context. Data from apps, wearables and automated scoring systems must be interpreted in the light of the client’s actual day to day experience. If not, they risk being used to support convenient narratives rather than accurate ones. For those instructing experts, there is a clear implication: we will need to become more adept at questioning how these technologies work, what they truly measure and how far they assist in explaining the client’s difficulties, rather than merely lending an air of sophistication to a report.
Music therapy, function and client experience
Two linked sessions on music therapy showed, in very concrete ways, how apparently softer interventions can deliver robust functional gains. Daniel Thomas traced the development of music therapy from its roots in general psychosocial work through to its present role in complex neurorehabilitation. His emphasis was on everyday outcomes: improved communication, calmer behaviour, better gait and greater engagement with family and community.
He explained neurologic music therapy in accessible terms and illustrated it with video material, including examples of work on language, emotional regulation and motor control. The impression was of a discipline that is both structured and responsive, using music’s rhythmic and melodic properties in a targeted way. Seen from the perspective of litigation, this raises serious questions about the content of rehabilitation programmes in higher value cases, particularly where standard therapies alone have not yielded the desired level of functional recovery.
A companion session on the practical delivery of music therapy developed these ideas further. One case involved a man with locked in syndrome, using a vibrating speaker to obtain immediate sensory feedback from very small facial movements, so that he could begin to reconnect with his own bodily signals.
Another strand concerned shorter, carefully timed “fractional” sessions designed to fit into the lives of families already under immense pressure. The speaker demonstrated how technology, used judiciously, can support rather than dilute humane and highly individualised work.
AI featured here as well, in the form of regulated tools which analyse playlists or help generate therapeutic music content, contrasted with unregulated consumer applications that raise obvious concerns about privacy and clinical suitability. From a claimant perspective, these developments suggest that, where supported by evidence and expert opinion, such interventions can properly form part of a claim, particularly where they contribute to gains in participation and independence.
Education pathways after brain injury
Judith James’ lecture on education for children and young people with brain injury was a candid examination of a system under very considerable strain. She described a landscape marked by staff shortages, frequent policy shifts and mainstream schools struggling to meet increasingly complex needs, all against a policy backdrop that still presses for inclusion.
Her account of Education, Health and Care Plans was particularly instructive. On paper they are powerful, legally enforceable documents. In practice they are often drafted in broad terms, especially around therapy, making it difficult for families to insist on the input their children require. She drew a careful distinction between elective home education, where parents assume primary responsibility, and education other than at school, where the local authority accepts that needs cannot be met within its usual framework and agrees to fund a bespoke package.
Through a series of examples, she illustrated how determined, well evidenced advocacy can secure high value, individually tailored programmes that combine home based learning, therapy and community engagement, supported by a live EHCP. She also demonstrated how the ASDAN curriculum can be used to construct genuinely person centred programmes for older children and young adults, particularly where traditional college placements are unavailable or unsuitable.
For those acting in paediatric brain injury claims, the practical implications are significant. There is scope, more than is sometimes appreciated, to argue for flexible educational arrangements which genuinely reflect the young person’s abilities and aspirations, provided that the case is built carefully and with the right expert support.
Court of Protection: integration, capacity and deprivation of liberty
Sarah Jackson’s session on the Court of Protection highlighted the increasing complexity of work in that jurisdiction.
Application numbers continue to rise, and there is a noticeable growth in cases involving multiple agencies and overlapping issues. She described a shift in judicial approach, with stronger expectations that P will be involved in decisions, and judges more ready to engage directly, including through visits to care settings.
Her central message was that financial, health and welfare decisions cannot sensibly be compartmentalised. Housing, funding and care arrangements are interdependent, and failures in planning any one of these elements can push an otherwise stable situation into crisis. She also explored constructive uses of technology and environmental adaptation to support autonomy, rather than simply reinforcing existing care models.
Victoria Butler Cole KC spoke upon the Mental Capacity Act and current difficulties in its application. She drew attention to appeal decisions in which judges have been criticised for conflating the presence of a mental impairment with a lack of capacity, and reminded the audience of the need to focus on the specific decision in question and on the statutory requirement to consider understanding, retention, use and weighing of information.
She discussed the Court of Protection’s guidance promoting short, focused letters of instruction to experts in place of documents overloaded with case law and commentary. Her wider survey of contentious issues included the role of health and welfare deputies, the position of financial deputies faced with debts incurred through drug use, and the looming reconsideration by the Supreme Court of the Cheshire West test for deprivation of liberty. It is plain that significant change is possible, with obvious consequences for community and institutional care arrangements alike.
Developments of note in civil litigation
Professor Dominic Regan’s review of recent case law and procedural developments provided an essential framework for all of this clinical and public law material. He began with a claim involving a child with reduced life expectancy, in which the court nonetheless permitted a claim for lost years. This has reopened an old debate about the proper scope of such awards and may well prompt further appellate scrutiny, with potential implications for many serious injury cases involving young claimants.
He revisited surveillance, highlighting recent cases where findings of exaggeration or dishonesty have had drastic consequences for claimants. He reminded us that surveillance remains a distinctive and powerful feature of personal injury litigation and must be approached carefully by both sides. Experts, in particular, should not be asked to pronounce on honesty, but should confine themselves to the proper interpretation of the material in clinical terms.
He then turned to costs. Recent challenges to medical agency fees, including instances where recovery has been refused altogether in the absence of a clear breakdown, are now moving towards appellate guidance. His comments on costs budgeting, the evolving role of the Legal Ombudsman, possible guideline rates for counsel and reforms to the Solicitors Act all underlined the extent to which the financial and procedural environment is changing around serious injury practice.
He also spoke about the increasing presence of AI in litigation, from drafting assistance to judicial tools for analysing evidence. Whatever efficiencies may be achieved, the underlying theme was that responsibility for the content of documents and for forensic judgment calls remains firmly with practitioners.
Bringing the themes together
Taken together, these lectures presented a picture of catastrophic injury practice that is both demanding and intellectually engaging. We are now expected to have at least a working grasp of AI assisted neurodiagnostic, innovative therapies, the realities of special educational provision, the nuances of Court of Protection work and the fine print of civil procedure and costs.
For claimant practitioners, several practical points follow. Early and constructive engagement with experts at the forefront of neurorehabilitation and education is essential if our claims are to reflect what can genuinely be achieved for clients over time. We need to anticipate how courts, whether in the civil sphere or the Court of Protection, will respond to newer forms of evidence and to rehabilitation proposals which do not fit traditional patterns.
Above all, summarising the day I would say as a reminder that, however sophisticated the technology or intricate the law, the central question remains a simple one. What does this individual need, here and now and in the future, in order to live a life with dignity, purpose and connection, and how can the legal process assist rather than hinder that aim.
About the author
Pankaj Madan was conference chair and a speaker. He is a Barrister specialising in catastrophic injury with a specialist interest in brain injury. He acts for both Claimants and Defendants. He is the author of leading texts on Subtle Brain Injury and Chronic Pain and a recent book on Catastrophic Brain Injury. He practises from Exchange Chambers and 12 King’s Bench Walk. He is President-Elect of the Royal Society of Medicine, Pain Section Council. He is Legal 500 PI Junior of the year 2025.
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