Medico-Legal Magazine - Articles

Mediation Within The NHS in Scotland

The use of mediation within the NHS in Scotland is proving to be a slow burn.

Psychiatric Assessment of The Effects of Historical Child Abuse

The recent public focus on historical child abuse has led to an increasing number of personal injury claims.

Patient Consent for Aesthetic Treatments – More Than Merely Cosmetic?

It’s been over three years since the Government Committee chaired by NHS Medical Director Sir Bruce Keogh published its final report into the regulation of cosmetic interventions.

Whiplash Numbers – Fact or Myth?

Statistics have a wonderful ability to be manipulated to prove almost anything.

Medical Reporting in 2017, The Year of Innovation?

MedCo has seen little evidence of the mature, fit for purpose Medico-Legal sector that industry has spent so many years portraying to both government and the market in general.

Medico Legal News, Issue 4

A Perfect Storm – The Spiralling Cost of Claims

When a patient receives a multi-million pound compensation claim, it often makes headlines. But few of us stop and think about the effect the rise in such claims is having on NHS finances.

Mediation in Clinical Negligence Claims The New NHS LA Scheme

The NHS Litigation Authority (now renamed NHS Resolution from April 2017) recently launched its new Claims Mediation Service following a successful pilot and a public tender.

Robotics and Artificial Intelligence in Healthcare

The idea of ‘robotic surgery’ is not a new one. The first robot assistant for surgery, the Arthrobot, was developed in the early 1980s and first used in 1984, in an orthopaedic procedure.

An Invitation To Mediate? Accept!

change is on the horizon. In 2014, the NHSLA published “Mediating claims in the NHS”. It runs to four pages, in which the NHSLA states its commitment to mediation

Medico-Legal Aspect of Hand Arm Vibration Syndrome

Hand Arm Vibration Syndrome (HAVS) is a medical syndrome of symptoms and signs affecting the vascular, neurological and musculoskeletal systems

New Industry Body Launched to Represent Medical Reporting Organisations

The Confederation of Medical Agencies, launched in March, aims to offer a true voice and representation for the smaller Medical Reporting Organisations

Understanding The Unsaid Signals

There is an old saying, "It's not what you say, it's the way that you say it" and, like many old things, it has become hackneyed and overlooked with time

Medico Legal News, Issue 5

Short Term Pain From New European Data Regulations Will Lead To Long Term Gain in Digital Health

Damaging as it was, the WannaCrypt ransomware attack earlier this year made one thing very clear to everyone who heard about it: the UK’s health comms are broken.

Claimant Interview Tips for Experts

Five years ago, when I set up my own boutique personal injury firm, I wrote a blog entitled ’What to expect at a personal injury medical appointment’.

Common Medico-Legal Issues in Facial Trauma (part one)

The treatment of facial injuries has evolved considerably over the last 30 or so years and many injuries can now be reliably repaired to a reasonable level of precision.

Update in Selected Gynaecology Medico-Legal Aspects

Endometrial ablation has now firmly established itself as an excellent surgical option to treat heavy periods.

About The Parliamentary and Health Service Ombudsman

The Parliamentary and Health Service Ombudsman (PHSO) makes final decisions on unresolved complaints about the NHS in England

Medico Legal Agencies: The Good, The Bad and The Ugly. How to Choose?

When choosing and negotiating with medico-legal agencies, you need to consider a number of different factors.

Facilitate Expert Solutions Takes the Stress Out of Running Your Business

Running a business is hard, not least having to learn a whole new skill set to stay on top of the paperwork and ensure the smooth running of a medico-legal practice.

Medico Legal News, Issue 6

Medical Experts’ Tips for Lawyers

I can offer a few thoughts to the legal profession that crop up regularly in the course of my own many years of medico-legal practice

The Primacy of Independence and Objectivity in Expert Evidence – A Review of EXP V Barker [ 2017 ] EWCA CIV 63.

the Court of Appeal decision in EXP v Barker [ 2017] EWCA Civ 63 is a salutary read reinforcing the principles of independence and objectivity in the provision of expert evidence

Common Medico-Legal Issues in Facial Trauma (part two)

I will discuss the impact of NHS targets on treatment of facial trauma, as well as other issues such as patient consent

The Loneliness of The NHS Whistleblower

Where are we now with whistleblowing in our health services?

How Virtual Reality Software Could Begin to help Injured Accident Victims Deal with Life Debilitating Chronic Pain

It is estimated that 28 million people in the UK suffer from some form of Chronic Pain.

Medico Legal News, Issue 7

About The Association of Personal Injury Lawyers (APIL)

A group of barristers and solicitors founded APIL in 1990 to give a voice to those injured through no fault of their own.

Childbirth and Oasis - What is New?

Childbirth is exceptionally safe in United Kingdom, thanks to the progress made over decades in safety and quality of care.

Experts and Fixed Costs Extension

Lord Justice Jackson’s report – Review of Civil Litigation Costs: Supplemental Report: Fixed Recoverable Costs

Accidental Awareness During General Anaesthesia (AAGA)

Two fears almost universally expressed by patients before surgery are first that they might die during the operation, and secondly that they may wake during the procedure unable to alert anyone to their plight.

Child Mental Health and The Law: The Future May be Fusion and No Bright Lines

‍The year 2018 may see the introduction of new Deprivation of Liberty Safeguards for young people.

The use of Fractional Laser Technology to Reduce Scarring

Scars are a very common complication of traumatic injuries affecting millions of people worldwide every year.

Medico Legal News, Issue 8

Why Effort Tests Should be Employed as Standard in Neuropsychological Assessments

Neuropsychologists are frequently invited to report to the court on the extent of an individual’s level of cognitive impairment.

Litigation After Total Hip Replacement Surgery

Total hip replacement (total hip arthroplasty) has been described as the “Operation of the Century”

Lack of Informed Consent to Spinal Surgery: Tracy Hassell V Hillingdon Hospitals NHS Foundation Trust

Mrs Hassell was 41 at the time of surgery to her neck in 2011. She worked full-time as head of year for years 7,8 and 9 at a secondary school and had 3 children.

Rise of The Robo-Diagnosis

The word “diagnosis” can be defined as “the act of identifying a disease from its signs and symptoms”.

Vascular Surgery – The Problem with Legs

Vascular surgery is a high-risk speciality for medicolegal claims because when problems occur they do so quickly and with severe limb and life- threatening complications.

Are We Safe in a Public-Private Health Service?

Outsourcing medical treatment to private providers is common practice in many areas of the NHS, with private companies increasingly operating alongside NHS trusts.

Fingertip Injuries in Personal Injury

Fingertip and nail injuries are common in the general population, and more common in children, mechanics, carpenters and people who work in manual trades.

Medico Legal News, Issue 9

Consent in pain medicine

The Hippocratic oath, whilst holding the physician to account over his actions, implicitly assumes the agreement of the patient and/or the relatives to whatever course of action the physician decides.

A Summary of The DR Bawa-Garba Case; Should A Doctor's Gross Negligence Manslaughter conviction lead to Automatic Erasure from The GMC Register?

Dr Bawa-Garba, a Trainee Paediatrician, was responsible for the care of Jack and has been found to have been responsible for a series of errors, which led to Jack’s death later the same day.

CRPS in The Medico Legal Setting: Experts Need to Consider a Range of Opinion

Complex regional pain syndrome [CRPS] is a chronic pain syndrome of unknown cause.

NHS Outsourcing: Who Foots The Bill when it all goes Wrong?

NHS outsourcing arrangements raise important questions. Is the NHS able to recover the full cost of compensating outsourced patients who suffer injury as a result of a private provider’s negligent care?

Immediate Custodial Sentence for Those Who Submit Fraudulent Claims Against The NHS

Calderdale and Huddersfield NHS Foundation Trust - v - Sandip Singh Atwal

Medico Legal News, Issue 10

Clinical Partnerships: A Lifeline for The National Health Service?

Whilst the case for further funding is clear, the NHS itself recognises that innovative solutions are vital to achieve its ambitions.

CCG Policy on Prescribing Avastin for Wet AMD Not Unlawful (Bayer Plc V NHS Darlington CCG; Novartis Pharmaceuticals UK LTD V NHS Darlington CCG)

It is critical each patient has the opportunity to have a full discussion with their clinician to give consent prior to switching or embarking on treatment.

Learning from Litigation – A Missed Opportunity

We are all encouraged to learn from our mistakes and also to learn from the mistakes of others. On top of this we have a duty of candour to patients to explain to them when we have made a clinical error.

Changing Minds – Mediation in Healthcare

It was a wet Tuesday morning in February a few years ago. You were up early and into the hospital before it was light. Patients were already waiting.

What is Medical Indemnity & Who need's it?

The GMC states; “A doctor must have adequate and appropriate insurance or indemnity in place when they start to practise medicine in the UK” – which begs the question, what is Medical Indemnity?

Medico Legal News, Issue 11

Redefining The Rehabilitation Model

STEPS Rehabilitation is a state-of-the art, purpose-built rehabilitation facility in Sheffield. Since opening its doors in 2017 it has quickly established itself amongst the legal sector as the ‘go to’ rehabilitation facility for seriously injured clients looking for high quality rehabilitation care.

CQC Bares it's Teeth: A review of the duty of candour 4 years on

In January 2019 the CQC announced that Bradford Teaching Hospitals NHS Foundation Trust had become the first NHS Trust in England and Wales it had prosecuted for failing in its duty of candour.

Doctors' Scope of Duty for Wrongful Birth: An Analysis of DR Hafshah Khan V MNX [ 2018 ] EWCA CIV 2069

The Respondent’s nephew had been born in January 2006 and was subsequently diagnosed with haemophilia. The Respondent wished to avoid having a child with that condition and so consulted her GP in August 2006 to ascertain whether she carried the haemophilia gene.

How New Sentencing Council Guidelines and the GMC review could impact Healthcare Professionals and Organisations Convicted of Gross Negligence Manslaughter

On 1 November 2018 sentencing guidelines were introduced in relation to convictions for Gross Negligence Manslaughter (GNM).

Medico Legal News, Issue 12

Yet More Court Reforms

Dominic is an acknowledged authority on civil litigation and liability. He assisted Sir Rupert Jackson between 2010 and 2018 on costs controls and has advised the Government on law reform.

Women and Heart Disease: The Cardiology Gender Gap

Men and women do not always experience serious heart problems in the same way. Women’s lives are being put in danger as a result.

“What If My Patient Decides to Sue Me?”

It’s a sobering thought that if you follow a career in medicine, the chances are that you may find yourself involved in court proceedings at some point during your professional life.

Diagnosis of Sepsis - The History and Pitfalls

Sepsis is the commonest cause of death from infection. This is a statement that is often quoted, but why is this so? What is sepsis? How do we treat it, how do we monitor progress and what happens when things get worse?

Medical Errors: Sanctions and Compensation – Is There Another Way?

This lecture addresses disciplinary proceedings against health professionals, decisions to prosecute and civil claims arising out of medical mishaps. The subject matter is not unimportant.

Medico Legal News, Issue 13

How to Assess The Risk of Arthritis After Trauma

Arthritis is a degenerate joint condition that occurs commonly as part of the normal ageing process.

Honesty & Integrity: The Difference Between the Two and Why it Matters to the Regulators

The two examples are based (loosely) on actual cases, and illustrate the importance the GMC (like all regulators) places on honesty and integrity.

More Doctors to Serve as Expert Witnesses says Medical Protection Society (MPS). A Short Commentary

Medicine and the Law have been closely intertwined since time immemorial; however, in practice, the two disciplines are separate, medico- legal work still being thought of as something which is largely outside mainstream practice.

Women and Heart Disease – Part 2: Medical Risk Factors

In the second of this series of articles, Enable Law lawyer Laurence Vick looks at medical risk factors in women’s heart medicine, and how they support accusations of a gender bias.

Medico Legal News, Issue 14

Both sides in the personal injury sector have collaborated to create a new set of standard practices for dealing with coronavirus disruption.

Duties of an Expert Witness: The Importance of Knowing Your Limits

The recent case of Samantha Thimmaya v Lancashire Teaching Hospitals NHS Foundation Trust [2020] sounded an alarm bell for all medico-legal experts.

In It Together

Artificial Intelligence (AI) presents clinicians with a challenge: can they harness AI to improve outcomes for patients without creating increased litigation risk?

Mediating Online in the COVID-19 Environment

In this time of self-isolation online mediation becomes more relevant than ever. There are, of course, advantages and disadvantages to mediating online. However, given that it may be the only option, this article focuses on tips for online mediation.

Lessons From Paterson: The Need for Private Healthcare Providers to Have Skin in the Game

The Paterson case highlighted multiple failures of governance, regulation and patient care at all levels in the NHS and private sector.

Medico Legal News, Issue 15

Consent in Obstetrics – The Musings of an Obstetrician Five Years Post-Montgomery

For this essay I will limit my attention to consent being obtained for procedures being performed on the labour ward (due to time and word pressures).

Skipping The Light Fandango?

Ahead of his presentation at the Medico-Legal conference, Warren Collins, Solicitor Advocate and Personal Injury Partner at Penningtons ManchesLLP, looks at the sharp edge of expert evidence.

Lessons Learned From The Bristol Heart Scandal and The 2001 Kennedy Inquiry – Part 1

‘All changed, changed utterly’ said Richard Smith in the BMJ in 1998 in the aftermath of the 90s Bristol heart children scandal, borrowing from the line in W.B Yeats’ Easter 1916.

We Can Work it Out – or Day Tripper?

The purpose of this article is to review that report, and what has happened in the four unprecedented months since that time – and then to gauge the future of NHS Dispute Resolution, at least for patients and staff.

Medico-Legal News, Issue 16

Placement of Nasogastric Feeding Tubes and The “Too Long To Read” Clinical Guidelines: Part 1

The Healthcare Safety Investigation Branch (HSIB) published their final report on 17 December 2020 following their investigation into safety issues surrounding the placement of nasogastric feeding tubes raised.

Patient-Specific Instruments: An Adequate Middle-Ground Alternative in Knee Surgeries

Total Knee arthroplasty (TKA) is a common and successful surgical procedure. However, surgeons, engineers and scientists are trying to employ the new technologies of robotics, navigation and 3D printing to improve the outcome and patient’s satisfaction of TKA.