Clinical Services for Financial Deputies Managing ABI Clients
What Financial Deputies Need to Know About Nexus ABI
As a professional deputy or personal welfare deputy, your responsibility is to act in the best interests of your client — managing their financial affairs, authorising clinical expenditure, and ensuring that the services you fund are appropriate, necessary, well-governed and properly documented for Office of the Public Guardian (OPG) review.
Nexus ABI is a CQC-registered specialist clinical service operating exclusively in the Acquired Brain Injury space. We are not a general medical provider. Every clinician, every service and every process has been designed around the specific and complex demands of ABI care — and the governance expectations of the Court of Protection, the OPG and the professional deputies who work within those frameworks.
At Nexus ABI, our endocrinology service provides structured assessment and evidence-based management of post-ABI hormonal conditions, following current NICE guidelines, British Society for Sexual Medicine (BSSM) guidance, Society for Endocrinology recommendations and the British Menopause Society (BMS) position statements.
What we provide for deputies
- Fully itemised clinical invoices with clear service description, date, clinician registration details and clinical indication — suitable for OPG audit and Court of Protection reporting
- CQC inspection reports and compliance documentation available on request
- Data Processing Agreements (DPAs) for formal contractual documentation
- Transparent fee schedule — no hidden costs, no retrospective charges
- Pre-authorisation quotes for all planned clinical services — no surprises on the invoice
- Budget forecasting support for ongoing monitoring and treatment programmes
- Written clinical justification for all treatment decisions — supporting your best interests documentation
- Direct communication pathway for deputies — a named Nexus ABI administrative and clinical contact
Our governance credentials
- CQC registered and inspected — registration documentation and inspection reports available on request
- All clinicians hold current GMC or NMC registration — verifiable via public registers
- Clinical indemnity and professional liability insurance maintained by all practitioners
- Fully GDPR compliant — UK GDPR, Data Protection Act 2018, NHS Caldicott Principles
- Internal clinical governance framework including peer review, incident reporting and quality assurance
- All clinical records held securely and available to the deputy as the legally authorised representative
- Complaints procedure in place — details available on the CQC & Compliance page
- Annual CQC regulatory review — Nexus ABI is subject to ongoing regulatory oversight
Clinical Expenditure — Our Approach to Transparency
We understand that every clinical expenditure you authorise carries professional accountability. You need to be confident that the services you fund are clinically necessary, appropriately priced relative to the market, and properly documented. Our approach to financial transparency is built around these requirements.
Pre-service quotes
Before any non-emergency clinical service commences, we provide a written fee estimate or fixed-price quote specifying the service, the clinical rationale, the clinician involved, and the anticipated timeline. This can be countersigned by the deputy as a formal instruction to proceed — creating a clear audit trail from authorisation to invoice.
Annual cost planning
For clients receiving ongoing clinical services — monitoring programmes, regular GP consultations, TRT or HRT management — we produce an annual cost projection at the start of each calendar year, updated at the 6-month review. This supports your annual revenue account and enables proactive financial planning rather than reactive invoice management.
Itemised invoicing
Every invoice specifies: the exact service delivered, the date, the clinician’s name and GMC/NMC registration number, the duration where relevant, any associated costs (laboratory analysis, consumables, mileage) as separate line items, and the clinical indication. Invoices are formatted for Court of Protection Deputy Annual Report submissions.
Funding Routes for Nexus ABI Services
Nexus ABI services are funded through a range of routes depending on the client’s legal and financial circumstances. We are experienced in working within all of these frameworks and can provide the documentation required by each.
Personal injury compensation
The most common funding route for Nexus ABI services. Clinical fees are drawn from the personal injury compensation fund held under Court of Protection management. All expenditure must be authorised by the deputy and is subject to OPG review. We provide the clinical justification documentation needed to support expenditure authorisation.
NHS Continuing Healthcare (CHC)
Where a client meets the NHS CHC eligibility criteria, clinical services may be funded wholly or in part by the NHS. We can assist in the clinical documentation required to support a CHC application and can liaise directly with the CHC funding team. Note: Nexus ABI does not bill NHS commissioners directly — CHC funding must be authorised through the appropriate clinical commissioning pathway.
Court of Protection — property and affairs
Where the deputy holds a property and affairs deputyship, clinical expenditure from Nexus ABI is processed as an authorised disbursement from the client’s estate. We provide the documentation required to support your annual Deputy Report to the OPG, including a summary of all clinical services provided and their individual costs.
Local authority social care funding
In cases where the client’s care needs are jointly funded by the local authority under a Care Act 2014 care and support plan, some Nexus ABI clinical services may form part of the funded care package. We can provide clinical reports and service summaries to support care needs assessments and direct payments applications.
Community rehabilitation funding
Where the client is accessing community rehabilitation under an NHS-funded package — for example, via specialist ABI rehabilitation commissioned services — Nexus ABI can operate as a specialist clinical provider within the wider funded package. We work with commissioning bodies to agree the scope of service and governance documentation required.
Privately funded
Where the client has personal resources independent of a compensation fund or NHS funding, services can be funded privately. We maintain the same governance, reporting and invoicing standards for privately funded clients as for all other funding routes. Full invoices and receipts are provided for personal tax and estate management purposes.
Best Interests and Mental Capacity — Our Framework
Many clients whose care is managed by a financial or welfare deputy lack capacity to make some or all decisions about their clinical care. Nexus ABI operates within the Mental Capacity Act 2005 framework as standard across all of our services.
Our approach to capacity and best interests
- All clinical assessments include a preliminary capacity assessment relevant to the specific decision in question — capacity is decision-specific and time-specific
- Where a client lacks capacity to consent to treatment, we initiate a formal Best Interests process in accordance with the MCA 2005 Section 4 framework
- Best Interests meetings are convened as needed — deputies, case managers, family members and other relevant parties are included
- All Best Interests decisions are documented in writing, with the reasoning recorded and made available to the deputy
- We do not proceed with any elective clinical intervention where a patient lacks capacity without an appropriately documented Best Interests decision
- Where there is disagreement between parties about a Best Interests decision, we will seek independent clinical advice and, where necessary, support an application to the Court of Protection
- Capacity and Best Interests documentation is produced in a format suitable for Court of Protection submission and OPG review
Frequently Asked Questions
Our FAQ section is here to answer the most common questions about this service and help you feel fully informed before getting started. If you don’t see the answer you’re looking for, please don’t hesitate to get in touch—our team is always happy to help and provide clarity where needed.
How does Nexus ABI ensure clinical expenditure is justified and auditable?
Every clinical service we provide is supported by a written clinical rationale — produced either in the initial referral confirmation, within the clinical report, or as a standalone justification letter where required. All invoices are fully itemised with the service description, clinical indication, date, clinician name and registration number, and any associated costs as separate line items. Pre-service quotes are available for all planned services. This documentation is designed to meet the standard expected for Court of Protection Deputy Annual Report submissions and OPG review.
What CQC documentation can Nexus ABI provide to support my records?
We can provide our current CQC registration certificate, most recent inspection report, and a summary of our compliance status across the five CQC quality domains (Safe, Effective, Caring, Responsive, Well-led) on request. This documentation supports your duty as a deputy to evidence that you are instructing appropriately regulated providers. All CQC documentation is also publicly available on the CQC website and accessible via the Nexus ABI CQC & Compliance page.
How do I authorise services on behalf of a client who lacks capacity?
Where your client lacks capacity to consent to clinical services, the authorisation pathway depends on the scope of your deputyship. For property and affairs deputies authorising expenditure, written confirmation from you as the legally authorised representative is sufficient for service commencement. For decisions that involve clinical intervention — where a welfare deputy or Best Interests framework applies — we will produce the necessary capacity assessment and Best Interests documentation before any treatment proceeds. We will never initiate elective treatment on a client who lacks capacity without the appropriate legal authority and documentation in place.
Can Nexus ABI provide a clinical justification letter for my Deputy Annual Report?
Yes. We can produce a structured clinical justification letter — or a summary of all clinical services provided during the reporting year — specifically formatted to support your Deputy Annual Report to the OPG. This letter details the clinical necessity of each service provided, the outcomes achieved or evidenced, and the total cost by service category. Please request this at least 4 weeks before your reporting deadline to allow adequate preparation time.
What happens if I have concerns about a clinical decision or invoice?
Our clinical team is available to discuss any aspect of a clinical decision or invoiced service with the authorising deputy directly. If you have a concern about clinical appropriateness, invoicing accuracy, or governance standards, please contact our practice manager in the first instance. We have a formal complaints procedure in place — full details of which are on our CQC & Compliance page — and all complaints are investigated by a senior clinician within the timeframes set by our CQC registration. We take governance accountability seriously and will always engage constructively with any concern raised.
How are my client's clinical records held and who can access them?
All clinical records are held on a secure, ISO 27001-aligned clinical management system with role-based access controls. As the legally appointed deputy, you are entitled to request access to your client’s clinical records held by Nexus ABI. Records requests are processed within 30 days in line with UK GDPR requirements. Records are provided in a structured format suitable for legal and Court of Protection use. We do not share clinical records with any third party — including insurance companies or litigation opponents — without explicit legal authority or a valid court order.
Can Nexus ABI provide cost projections for future clinical care?
Yes. For clients receiving ongoing or anticipated clinical services, we can produce an annual cost projection specifying the services likely to be required, their frequency, and their anticipated cost. This supports your Deputy Annual Report, your annual revenue account, and any future financial planning applications to the Court of Protection. Cost projections are updated at each 6-month clinical review and adjusted to reflect any changes in the client’s clinical needs or treatment plan.
Is there a minimum commitment or contract required?
No. There is no minimum term contract or ongoing commitment required to use Nexus ABI services. Services are commissioned on a per-referral basis, and ongoing monitoring programmes can be paused or terminated with appropriate notice. We operate on clear written terms of service which are provided at the point of first instruction and are available on request at any time. Our fee schedule is fixed and published — there are no variable or undisclosed charges.
What happens if my client is admitted to hospital while under Nexus ABI care?
If one of our clinical team is aware of a client’s hospital admission, they will produce a comprehensive clinical summary including current medication list, treatment history, recent observations and any clinical concerns — to be shared with the admitting team with deputy consent. On discharge, we offer a structured post-discharge monitoring programme to identify and manage any clinical deterioration in the high-risk period immediately following discharge. We recommend deputies notify us of any planned or unplanned admissions so we can coordinate appropriately.
Can I instruct Nexus ABI directly, without a case manager's involvement?
Yes. Financial deputies can instruct Nexus ABI directly for any of our clinical services without requiring a case manager intermediary. Many deputies engage us directly — particularly for the Initial Needs Assessment, medication review and ongoing monitoring programmes. Where there is an active case manager, we will always copy them into clinical correspondence with your agreement — but direct deputy instruction is entirely appropriate and straightforward. Simply submit a referral via our secure portal or contact the clinical team directly to discuss the instruction.