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Working group identifies main barriers causing medical expert shortages

President’s Working Group on Medical Experts in the Family Courts publishes report for consultation

The President of the Family Division's Working Group on Medical Experts have produced a report using information gathered from surveys of the legal and medical fields and a symposium held in London in July. The working group, under the chairmanship of Mr Justice Williams, confirms the nature and extent of the shortages of medical and other health professional is experts, identifies a wide range of causes and proposes solutions.

The next stage is to consult upon those proposed solutions to assess their viability and how best they might be implemented. The consultation closes on the 31st January 2020, and all responses are to be directed to .

The working group conducted a survey of the medical and legal professions which was responded to by 709 individuals (412 + 297). The survey results were consistent with the concerns expressed to the President of the Family Division which led to the formation of the working group and with the experience of the members of the working group.

The results of the legal survey confirmed that difficulties in securing expert witnesses were experienced across the country and in a wide range of specialisms. The impact of the shortages was principally in creating delay although there were also concerns about the quality of some expert evidence which appeared likely to be linked to the shortages.

The main shortages identified were: child and family psychiatrists and psychologists; paediatricians; radiologist and neuroradiologists; neurosurgeons; ophthalmologists; haematologists; neonatologists; and geneticists.

The results of the medical survey supported the conclusion that the pool of experts, in particular in some areas of specialism, was diminishing and a combination of factors was causing those who had previously reported to cease reporting and were acting as a disincentive to senior registrars or consultants considering taking on expert work in the future.

The main factors which were identified as barriers or disincentives were:

Fifty-eight per cent of healthcare professionals expressed concern about criticism in the press, by the judge or in cross examination. Thirty-eight per cent of healthcare professionals identified inflexibility in court timetabling (including scheduling witnesses) as an issue and 37 per cent the volume of material. Significantly 35 per cent of healthcare professionals identified lack of support from NHS Trusts.

The working group considers that there are some court process related factors which ought to be capable of effective resolution even in the short-term. Other potential solutions which are more structural and long-term in nature are also capable of resolution by action which is largely within the gift of the medical and legal professions. Other matters lie outside the power of those involved in the working group being in the hands of commissioning agencies (contract linked issues) or the Treasury (pension linked tax consequences) and will require more concerted action. The BMA amongst other are actively engaging the Government on this matter.

However, the working group are optimistic that even some of these changes are within reach given the compelling evidence and the enthusiasm of the agents of change.

Reassuringly there was considerable interest expressed by the medical profession in undertaking expert work and those conducting the work identified many positives both in terms of their clinical practice but also public service from doing so.

The working group has identified 22 recommendations to reduce the shortages by removing disincentives and creating incentives. The principal recommendations include:

For the full report, click here.