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Reforming the delivery of health expert evidence
On this page:
- The pilot
- Status update
- Pilot teams
- Evaluation
- Benefits of this approach
- How the pilot works
- For more information
The pilot
The LSC is working with the Department of Health to pilot the key proposal from the 2006 consultation on the Chief Medical Officer’s report, 'Bearing Good Witness: Proposals for reforming the delivery of medical expert evidence in family law cases'.
We piloted arrangements to commission multi-disciplinary teams of health professionals from the NHS and private sector organisations.
The idea is to provide jointly instructed health expert witness services to family courts in Public Law childcare proceedings.
These arrangements enabled the commissioning of both existing and prospective teams and were not intended to create a monopoly for NHS service providers.
This approach is something that the LSC has not tried before, and is the first step in developing a wider strategy on experts.
The pilot will evaluate the commissioning of multi-disciplinary teams of health professionals to provide jointly instructed health expert witness services to family courts in Public Law childcare proceedings.
Several organisations, both private and NHS trusts, have been contracted and are paid directly by the LSC to provide these services.
The contract had provisions regarding quality assurance and providing services within the court timescales, as well as agreeing rates of pay.
To be included in the pilot, the need for expert witness services had to meet the following criteria:
- More than one type of health professional was required to provide expert opinion
- Experts were to be jointly instructed.
The teams are all different although they all have a core of psychiatrists and psychologists. Details of each team, including the expert specialties they contain and the geographical areas are provided below.
Status update
The operational phase of the Alternative Commissioning of Experts pilot concluded on 30 September 2010.
Although pilot teams no longer accept cases through the pilot, work already started will be completed under the pilot.
The focus of the pilot will now shift to the independent evaluation, conducted by Cardiff Law School. A final evaluation report will be delivered on 30 June 2011.
The evaluation report will be used in conjunction with the Ministry of Justice’s consultation on proposals for the reform of legal aid, and the report from the Family Justice Review (which is also looking at the use of experts) in determining the way forward.
Pilot teams
Pilot teams are:
|
Team name |
Specialties within team |
Services provided for cases being heard in courts in the following locations |
Contact details |
|
Cambridgeshire and Peterborough Child and Family Court Assessment Service |
Clinical Adult Psychiatrist |
County of Cambridgeshire including Peterborough |
Douglas House Tel: 01223 746180 Email: Court team |
|
Carter Brown Associates |
Clinical Adult Psychiatrist |
County of Nottinghamshire County of Derbyshire County of Lincolnshire County of Leicestershire South Yorkshire |
Website:
|
|
Combined Healthcare Expert Witness Team (North Staffordshire Combined Healthcare NHS Trust) |
Clinical Psychologist Psychiatrist Independent Social Worker |
County of Staffordshire |
The Boat House |
|
Family Assessment and Safeguarding Service (Oxfordshire and Buckinghamshire Mental Health NHS Foundation Trust) |
Clinical Child Psychiatrist |
County of Oxfordshire |
Family Assessment & Safeguarding Service Reception: 0845 219 1002 |
|
Great Ormond Street Hospital for Children NHS Trust - Child Care Consultation Team |
Clinical Child Psychiatrist |
Nationally across England |
Tel: 0207 405 9200 Ext 5577 |
|
North East Family Court Assessment Service In conjunction with: Northumberland Tyne & Wear NHS Trust The Newcastle Upon Tyne Hospitals NHS Foundation Trust |
Child and Adolescent Psychiatrists Adult Forensic Psychiatrists Adult Learning Disability Psychiatrist Adolescent Forensic Psychiatrists Clinical Child and Adolescent Psychologists Adolescent Forensic Psychologists Child and Adolescent Learning Disability Psychologists |
County of Northumberland County of Tyne & Wear County of Durham County of Teesside |
Tel: 0191 219 6440
|
Evaluation
The pilot tests the effectiveness of multi-disciplinary teams of health professionals in providing expert witness services. It also tests the effectiveness of directly commissioning from NHS Trusts and other organisations.
This will be measured on the teams’ ability to deliver high quality, timely and cost effective expert advice.
The evaluation report will look into whether these arrangements achieve the goals set out in the CMO’s report and meet the requirements of the LSC as prospective commissioner.
The evaluation will be based on data provided by the teams, and feedback received from solicitors, judiciary and local authorities.
As part of the evaluation, feedback on the teams will be sought from the judiciary, local authorities and solicitors that have experienced their services.
Benefits of this approach
The pilot will determine whether this approach to procuring expert witness services has these benefits:
- easier for health professionals to get engaged as health expert witnesses
- sustainable increase in the supply of quality-assured expert witnesses
- easier and quicker for solicitors and clients to access health expert witnesses
- fewer delays in the provision of expert reports for the benefit of the child
- improved quality-assurance through peer review and multi-disciplinary input
- best use of public funds.
In addition, the evaluation will test whether the perceived benefits of using teams outlined in Bearing Good Witness are realised, such as:
- Teams ensure that the professional with the right expertise is used, and they are able to obtain other input from within the team reducing delay and effort on behalf of the solicitor
- A team consensus should give reassurance to the court that the appropriate conclusions have been reached. Differing views that may not be considered by an individual expert can be debated
- Knowledge and experience of similar cases and the basis of evidence can be pooled and the potential for the court to be more heavily influenced by an individual in the court room is reduced
- Internal quality assurance processes such as peer review ensure that the services are of the appropriate standard
- Resources for training and supervision may be more readily available
- Teams can conduct succession planning, ensuring increased capacity for expert witness work and increased sustainability of competent expert witnesses for the future.
How the pilot works
The pilot didn't change the way that solicitors in the pilot instruct experts or their relationship with experts when working to ensure that the child’s best interests are met.
The main change was that the LSC paid the expert directly for the work being carried out on behalf of clients.
This meant that solicitors did not have to seek prior authority for the experts' work, or claim the costs through disbursements.
If using a pilot organisation, solicitors did not need to submit evidence of getting more than one quote for the work.
Although solicitors were not responsible for paying the experts, any cost limitations on the case, such as on a certificate, still needed to be adhered to.
Apart from prior authority, correspondence with the LSC on a pilot case remained the same as for any similar case.
The level of choice wasn't removed, nor was the pilot mandatory.
No sanctions were applied where pilot teams were not used.
For more information
If you have any questions or would like further information, please contact Glyn Hardy.
Last updated: 18 October 2010