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Reforming the delivery of health expert evidence
On this page:
- The pilot
- Development
- Progress
- Evaluation - tender underway
- 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 and other public, private or voluntary sector organisations 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
The first pilot contracts have been signed.
| 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
Clinical Child Psychiatrist Clinical Child Psychologist Paediatrician Family Therapist Adult Psychotherapist Learning Disabilities Psychologist |
County of Cambridgeshire including Peterborough | Douglas House,
18d Trumpington Road, Cambridge CB2 8AH Tel: 01223 746180 Fax: 01223 746002 |
| Carter Brown Associates | Clinical Adult Psychiatrist
Clinical Child Psychiatrist Clinical Adult Psychologist Clinical Child Psychologist Educational Psychologist Forensic Psychologist Counselling Psychologist Paediatricians Independent Social Worker |
County of Nottinghamshire
County of Derbyshire County of Lincolnshire County of Leicestershire South Yorkshire. |
www.carterbrownassoc.co.uk/ |
| Family Assessment and Safeguarding Service (Oxfordshire and Buckinghamshire Mental Health NHS Foundation Trust) |
Clinical Child Psychiatrist Clinical Adult Psychologist Independent Social Worker Child Psychotherapist Nurse Community Psychiatric Nurse Psychological Therapist |
County of Oxfordshire |
Family Aassessment & Safeguarding Sservice Reception: 0845 219 1002 |
Evaluation
The pilot will test the effectiveness of multi-disciplinary teams of health professionals in providing expert witness services and 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. We are in the process of tendering for an independent organisation to conduct the evaluation, on which our recommendations as to the extent that this approach is included in future strategy will be based.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, including 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.
We are currently out to tender for an organisation to conduct the evaluation. For the tender documentation or for more information please contact Howard Morris. The tender return date of the Invitation to Tender is 12.00 on Thursday, 25 June 2009.
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 the solicitors involved is that due to the LSC paying the expert directly for the work being undertaken on behalf of your clients, 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 Emily Paddy.
Last updated: 16 June 2009