Understanding the value of desktop medico-legal reporting
28 May 2020
In response to the Covid-19 crisis affecting the medical and justice systems in the UK, NRC Medical Experts has adapted its ways of working to ensure as far as possible, legal cases can progress during lockdown and social distancing. Desktop expert witness reports are proving particularly valuable at this time.
When NRC’s medical experts begin working on a case, they undertake extensive research which is usually followed by a face to face consultation. This ensures the expert witness can develop an in-depth picture of the individual and their presentation.
What kind of desktop research is carried out?
For the medical expert to begin gaining a thorough overview of the individual and the circumstances of the case, they will first review a range of records. This includes requesting and reviewing hospital, GP, and other medical records.The expert will also gain an understanding of relevant medical and therapeutic interventions which have been carried out by clinical teams to date. They may also review factual reports into any accident or incident which led to the injury or current presentation of the individual.
To build on this initial review of available records, the medical expert witness will explore the view and experience as understood by the patient, their loved ones, and where possible the professional view of those experts already supporting them. Much of this research can be achieved via video calling and online meetings.
Speaking to loved ones, carers and the medical team
Often, a close family member who knew the person before their injury or illness is well placed to contextualise their current behaviour and to comment on the changes they have experienced. A carer, who might spend a large amount of time with the person, can also provide insight into how the individual is coping with daily living and the adaptations that are required for them to carry out tasks.
The expert may also choose to speak to the therapy team or lead clinician to find out further details about the individual’s response to any intervention carried out so far.
Environmental and social cues
When it comes to reporting on individuals who have experienced brain injury, the medical expert will take into account the visual and social cues a person is exhibiting, in addition to posing questions and asking for specific information. This might include looking at the person’s environment – such as if the room they are in is ordered or tidy, or if there is evidence of the individual using visual cues to aid memory, such as leaving notes for themselves.
An expert view
Professor Mike Barnes has carried out in excess of 3000 medico-legal consultations and feels that desktop reporting and online consultations provide a suitable response to the limitations of Covid-19 at this time, but face-to-face meetings continue to provide crucial insight.
“For some patients, a face to face consultation may not ever be required – such as for individuals who are living with spinal injury or orthopaedic injury. When it comes to brain injury, where individuals are experiencing cognitive deficits, behavioural or emotional difficulties, it can be more nuanced.
I look to see how people react to my questions, if they are able to concentrate, organise their thoughts and remain on task, some of which can be achieved via video call – but not all. I feel that some of the insight gained from the subtleties of visiting a person in their own home are not possible in the artificial environment of a video consultation. In these cases, I would prefer to provide the court with a fuller picture by augmenting my desktop report at a later date, after following up with a face to face visit when possible.”
Providing legal teams with highly informative reports developed from desktop research and virtual consultations at this time are crucial to keep cases progressing. Our experts work to ensure solicitors have a clear picture of any follow up which might be required, and our Head Office team provide valuable updates to clients as reports progress.
Instruct a medical expert witness
At NRC Medical Experts, we’re doing all we can to support solicitors and clients during this time, we’re pleased to be providing business as usual service as far as possible.