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Reforming the delivery of health expert evidence
On this page:
- The pilot
- Development
- Progress and Pilot Teams
- Evaluation
- Benefits of this approach
- How the pilot will work
- 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 are piloting arrangements to commission multi-disciplinary teams of health professionals from the NHS. Also, other public, private or voluntary sector organisations.
The idea is to provide jointly instructed health expert witness services to family courts in Public Law childcare proceedings.
These arrangements will enable the commissioning of both existing and prospective teams and are 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, will be contracted and paid directly by the LSC to provide these services.
The contract has 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 must meet the following criteria:
- More than one type of health professional is required to provide expert opinion
- Experts are to be jointly instructed.
The teams are all different, however they all have a core of psychiatrists and psychologists. Details of each team, including the expert specialties they contain and the geographical areas they will work in will be made available here as contracts are signed.
Development
As we learn from the first phase teams, the pilot will evolve and we may invite some or all of the other organisations that applied to join a later phase if they meet the requirements for that phase.
Pilot contracts will be for one year, however work started as part of the pilot will need to be completed and the potential for future phases means that the period of the pilot is likely to be longer.
Progress and Pilot Teams
Current 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: courtteam@cpft.nhs.uk |
|
Carter Brown Associates |
Clinical Adult Psychiatrist |
County of Nottinghamshire County of Derbyshire County of Lincolnshire County of Leicestershire South Yorkshire |
|
|
Combined Healthcare Expert Witness Team (North Staffordshire Combined Healthcare NHS Trust) |
Clinical Psychologist Psychiatrist Independent Social Worker |
County of Staffordshire |
The Boat House Email the team here |
|
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 Email: parentingandchild@gosh.nhs.uk View the website here |
|
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 |
Joanne Bent Telephone: 0191 219 6440 Email: joanne.bent@ntw.nhs.uk |
Details of other teams will be added here as contracts are signed.
Evaluation
The pilot will test the effectiveness of multi-disciplinary teams of health professionals in providing expert witness services. Also, 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.
We hope that the pilot teams will be utilised where appropriate to ensure that we have a sound evidence base for conclusions reached.
It is likely that as part of the evaluation, feedback on the teams will be sought from the judiciary, local authorities and solicitors that have experienced their services.
Once the evaluation has been carried out we will develop recommendations for future development.
This will include the potential for the approach to be expanded to include other categories of law or types of expert. This is likely to be complete in the first half of 2011.
Benefits of this approach
The pilot will determine whether this approach to procuring expert witness services has these expected 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 will work
The pilot does not intend to change the way that solicitors involved in the pilot instruct experts or their relationship with experts when working to ensure that the child’s best interests are met.
The main effect that the pilot will have on solicitors involved is a result of the LSC paying the expert directly for the work being carried out on behalf of your clients.
This means that solicitors will not have to seek prior authority for the experts work, or claim the costs through disbursements.
If using a pilot organisation, solicitors will not need to submit evidence of getting more than one quote for the work. We expect the Experts Practice Directions to be adhered to.
Although the solicitors firms who have cases involved in the pilot will not be responsible for paying the experts for their service, any cost limitations on the case, such as on a certificate, will need to be adhered to.
If it is thought that costs will exceed this limit, then it will be necessary to seek an extension of the limit, as per current procedure.
The steps outlined in the attached document illustrate the process that will be followed to ensure that solicitors are aware of the cost of the expert’s service in a case.
Apart from prior authority, correspondence with the LSC on a pilot case will be the same as for any other similar case.
The current level of choice will not be removed, and the use of the pilot is not mandatory.
No sanctions will be applied where pilot teams are not used. However, to ensure that the evaluation and any future strategy is as well-informed as possible, we would encourage the use of the pilot where appropriate.
To ensure that we obtain the best value for money from these services, we would encourage the use of video-conference for the experts to give evidence at court wherever possible.
A list of courts that are set up to do this can be found on the HMCS website.
For more information
If you have any questions or would like further information, please contact Glyn Hardy.
Last updated: 22 February 2010