Concerns continue as to the quality of medical reports (SRA Report October 2016)

It is a sad fact that medical reports are still not of the quality demanded by lawyers, as revealed in a recent survey.

There remain concerns [amongst solicitors] over the quality of medical reporting and even with the introduction of the MedCo system which was designed to remove conflicts of interest and improve the quality of medical reports. Only a quarter of those surveyed felt that MedCo had achieved its objective of independence. Whilst the principles behind MedCo were generally supported, the implementation was criticised. There were also criticisms over the depth of scrutiny required to remove poor quality medical reports (some felt the information contained in the reports was overly standardised or superficial).” – An Assessment of the Market for Personal Injury – A final report for the Solicitors Regulation Authority (October 2016)

Perhaps given the absence of any formal accreditation scheme for experts, or any required standards, that is not a surprising finding.  However the continuing disappointment amongst the end-users of medical reports even with MedCo reports highlights the inadequacy of the compulsory training and so-called ‘accreditation scheme’ imposed by MedCo for these low value claims.  And if that is the approach to raising the standard of medico-legal reporting in the ‘controversial’ field of whiplash injuries, what does that tell us about any system for raising the standard of reporting more generally?

‘Accreditation’ (others would call it ‘certification’) is achieved after 30 – 40 hours online, studying 9 modules and answering online questions (and paying the fee).  Of those modules, how many address the issues relevant to preparing a quality medico-legal report, and how is that approached? No lawyer can answer that question because information as to the detailed content of the training or as to the standards intended to be achieved by the training is not available, at least not for those not paying the fee and taking the training (such as end-users).  However one can only assume that somewhere in module 8 (law and procedure) there is some hint as to how to construct an effective report (the other 8 modules appear to address soft tissue injuries and methods of clinical assessment).

Any attempt to ascertain from MedCo or the MoJ what the course content and objectives are, and what the required accreditation standards are, is met with silence.  So there is no public information as to:

  • the defined standards which the course was prepared against
  • the defined standards which those following the training are required to demonstrate in order to pass
  • any defined course content.

It is hard not to conclude that there are no such standards.  And that no or little attempt is made to explain how to provide what a lawyer and the court need from a medico-legal report (‘the medico-legal mind‘) and to give appropriate training to that end (something which some of us have been providing for many years).

If anyone does obtain answers from MedCo to any of these issues, please do share them with those who are paying for the reports and relying on them for the conduct of litigation!  And with me!

A last thought:  much of the course is in relation to imparting learning on ‘whiplash associated disorder’.  ‘Accredited’ experts are expected to have learnt what they are taught and presumably to have applied it in expressing their opinions.  Should not the lawyers and injured claimants be entitled to know what it is their experts (whose opinions they are paying for) are being taught as fact, and therefore on what their opinions are based?

[Who or what is medico-legal minder?  Terms and conditions apply]

What does expert accreditation guarantee? The Whiplash/MedCo saga continues

I return from a period abroad to find that MedCo has been involved in further delays and fundamental changes to the much heralded accreditation process which is intended to guarantee a more robust system of expert report production in whiplash claims.

Perhaps the most interesting change is the accreditation system being brought in-house.  As MedCo’s announcement of 7th March 2016 stated:

“Due to the rapidly evolving policy environment, MedCo has made the difficult decision to bring accreditation training in-house.  The original training model, which allowed for separate training providers, does not enable MedCo the speed and flexibility required to be able to update the accreditation training as necessary in order to ensure a current, robust, resilient and consistent programme.  This is in no way a reflection of the training provided by third party suppliers to date and MedCo thanks Opil Bond Solon and DocSlot.

From March 7th 2016, MedCo Accreditation Training will only be available from MedCo and MedCo owns and manages the training programme. “

This was rapidly followed by the announcement of 24th March that the accreditation deadline has been knocked back yet again, this time to 1st June 2016. (See previous blog)

So what does all of this mean?  What is the “rapidly evolving policy environment?”  Were the experienced providers unable to adapt or change?  What is this sudden need for “speed and flexibility” for a “current, robust, resilient and consistent programme”?

Anyway I am sure that MedCo as the sole and independent safeguard of quality in whiplash reports will share with all users, and particularly lawyers, judges and politicians, just what this “robust” system guarantees, what the training provides and what the accreditation denotes!  What are the standards guaranteed by, and tested for, in MedCo’s accreditation process?  There appears to be no public access to such information, and no willingness to provide it, on the part of MedCo, at least to me!

So if anyone knows what standards we are purportedly getting for our money (as instructing lawyers or reporting medics), do tell!

[Who or what is medico-legal minder?  Terms and conditions apply]