BISCUSSIONS

About BISCUSSIONS

Bringing honest conversations from the voices behind neurorehabilitation. Each episode will feature a BIScussion with someone new; clients, CRAs, case managers, families, psychologists, OTs, solicitors and anyone else in the neurorehab sphere. In each episode we will dive into a different topic, be it lived experience, culture, boundaries, fatigue, research, or the realities, challenges and insights that shape the work we do at BIS Services and beyond. Real conversations, real experiences, and real opportunities to connect and learn from each other. Have something to say? Come and have a BIScussion with us.

Publisher

BIS Services

Category

business · education

Language

en

Explicit

No

First episode

27 Feb 2026

Latest episode

21 Oct 2026

Latest episodes

13 episodes in the feed.

1. 

   21 Oct 2026

   Emma's Brain Injury Recovery Journey: Rehab, Routine, and Independent Living

   In this BIScussions episode, hosts Natalie  and Eky from The BIS Services welcome long-standing client Emma to share her brain injury story and rehabilitation journey. Emma explains a 2008 car crash at age 18 that left her with severe brain injury, a coma, right-sided physical impairments, and major challenges with speech, daily living, and parenting her young son. She describes transitioning from hospital and a rehab unit to supported living, working with a multidisciplinary team, and learning skills through repetition, structure, and routine. Emma reflects on setbacks, the importance of planning and safety, and how support enabled greater independence, travel, and community activities. Now living independently with reduced support, Emma discusses future goals including more travel, walking, and continued progress.

2. 

   10 Sept 2026

   Supporting the Supporters: Line Management, Mental Health Shifts & Client Complexity

   Natalie and Eky welcome Pedro Knight, BIS Services' senior line manager, to discuss how line management supports cognitive rehabilitation assistants (CRAs) while still staying "boots on the ground" with clients. Pedro explains how staff support needs have shifted since COVID, with CRAs more vocal about mental health and requiring more frequent check-ins, leading the line management team to train as mental health first aiders and balance staff wellbeing with client needs and case manager expectations while maintaining confidentiality. They also explore why client presentations feel more complex, including increased online-related safeguarding and disinhibition, alongside improved staff skill in spotting nuances. Pedro shares a positive client football tournament experience that connected clients and staff, highlighting the value of bringing people together and raising standards in brain injury support.

3. 

   27 Aug 2026

   The Big F-Word: Why Fatigue Has to Come First in Brain Injury Rehab

   In this episode of BIScussions the format flips and Eky Popat interviews Natalie Mackenzie, founder and cognitive rehabilitation therapist at BIS Services, about the subject she is best known for pushing to the front of every rehab conversation: brain injury fatigue. Natalie makes the case that fatigue belongs beneath attention at the base of the cognitive hierarchy, and that when it goes unmanaged it gets mistaken for something else. Clients described as disengaged, lacking initiation or non-compliant are very often clients whose fatigue nobody has assessed properly. What Natalie and Eky cover: Why fatigue is spoken about far more often than it is measured, and what a proper assessment looks like Two to four weeks of structured logging, why it stops there, and the risk of clients hyper-focusing on fatigue Triggers and vulnerabilities: light, noise, children, vestibular dysfunction, emotional load, medication, hydration, missed meals Distinguishing brain injury fatigue from vestibular symptoms, migraine and pre-existing conditions , and what gets missed when a post-injury ME diagnosis leaves the brain injury out of the picture The education piece, including motorways becoming B roads, and why analogy and storytelling do the heavy lifting Scheduling therapy around cognitively optimal windows, getting fatigue evidence into the rehab plan, and why inconsistent MDT practice makes client consistency impossible Reading fatigue in a session: fidgeting, hair twisting, face scratching, and clients who report being fine until they are not Recharge that is not sleep, the points system, and why crochet is restorative for one person and cognitively expensive for another Why improving fatigue scores can dip as clients do more, and why that is progress Fatigue in the workforce, and CRAs using the same tools they deliver Natalie also announces the digital version of the Fatigue Management Journal for the first time, with clinician and CRA logging being built in, and confirms a paediatric edition in development. Resources The Fatigue Management Journal, digital: The Fatigue Management Journal, pace your day, notice your patterns The Fatigue Management Journal, print edition: available on Amazon Fatigue courses for case managers and MDT members, and the brain injury membership: Home - BIS Services Cognitive Rehabilitation Contact Natalie: natalie.mackenzie@thebiss.co.uk Instagram: @thebraininjurytherapist Have something to say? Come and have a BIScussion with us.

4. 

   16 Jul 2026

   Securing Rehab Fast: A Serious Injury Lawyer's View with Sarah Griggs

   In this episode of BIScussions, Natalie and Eky are joined by Sarah Griggs, partner in the London office of Irwin Mitchell's Serious Injury Team and the firm's national brain injury coordination lead, for a conversation from the legal side of neurorehabilitation. Sarah shares her route into law via an English degree and a small-firm training contract, and how she came to specialise in traumatic brain injury, capacity issues, and securing interim payments to get rehab funding flowing fast. They discuss what genuinely distinguishes a specialist catastrophic injury lawyer, how to choose the right solicitor (APIL accreditation, asking about experience, avoiding jargon and red flags), and the fine line between close, trusting client relationships and professional boundaries across cases that can run many years. Sarah, Natalie and Eky explore why brain injury remains hard to evidence, particularly "walking wounded" cases, the rising demand for detailed reporting, cost-budgeting and proportionality pressures, delayed interim payments, and the disruption of frequent team and case manager changes. They also reflect on family support as a recognised need, how environment shapes outcomes, redefining independence and interdependence after brain injury, and Sarah's work with ABIL, Headway East London and UKABIF. A warm, honest look at connection, communication and why early rehab matters.

5. 

   25 Jun 2026

   Neurologic Music Therapy: The Rehab Tool You're Probably Not Using with Guest Expert Elizabeth Nightingale.

   Natalie Mackenzie and Eky from BIS Services welcome their studio guest, Elizabeth Nightingale, founder of Nightingale NMT, to discuss neurologic music therapy (NMT) in brain injury rehabilitation. Elizabeth shares her background, training, and how NMT differs from traditional music therapy through standardised techniques and a functional assessment-led "transformational design model," using music as treatment and aiming to remove it as skills generalise. She explains how NMT supports speech and language (including melodic intonation therapy for aphasia), cognition, sensory-motor goals, and family-based rehabilitation, with examples including bespoke songwriting for pediatric receptive language and joint working with physio. The episode also covers referrals, outcome tracking, myths about needing to be musical, using music in anxiety regulation, PDOC assessment via MATADOC, access routes, and Elizabeth's expert witness work.

6. 

   10 Jun 2026

   Medico-Legal vs Statutory/NHS Brain Injury Rehab: Funding, Outcomes, and the Postcode Lottery

   In this BIScussions episode, Natalie and Eky discuss key differences between BIS Services' medico-legal  and statutory/NHS/local authority-funded brain injury support, focusing on funding constraints, inconsistent information at referral, and gaps in specialist understanding. They describe how statutory packages often provide minimal hours with high expectations, limited MDT involvement, infrequent or inadequate reviews, and a "postcode lottery" in funding and social worker brain injury knowledge, which can leave providers effectively coordinating care without resources. They share examples of inaccurate referrals affecting safety and appropriate signposting, and note families often lack guidance on assessments and support pathways after discharge. They emphasise the need for better education, joined-up working, specialist provision, and evidence on optimal rehab hours, while acknowledging positive client-centered advocacy in statutory work.

7. 

   8 May 2026

   Recruitment in Brain Injury Support: Finding the Right Psychology Graduates, Soft Skills & the "Dreaded Venn Diagram"

   In this episode of "BIScussions," Natalie and Eky are joined by Mike, BIS's talent acquisition manager, to discuss recruitment challenges in brain injury community support and why getting it right matters for client outcomes. They explain BIS's focus on hiring psychology graduates, the importance of balancing academic knowledge with soft skills, and how CV screening, a demanding application form, multi-stage interviews, and client meet-and-greets shape a lengthy process. The team describes the "dreaded Venn diagram" of matching candidates to referrals based on skills, location, driving ability, personality, interests, and cultural competency, plus the use of hold lists. They cover external delays, funding changes, schedule shifts, retention impacts from the COVID cohort, increased wellbeing supports, rural recruitment issues, AI use in applications, planned gamification, and anticipated 2026 needs including reasonable adjustments for neurodiverse and mental health-related accommodations.

8. 

   16 Apr 2026

   Inside Independent Living Trials: A Journey with the BIS Team

   In this BIScussions episode, Natalie and Eky are joined by Cam, BIS's ILT coordinator, to explain independent living trials (ILTs) for people after brain injury: their purpose, how BIS runs them, and the staffing, evidence, and practical challenges involved. They describe ILTs as structured, safe opportunities for positive risk-taking that establish a client's long-term support needs, with success defined by evidence gathered rather than perfect performance. Drawing on lessons from "The Link," a community-style, non-clinical smart-tech house, they explain why BIS shifted from a single property to delivering a portable 12-week Independent Living Trial Assessment (ILTA) in clients' own communities. They outline a three-phase approach that scaffolds skills, introduces strategies and assistive tech, then reduces supervision to test independence, emphasising client buy-in, MDT collaboration, family involvement, and skilled observation by rehab assistants. Key barriers include property sourcing, funding delays, and recruitment/matching needs, including cultural considerations.

9. 

   31 Mar 2026

   Neuro Rehab on Holiday: Risk, Realities, and Why CRAs Need a Plan

   In this episode of BIScussions, Natalie and Eky explore the varied role of CRAs in neuro rehab and focus on supporting clients with brain injuries on holidays, including unusual activity requests and the "can-do" ethos of making goals possible within safe parameters. They describe how holidays can reveal increased cognitive challenges, reduced insight, sensory overload, and changing behaviours, making constant supervision, daily reporting, and careful boundary-setting essential. Drawing on experiences such as taking a client on a cruise, they explain the importance of bespoke holiday guidelines, detailed risk assessments, logistics planning, and often sending more than one CRA due to fatigue, safety, and evidence collection demands. They also discuss how holidays can provide valuable data for litigation and help families build confidence, sometimes serving as a stepping stone toward independent living trials.

10. 

    17 Mar 2026

    Parenting & Pregnancy After Brain Injury: Challenges and Insights

    In this episode of "Biscussions," Natalie & Eky revisit pregnancy and brain injury, focusing on challenges when clients become pregnant after injury and on parenting from birth through adulthood. They discuss the complex role of community rehabilitation assistants (CRAs) in scaffolding parenting without overstepping, gaps in professional understanding (including medical staff), and the need for more training and research. A key case involved long-term support, a CRA acting as a birthing partner, 24/7 packages, collaboration with nannies and other disciplines, and significant safeguarding difficulties and delays with social services. They highlight issues of insight, fatigue, changing routines, medication and epilepsy risks during pregnancy, cultural differences and judgments about parenting, boundary and attachment challenges for children, and the importance of planning and funding for parenting support in medicolegal claims.

11. 

    6 Mar 2026

    A Journey Through Cognitive Rehabilitation: Spotlight on Eky Popat

    Eky Popat's Journey: From Rehab Assistant to Operations Director at BIS Services Natalie Mackenzie introduces Biscussions and spotlights Eky Popat, BIS Services' operations director and registered manager, exploring her 15-year journey in brain injury rehabilitation. Eky shares studying psychology and child psychology, realising school work felt too routine, and applying widely before joining BIS as a rehab assistant after a relaxed coffee-shop interview with Natalie and Clive. She describes being thrown in at the deep end, shadowing clients, and gaining confidence when trusted to cover Natalie's caseload. Eky recounts progressing from CRA to team lead and into operations, developing policies and a staff handbook, and completing the Certified Brain Injury Specialist (CBIS) accreditation in 2017. She discusses adapting operations during COVID, taking on registered manager responsibilities in 2022 alongside Level 5 study and personal challenges, and emphasises trust, mentoring, self-belief, and overcoming imposter syndrome.

12. 

    28 Feb 2026

    Celebrating 20 Years of BIS Services & Why We Started

    Ep. 1: Celebrating 20 Years of BIS Services & Why We Started In the first episode of BIScussions, Natalie introduces BIS Services and launches the podcast to mark the company's 20th year since being founded in 2006. She shares how BIS began after the brain injury charity she worked for became insolvent, leading her and co-founder Clive Jarrett to quickly set up Brain Injury Support and continue services for existing clients. The conversation reflects on BIS's growth from early local authority work with acquired brain injuries and neurological conditions to expanding into litigation, and on how regulation and compliance have changed over time while the company's ethos and values have remained central. They discuss the scale of today's team, the behind-the-scenes operational work, challenges in the sector including uneven provision, COVID, and regulatory pressures, and what they believe sets BIS apart: specialist training, competency-based standards, supervision, quality assurance, and leaders who still carry client caseloads. 00:00 Welcome to BIScussions 00:56 Why Start the Podcast 01:56 Founding BIS in 2006 02:48 Charity Collapse to Startup 04:34 People First Ethos 05:07 Growing Into Neuro Rehab 06:28 How the Landscape Changed 07:24 Values and Culture Today 08:05 Behind the Scenes Operations 10:27 Advocacy and Support Gaps 11:35 COVID and Team Resilience 12:37 Pressure and Regulation 13:38 Not a Care Agency 14:19 Values and Training Edge 15:50 Supervision and Quality Checks 16:37 Leaders Still Do Client Work 18:32 Learning From Mistakes 20:04 Business Growth and Strategy 21:10 BIS as a Family 21:54 Network and Future Episodes

13. 

    27 Feb 2026

    Welcome To BIScussions.

    Natalie Mackenzie, founder and cognitive rehabilitation therapist at The BiS Services, and Eky, operations and registered manager, introduce "BIScussions," a podcast focused on brain injury support, community-based cognitive rehabilitation, and raising industry standards. Marking The BIS Services' 20th anniversary since its 2006 founding, they describe the organisation's growth and its consistent people-first ethos amid sector changes. The podcast targets case managers, solicitors, support workers, rehab assistants, clients, and families, addressing the "postcode lottery" of care by exploring what works, the distinct role of cognitive rehabilitation assistants, and operational challenges like regulation, recruitment, and quality pressures. Episodes will feature experts and real client/family voices, cover assessments and evidence for funding, highlight key soft skills, and share honest reflections, with links to subscribe and access resources online and on social platforms.

Reach and audience

Public platform figures. Ratings count people who left a rating, not total listeners.

Apple Podcasts (US)

5.0 / 5

1 ratings

Spotify

5.0 / 5

11 ratings

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Guest appearances

Books guests

Based on episode analysis; this does not confirm that the show is currently accepting guests.