Your Expert Witness Issue No. 37 (1YWP)

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contents IN THIS ISSUE 7

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Opening Statement

NEWS 8 Largest-ever legal needs survey published 8 Latest PI measures condemned by lawyers’ leader 8 MoJ acts against rogue claims companies CCTV, MOBILE & VIDEO FORENSICS 11 Care home CCTV petition reaches landmark 11 Beyond forensics: report looks to the future 11 Junior CSIs solve the ‘crime’ WILLS, LEGACIES & CHARITABLE BEQUESTS 13 Charity legacy beneficiaries see 10% rise in numbers 14 Legacies can help pioneering research 14 Delivering a supporting role 15 Work needed to promote trust between charities and solicitors 15 Queen’s Speech Gift Aid reform welcomed by charities 15 Failing sight brings with it so many problems!

16 Enriching the lives of people with learning disabilities 16 Care and support for injured service men and women 17 Will-making figures remain static, despite rising awareness of intestacy 17 Short breaks offer a normal life and boost self-confidence 18 What happens to our digital self after death?

18 Improving the lives of equines in The Gambia

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MEDIATION 19 Mediation can cross borders in family disputes 19 Parliamentarians form ADR group 19 Conference will address influences on mediators FINANCE 20 So what exactly are my shares really worth?

22 Tax evasion Bill meets with lukewarm reception 22 Whose profits are hit by fire and flood?

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BUILDING & PROPERTY 23 Govt watchdog criticises Land Registry proposals 23 FMB welcomes court decision on affordable housing

A to Z WEBSITE GUIDE 24 Our A to Z guide to the websites of some of the country’s leading expert witnesses.

Your Expert Witness Suite 2, 61 Lower Hillgate, Stockport SK1 3AW Advertising: 0161 710 3880 Editorial: 0161 710 3881 Subscriptions: 0161 710 2240 E-mail: ian@dmmonline.co.uk Copyright Your Expert Witness. All rights reserved. No part of this publication may be copied, reproduced or transmitted in any form without prior permission of Your Expert Witness.

Views expressed in this magazine are not necessarily those of the publisher. Printed in the UK by The Magazine Printing Company Plc www.magprint.co.uk

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MEDICAL ISSUES 27 Medical Notes

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NEWS 29 Surgeons accuse CCGs of ‘targeting’ smokers and obese patients 29 MPs criticise NHS staffing management 31 Experts make recommendations on NHS safety 31 Forensic provision enters a new age INSTRUCTING AN EXPERT 33 Guidance helps those instructing experts 33 ‘Hot-tubbing’ comes under CJC scrutiny 33 Medical experts must have appropriate expertise 35 Do’s and Don’ts for medicolegal experts CLINICAL NEGLIGENCE 37 Doctors’ disciplinary body to get new chair 37 Cost of private practice claims rockets 37 Law Society renews offensive on fixed costs for negligence claims

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PAIN MEDICINE 39 Rehabilitation programmes for chronic pain CARDIOLOGY 41 IT statins error prompts response from MHRA and GPs 41 New guidelines on heart failure published by European society PLASTIC SURGERY 43 New guidance welcomed, but surgeons want statutory change CULTURAL, RELIGIOUS & ETHNIC ISSUES 44 Male circumcision and the worldwide legal controversy REHABILITATION 46 Rehabilitation forms part of compensation claims 46 Brain injury issues 47 Physios say new guidance can help ‘give people back their lives’ 47 Speech and language therapy involves more than talking

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PSYCHIATRIC & PSYCHOLOGICAL ISSUES 48 Mind condemns number of mental health patients sent ‘out of area’ 48 New funds will take mentally ill people out of police cells 49 Finding the right psychiatric expert – a new approach

AND NOW FOR THE WEATHER...

50 Pennies from heaven – the life and times of a forensic meteorologist

EXPERT CLASSIFIED 51 Expert Witness classified listings 54 Medico-legal classified listings www.yourexpertwitness.co.uk

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Opening Statement [EVERYTHING STOPS FOR the Queen’s Speech. The State opening of Parliament has now fixed itself in May or early June, following the passing into law of the Fixed Term Parliament Act in 2011.

That earlier timing – the event used to be later in the year unless there had been a General Election – still catches this writer on the hop.

One of the measures outlined by Her Majesty was the reform of the tax system for small donations to charity. This will make it easier for smaller charities to claim back the tax on donations. The change comes as a welcome relief for the charity sector, which endured a bumpy ride last year – one commentator remarked after the Budget that the sector could be relieved if only because it wasn’t mentioned!

Nevertheless, legacy giving continues to form a major backbone of charities’ funding, with more organisations than ever mentioned in wills. That is according to research by Smee and Ford, the authoritative voice on the sector. Many of the extra names mentioned last year figured for the first time in a legatee’s wishes.

• What is continuing to frustrate lawyers, charities and anyone else who has had to deal with the administration of an estate is the continuing number of people who do not leave a will at all. With the recent sustained rocketing of house prices, even a modestly-off person can leave a substantial asset.

Assets left behind nowadays that didn’t even feature just a few years ago are the ‘digital legacy’.

Not only does that apply to the passwords and codes needed to access online bank accounts and the like, but it also involves our digital identity. What happens to our photographs, music collections and even our Facebook account? The need for a will becomes ever more pressing.

• Another measure included in the Queen’s Speech was the privatisation of the Land Registry. That measure has come under fire even from the government’s own Competition and Markets Authority, which paints a pessimistic picture of a private company unable to resist the temptation to ‘weaken competition to its own commercial products, despite the best efforts of oversight bodies to regulate prices and impose safeguards’. It is incredible that the possibility of that conflict of interest did not occur to the government when it embarked on that course of action.

• Also announced on 18 May was the Criminal Finances Bill, which creates an offence on the part of companies of failure to stop staff from facilitating tax evasion. That element of the Bill also came under fire from quarters where the government might expect support. Putting the onus on companies to know everything their employees are up to would prove ‘unworkable’, according to some. The opposition, on the other hand, can complain the measures don’t go far enough.

• What seems to be the common thread in all the criticism of this year’s Queen’s Speech legislation is that it seems to be drafted in a hurry and not thought through. Could it have something to do with the fact that the PM and a number of his colleagues are a little distracted by the upcoming referendum?

By the time the next issue of Your Expert Witness is being compiled we will know whether or not the whole European legal framework will still apply to UK law in the future. q

Ian Wild

Ian Wild, Director of Business Development Your Expert Witness

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Largest-ever legal needs survey published [IN THE LARGEST ever survey of legal

needs in England and Wales, more than 8,000 people responded to questions about how they dealt with a range of legal issues. The survey was conducted by Ipsos MORI for the Law Society and the Legal Services Board.

Legal issues raised included wills, probate, conveyancing, consumer rights, arrest, debt and more complex legal concerns, such as relationship breakdown.

Over half of those who responded (54%) had experienced at least one legal issue in the past three years. They were most likely to have had a consumer rights issue, bought or sold a home, made a will or dealt with the estate of a deceased relative. Disputes with neighbours, problems with benefits, debt/money problems and problems with an

employer were also common issues. Only 3% had been arrested.

Over three quarters of the respondents who chose to seek advice were satisfied with both the quality of formal legal advice given (77%) and the outcome (78%). Two thirds of the issues raised in the survey were not initially thought of as ‘legal’ issues.

Law Society president Jonathan Smithers commented: “This survey highlights the benefits of obtaining expert legal advice, the need to raise awareness among the public of legal issues and how people can access legal advice when they need it. Access to legal advice is a fundamental right, essential to democracy and a cornerstone of justice.”

The survey also revealed that awareness of legal aid eligibility is low. People surveyed did

not understand which issues were covered by legal aid and how to get advice on issues.

Jonathan Smithers continued: “The survey reveals the complexity and diversity of legal needs. It provides information and insight to solicitors that will support their continued efforts to improve their services and better meet the legal needs of the public.”

The chairman of the Legal Services Board, Sir Michael Pitt, said: “Access to justice is a fundamental right but many people do not seek legal advice for a variety of reasons.

Lack of information on legal rights and what legal services are available and the assistance they could provide, as well as preconceived expectations of the cost of legal services, are among the main factors that influence whether legal advice is sought.” q

Latest PI measures condemned by lawyers’ leader [

GOVERNMENT PLANS TO plough ahead with reforms to personal injury claims have been branded ‘baseless’ and ‘frustrating’ by the new president of the Association of Personal Injury Lawyers.

Greater Manchester solicitor Neil Sugarman said: “The government’s apparent determination to make life harder for people with personal injury claims is both disappointing and deeply frustrating.”

He was reacting to remarks from justice minister Lord Faulks at the association’s annual conference in Birmingham.

He continued: “The government continues to give the impression that injuries which don’t attract a great deal of compensation, such as whiplash injuries, are somehow ‘trivial’ or ‘unnecessary’ and that people suffering with those injuries should not be allowed damages for their pain and suffering at all. But anyone who has had such an injury knows just how painful and debilitating it can be.

“Three years ago the government deferred a decision to force more claims through the small claims court until safeguards are in place to ensure access to justice will not be affected. Today, it seems that promise has been forgotten and people forced to bring personal injury claims in the small claims court will still either have to represent themselves or pay for their lawyers because those whose negligence has injured them won’t have to pay for their costs.”

He went on to declare: “What I find most frustrating of all is the fact that these proposals are utterly groundless. Government figures show us that whiplash claims are falling and a whole raft of reforms have been introduced to reduce costs and help prevent fraud. But innocent and vulnerable people are still being targeted in what has become a game of numbers rather than of the needs of individuals.” q

MoJ acts against rogue claims companies [

TWO CLAIMS FIRMS suspected of making thousands of nuisance calls and ripping off hundreds of vulnerable people have had their offices raided by the MoJ’s Claims Management Regulation Unit (CMRU).

Investigators teamed up with police to raid and make arrests in connection with the businesses – thought to be at the centre of largescale and sophisticated cold-calling operations.

Five people were arrested after a raid on a Swansea company which had been operating illegally without a licence. The company is believed to have conned the public out of hundreds of thousands of pounds through misleading marketing calls – taking one-off payments in excess of £500 from vulnerable consumers.

CMRU officers later worked with police to raid a company in central Birmingham which bombarded people with hundreds of calls a day about claims for payment protection insurance. The firm is believed to be linked to numerous other businesses operating in a network of unlicensed claims companies. q

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Care home CCTV petition reaches landmark [

AN ONLINE PETITION calling for CCTV to be installed in all care homes across the UK has notched up 10,000 signatures, the point at which the government is required to provide an official response.

Lisa Smith (pictured) created the petition in January, having taken her 86 year old father Joshua out of care after four years, claiming his life had been a ‘living nightmare’ during that time due to poor care.

“I’m delighted and really made up that so many people have signed the petition, and that the whole issue of care home abuse and neglect is being placed into the spotlight and being discussed,” said Lisa.

“CCTV is now a must. There have been some horrendous cases gone to the courts and reported in the media. Let’s get CCTV in care homes and stop this poor treatment.”

Lisa’s campaign is being backed by Hudgell Solicitors, who have supported Lisa in bringing the matter to the national spotlight by backing the petition as part of their on-going Love Our Vulnerable and Elderly (LOVE) campaign.

It follows an increasing number of cases in which concerned families have caught care home staff either abusing or neglecting their loved ones by secret filming and recording. Hudgell’s have also represented a number of families who had turned to secret filming and recording.

It also came after an independent survey revealed eight in 10 people would be prepared to allow their loved one to be filmed in care, 24 hours a day, to protect them from abuse and neglect.

In May the case of 85 year old Freda Jobson hit national media headlines and was featured on national television, as her family revealed how she had not only been subject to ill-treatment through care home staff mocking and taunting her, but also had the worst level of pressure sores, leaving her skin ‘looking like raw meat’.

The shocking details and pictures of Freda’s injuries led to thousands more people signing the petition, and solicitor Lauren Dale says there is growing support for CCTV as more cases are highlighted.

“Our campaign has called for CCTV in all care and residential homes across the UK which is able to record footage in all areas used by residents, for the protection of both residents and the home operators themselves,” she said.

“We believe that, in light of the increasing number of care home abuse cases handled by our team of solicitors, and reported on in the national media, there is genuine evidence that such measures are needed. We know there are many areas which will need carefully considering, but the time has now come for this matter to be seriously debated and considered in parliament.

“This campaign is not just about CCTV, it is about ensuring care for vulnerable people at the latter stages of life is provided with love, respect and dignity. That is not happening far too often, and that is simply unacceptable.” q

Beyond forensics: report looks to the future [

IN DECEMBER the government’s chief scientific adviser, Sir Mark Walport, published a new report on forensic science in the UK, aimed at capitalising on the country’s expertise in the subject.

Launching the report, Forensic science and beyond: authenticity, provenance and assurance Sir Mark claimed that the UK could become the world leader in forensic science, building on its long-standing reputation for being at the forefront of forensic science innovations.

Sir Mark Walport said: “Forensic science offers great potential as it draws on almost every discipline and in doing so creates widespread opportunity for innovation. The UK needs to capitalise on its current

high standing in the traditional applications of forensic science and seize the opportunity to become a world leader in the development and use of technology for prevention, deterrence and detection of fraudulent products and services.”

The report drew on evidence provided by experts in several fields.

The review starts with forensics – the use of analytical science to assist the courts – but then moves on to explore the many ways in which we can use analytical scientific tools, combined with the approaches and skills of forensic scientists, to assure the authenticity and provenance of products and services. q

Junior CSIs solve the ‘crime’ [ON 17 MARCH pupils of

Hunsbury Park Primary School in Northamptonshire were introduced to the world of digital forensics when they took part in a lifelike crime scenario. A memory stick had been ‘stolen’ and Year 4 pupils had to help experts Chris Watts and Leeann Gibbs from consultants Griffin Forensics to retrieve and search data to solve the crime.

Following the instructive day the appreciative children presented the experts with a Thank You card. q www.yourexpertwitness.co.uk

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A world without hunger – let’s finish the job!

[CONCERN WORLDWIDE is an international humanitarian

organisation that works with the world’s most vulnerable communities to end hunger. Concern’s sustainable solutions to hunger are working.

They’ve helped create a world where 200 million fewer people are hungry than 25 years ago. But now they need to finish the job.

By leaving a gift to Concern in their Will, your client can help Concern get closer to ending hunger. Their special gift can help transform the lives of people living in extreme poverty and hunger like Queen Pova, a smallholder farmer living in rural Zambia. Queen was not able to produce enough on her land, her family had to miss meals and they became unwell. She said: “I didn’t feel strong enough when doing daily chores and the children were in bad health. They were getting sick with diarrhoea.”

Queen now produces enough food for her family to eat and sell at a local market, thanks to receiving livestock, seeds, tools and training from Concern as part of one of their conservation agricultural projects.

The conservation agricultural projects were set up increase food security for smallholder farmers in the world’s most vulnerable rural areas. This essential work wouldn’t be possible without the help of Concern’s supporters and the generosity of people who choose to leave a gift in their Will.

If your client kindly wishes to help Concern end hunger, the following details will need to be included in their Will to make sure that the gift reaches them safely: Concern Worldwide UK (registered charity number 1092236), 13/14 Calico House, Clove Hitch Quay, London SW11 3TN, United Kingdom. q • For more information visit www.concern.net/legacies, call 020 7801 1881 or email legacy.enquiries@concern.net.

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As we reach the half-way point of 2016, legacy giving is once more in the spotlight.

In this latest feature on the issue, we report on two events that coincided in May to offer opportunities to promote legacies and will-making – the annual conference of the Institute of Legacy Management and the Dying Matters Awareness Week.

Both events brought to the fore the issue of digital legacies, with solicitors encouraging people to consider disposal of digital assets and care workers being urged to help patients with management of their digital life after death. There was also discussion of forthcoming codes of conduct, in the light of a difficult year last year.

We also report on the dramatic increase in the number of charities benefiting from legacies.

Charity legacy beneficiaries see 10% rise in numbers [

NEW DATA SHOWS that the number of charities benefiting from legacy donations is once again rising. Following a slight dip on 2014, the number of organisations receiving legacies rose by nearly 10% in 2015. The research was carried out by specialist legacy information providers Smee & Ford and was published at a forum event on 19 April run by campaigning umbrella group Remember A Charity.

According to the report, the number of charities named in a will in England, Scotland and Wales increased from 9,019 to 9,910 organisations. Of those, 4,410 (45%) had not previously been named as legacy beneficiaries since Smee & Ford first started recording every charity beneficiary in wills in August 2012. From then to the end of 2015, a total of 19,261 charities have been named in wills.

Almost half of charities that were included in a will for the first time in 2015 represent religious (18%), culture and heritage (12%), community (10%) or educational causes (7%). There has also been a notable increase in the number of health organisations introduced in charitable wills, with 195 health charities entering the legacy register, while fewer animal charities are being added to the list.

Rob Cope, director of Remember A Charity, said: “These findings mirror our own experiences at Remember A Charity, where we are getting more and more enquiries from a range of charities, including arts and health organisations, that have recently entered the legacy field.

“Greater competition may mean that some charities will see their market share squeezed, which is why our collective work to encourage and grow legacy giving is so important. Our drive for behavioural change in the wider public is ever more important in making legacy giving a social norm.”

Mark Pincher, data analyst at Smee & Ford, added: “Considering the whole charitable population, totalling over 180,000 organisations in the UK, it is true that there is a small group which attract the majority of bequests. However, our research shows that annually there are up to 10,000 charities mentioned in wills, which is much broader than we initially perceived.

“Of the 19,000 organisations we have identified since 2012, nearly half (49%) have only been mentioned once, meaning that around 9,500 organisations have been mentioned twice or more. It is certainly positive to see the number of charities supported increasing by 10% in 2015 and we look forward to examining the results for 2016.”

Over the long term, the number of charitable estates is on the rise, growing from 28,982 in 2007 to 36,226 in 2015, against the backdrop of a falling death rate – which declined from 560,038 to 555,478 within the same timeframe. One in six people whose wills go to probate include a charitable bequest.

Last year Smee & Ford revealed that legacy income had grown by 8% from the year 2013 to 2014, escalating to £2.208bn in 2014, despite a 1% decrease in the number of people that died in the same period. Legacy income figures for 2015 will be published by Smee & Ford later this year. q • Smee & Ford run a number of training webinars for legacy administrators, to register visit www.smeeandford.com.

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Legacies can help pioneering research

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WITH 4.2 MILLION surgical operations carried out every year in England alone, the aims of the Royal College of Surgeons (RCS) to maintain and advance surgical standards in patient care have never been so important.

While some operations are minor, others are life-saving or will dramatically enhance the quality of life. In every case, the patient places their trust in the hands of the surgeon.

As a registered charity, independent of the NHS, the RCS is reliant on donations and legacies to develop and maintain its varied programme of clinical research, surgical education and training.

Today's surgeons perform operations barely dreamt of by their predecessors – and the achievements of tomorrow’s surgeons will depend upon the provision of resources and equipment to advance their knowledge and skills. Without the support of friends and donors, pioneering research into new technologies such as keyhole surgery, treatment of diseases including cancer and organ transplantation would simply not be possible. q

Delivering a supporting role [THE ACTORS’ BENEVOLENT FUND was established in 1882 with

the aim of helping professional actors and stage managers who are unable to work through injury, ill health or age. The acting profession has grown enormously in that time – with the need for help increasing in proportion.

The Fund provides support to some 230 beneficiaries of whom 190 receive regular financial help. It also provides assistance with general household expenses, the cost of replacing household equipment, mobility aids, physiotherapy, osteopathy, a shortfall on nursing home fees and holiday costs. Additionally it advises on entitlement to state benefits and on debt management.

During the year a number of beneficiaries are visited by the Fund's welfare adviser or a council member. The Fund aims to ensure that as many of them as possible, some of whom have been beneficiaries for a long time, have personal direct contact with a Fund representative.

The Fund's image may be that it only assists the elderly, however the reality is different. Although reflecting a national ageing trend with around two thirds of beneficiaries over 60, the rest are much younger with the youngest being in their early 20s. Illness or accidents can strike at any age, with a propensity of physical injuries afflicting the younger beneficiaries.

With no state funding, the Fund relies heavily on donations, legacies and investment to sustain the income required to support its beneficiaries. It remains as relevant today as ever and needs all the support it can get to help those for whom the show does not go on.

• For further information visit www.actorsbenevolentfund.co.uk.

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Work needed to promote trust between charities and solicitors [TALKS HAVE BEEN held between the Institute of Legacy

Management (ILM) and Remember A Charity, the umbrella group promoting legacy giving, to assess any effect a perceived decline in trust between charities and solicitors could have on legacy fundraising.

Speaking at the annual ILM conference in London on 13 May and reported in the journal Third Sector, Chris Millward, ILM chief executive, said: “We hear a lot of stories about overly zealous legacy administrators upsetting solicitors and intransigent and tardy solicitors upsetting legacy cases.

“Solicitors are responsible for writing 60-70% of wills in the UK and are most able to influence members of the public to leave charitable bequests.

“If we’re turning them off through our behaviour, be that perceived or real, then we’ve got a problem. I want to understand if trust is really declining or not and, if it is, what we can do to address it.”

The move follows a number of critical press reports of charities ‘chasing’ the relatives of legators, culminating in a front-page article in The Times in December accusing Age UK, the RSPCA and WWF-UK of ‘trawling’ through public records of wills.

In response to the article, Remember A Charity and the Institute of Fundraising said: “We know that charities will always seek to handle a donor’s gift in a sensitive manner, ensuring that this is approached in a compassionate and appropriate way. We will continue to work with charities to help them uphold the highest standards expected of us.”

The adverse publicity may put off many smaller charities from promoting legacies, according to some commentators.

Nigel Shaw of Garbutt and Elliott, a law firm specialising in advising charities, wrote on the firm’s website: “It is likely that this kind of controversy has caused some trepidation amongst smaller, regional charities when it comes to legacies. Even those which are actively promoting the idea are unlikely to have the time, resource or money to trawl through public records of wills in the way that national charities do in the hope that money has been left to them.

“However, it should not put any charity off. With a £2bn pot available from almost 35,000 charity supporters, legacies continue to be an extremely valuable source of income for charities. And with evidence to show that the legacy pot is growing – together with the legacies themselves as a percentage of estate – the opportunities will continue to grow.” q

Queen’s Speech Gift Aid reform welcomed by charities [

THE INCLUSION OF a new Small Charitable Donations Bill in the Queen’s Speech has been broadly welcomed by the charity sector.

The Bill follows a Government consultation process and calls from the charity sector for more to be done to help smaller charities access Gift Aid. It will be put in place as a reform to the Gift Aid Small Donations Scheme (GASDS), which has been criticised by charity umbrella bodies as cumbersome and inaccessible to small charities.

Daniel Fluskey, head of policy and research at the Institute of Fundraising, said: “Smaller charities make up the overwhelming majority of the sector, but have traditionally struggled to benefit as much as they could from the Gift Aid system.

“We welcome this Bill as it comes on the back of calls from across the sector to reform the GASDS. We have been working closely with colleagues in other sector bodies on this and will continue to do so to make sure that

this Bill delivers in making Gift Aid easier to claim for smaller charities.”

John Low, chief executive of the Charities Aid Foundation, commented: “The inclusion of a Small Charitable Donations Bill could be good news for charities, particularly for smaller organisations which have often struggled to unlock the benefits of Gift Aid. This provides a real opportunity to simplify the scheme and make it fit for the 21st century.” q

Failing sight brings with it so many problems!

[DO YOU HAVE a family member, friend or neighbour whose sight

is going? Reading, recognising friends, living skills are all affected when you lose your sight – and it’s much harder if you live alone.

The National Federation of the Blind of the UK (NFBUK) keeps its members in regular contact with information, help and updates on the organisation’s campaigning work. The charity also issues bi-monthly news magazines in audio or electronically, which allows members to hear from other blind and partially sighted friends across the country. q • For further information contact NFBUK on 01924 291313, email admin@nfbuk.org or vist www.nfbuk.org. www.yourexpertwitness.co.uk

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Enriching the lives of people with learning disabilities [

CAMPHILL FOUNDATION PROVIDES much-needed financial support to projects which enhance the quality of life of adults, children and young people with learning disabilities. Camphill communities throughout the UK and Ireland offer safe and supportive environments, in a variety of semi-rural and urban settings, where individuals can feel at home and develop their personal abilities and interests.

There is also a strong sense of belonging to a diverse but cohesive intentional community and supported living network. Work opportunities abound, giving a real sense of meaning, purpose and achievement, which is essential for a person’s well-being.

Camphill Foundation supports development projects such as the building of new accommodation, establishing new workshops and facilities, developing agricultural and horticultural activities, providing new equipment and various educational, training, cultural and social initiatives. Support is often in the form of grants to help projects get started and loans at a low rate of interest, usually over several years.

Supporting Camphill Foundation also means fostering a new understanding and recognition of people with disabilities and enabling them to develop and make use of their astonishing talents and skills as fully engaged, talented and co-responsible members of the community carrying out important and meaningful work which is both fulfilling for them and of great value to others. q • For more information and to help the foundation achieve their aims visit www.camphillfoundation.net.

Care and support for injured service men and women [ FOUNDED IN 1920 as a direct result of the Great War, The

Not Forgotten Association (NFA) is one of the UK’s oldest service charities and fulfils a unique role in the care and support of injured service men and women in this country.

The NFA provides leisure, recreation and entertainment for the benefit of serving men and women who are wounded, injured or sick and veterans with a disability, illness or infirmity.

Each year they support more than 10,000 eligible beneficiaries through a tailored programme of outings, holidays, concerts and events, plus the provision of televisions and TV licences.

Any serving or ex-service man or woman of any age, from any of the armed services, reserve or regular, whenever and wherever they served, may be entitled to their help.

As the charity’s Head of Events, Rosie Thompson, explains: “Our aim is to provide comradeship, fun, a lift to the spirits and, for those recovering from their injuries, a sense of challenge.

We enable like-minded people to spend time together and share their experiences. We’re really in the business of giving deserving people something to which they can look forward and of putting a smile back on their faces.”

As a small non-fundraising charity, the NFA does not have the resources for formal fundraising and therefore relies entirely on the generosity of those who recognise the value of its work. Every donation, legacy or grant will help the charity to ensure that those who have served their country and are now suffering will not be forgotten. q • For more information visit www.nfassociation.org.

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Will-making figures remain static, despite rising awareness of intestacy [WHEN WE BEGAN this series

of special features on legacy giving in December 2014, one of the major concerns of the legal sector when it comes to legacies was the large number of people in this country who do not make a will at all.

At the time, research carried out

by Opinion Matters revealed that 73% of 16-54 year olds didn't have a will, while 64% of people over the age of 55 had made their final wishes clear in a will. The research also found that men are more likely to have a will and keep it updated than women.

The research revealed that, in 2013, £8m went to the government because people died intestate, while 23% of respondents wrongly believed that, without a will, their possessions would automatically go to their family.

In the 18 months or so since then, very little seems to have changed. In May, research was carried out by ComRes on behalf of the annual Dying Matters Awareness Week – an awareness-raising campaign by Dying Matters, a coalition set up by the National Council for Palliative Care.

According to the research, only 35% of those polled said they had made a will, even though 48% said they had discussed it with someone.

That is despite the fact that, according to the research, more than half of people feel more comfortable talking about their own death, or that of people close to them, than they did five years ago. In addition, over the same period, 43% felt that people they know have become more comfortable talking about death.

A notable finding was that only 1% of 18-24 year olds reported having written a will, compared to 7% of 25-34 year olds and 74% of the over 65s. Data from the ONS have shown that an average of 0.25% of 15-19 year olds and 0.35% of 20-24 year olds in England and Wales die each year.

Younger people should consider making a will, says Dying Matters, even if they don’t have valuable assets to dispose of.

They quote Law Society President Jonathan Smithers, who said: “Younger people may not think they need a will if they don’t have

valuable assets such as a house, or children to provide for. However, a will is about much more than that: you can, for example, protect your digital assets such as Facebook photographs, Paypal accounts and YouTube videos. You can also establish a lasting power of attorney to enable a relative, friend or partner to make decisions on your behalf in case you are unable to do this in the future.”

However, there appears to be a growing awareness of the consequences of not leaving a will. Citizens Advice revealed in an interview with BBC Radio 5 Live that the number of enquiries about intestacy it had received has more than doubled in the past five years – from 1,522 in 2011 to 3,747 in 2015. It is also thought that awareness of the issue has been boosted by the revelation that pop star Prince did not leave a will.

Following on from that, Radio 5 Live invited Remember A Charity director Rob Cope to discuss the importance of writing a will and leaving a gift to charity. q

Short breaks offer a normal life and boost self-confidence

“

The Youth Cancer Trust gives amazing support, love and dedication to hundreds of young adults affected by cancer, without them I truly don't think I would have become the person I am today. They have given me back my confidence and made me realise that I can live a normal life, have fun and have the most amazing experiences like other young people who haven’t had cancer.

”

[THAT QUOTE FROM Kirsty sums up the value of the work done

by the Youth Cancer Trust. The organisation provides free therapeutic activity holidays for teenagers and young adults – those aged 14-30 – from the UK and Ireland who are suffering from cancer.

The residential breaks are designed to provide a safe space for young people with cancer to be with others of a similar age going through a similar experience, thus reducing the sense of loneliness that often accompanies a cancer diagnosis during their formative years. The activities are designed to help rebuild confidence and boost self-esteem, and include horse riding, sailing and water sports.

The charity receives no government funding and relies entirely on donations, such as those from legacies, to help support the needs of young cancer patients like Kirsty. q • For more information visit www.youthcancertrust.org. www.yourexpertwitness.co.uk

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What happens to our digital self after death? [

ONE OF THE most Tweeted sessions at the annual conference of the Institute of Legacy Management was by the Digital Legacy Association (@DigitalLegacyCo). The issue of what happens to our digital presence when we die has been the subject of increasing discussion and debate over the past couple of years, prompting the foundation of the Digital Legacy Association – a nationwide organisation that supports the general public, healthcare and social care professionals with areas relating to digital estate planning, digital legacy and bereavement.

Its founder James Norris avers: “As we spend more time using the internet and on electronic devices it is becoming increasingly important for us to make plans surrounding end of life that are suitable to the ways in which we live.”

Among the resources the association has made available is a guide created specifically for adult hospices in the UK. Sorting out your digital assets and digital legacy has been designed to help terminally-ill patients and their care workers to decide on and implement the disposal of their digital life.

The guide was published as part of the Dying Matters Awareness Week, during which the conference also took place. It follows a revelation, as part of the research for the campaign, that 40% of British adults wouldn’t unfriend someone they know on Facebook even after that person has died. The survey by ComRes found that only 8% of people agreed that, when someone they know on Facebook dies, they unfriend their account soon after. That compared with 40% who disagreed. The survey also found that only 26% of people agreed that Facebook is a good way of sharing news of a death beyond the immediate circle of family and friends, with 50% disagreeing.

The Dying Matters Awareness Week also prompted the issue of a reminder on disposing of digital assets by Gary Rycroft, chair of the Law Society's digital-assets working group and a Dying Matters trustee.

He commented: “In today’s digital world making a will is also about passing on your digital assets, such as photograph and music collections, and curating your social media presence.”

Gary identified three areas to think about and prepare for when it comes to your digital and online life: • Digital assets with financial value, such as online banking, PayPal, online • shopping accounts and cryptocurrencies • Digital assets with social value, such as Twitter, Facebook and • LinkedIn profiles • Digital assets of personal significance, such as Flickr, YouTube and • iTunes “You have the legal right to pass on digital assets with financial value to your chosen beneficiaries. You also have the legal right to manage the deactivation, memorialisation or removal of your digital social life, but you need to take steps to exercise your rights by making a will,” Gary Rycroft explained.

Research by YouGov found that 52% of us said no one would be able to access their digital accounts if they died because they had not left any arrangements about what should happen.

Gary Rycroft advises that everyone should have a will that includes provisions for digital assets to ensure that our wishes are carried out after death. It is important to make a digital directory that contains details of all of your online assets, social media accounts, logins and passwords, and keep it updated.

It should also carry instructions, of course, on whether any of our digital assets are to be included in a charitable bequest. q

Improving the lives of equines in The Gambia [

THE GAMBIA HORSE AND DONKEY TRUST operates to help the lives of working equines and their owners in The Gambia. Vast improvements have been made to the welfare of the animals in the area of Gambia where the charity is based – keeping horses and donkeys healthy in this region is a real challenge due to poverty and the many tropical diseases that are prevalent in the climate.

The Gambia Horse and Donkey Trust believes education is the key to progress and improvement. The charity aims to educate the Gambian farmers in good equine care and management practices to reduce the incidences of avoidable equine injuries and illness.

The Trust also works to improve human-animal relationships and promote compassion towards the animals by running regular farmers meetings, CPD courses and school education programmes to teach correct care and management of horses and donkeys. They provide veterinary treatments to equines via a mobile, twice weekly clinic that visits the surrounding area and offer hospitalisation at their centre to equines requiring more intensive or lengthy treatments.

A second centre is currently under construction in a more urban area of the country that will be an equine hospital and training centre. q • For further information about the work of The Gambia Horse and Donkey Trust, to make a donation or sponsor an animal, please visit www.gambiahorseanddonkey.org.uk.

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Mediation can cross borders in family disputes [

FORMED IN 2012, the Cross-Border Family Mediators (CBFM) network brings together family mediators from Europe and beyond, trained to deal with cross-border family conflicts.

Each year around 170,000 ‘international’ couples file for divorce within the European Union. These divorces often involve children and in some cases the conflict escalates to the point where one parent abducts the child to another country, taking away their right to contact with the other parent for an extended period of time.

In the EU, as well as internationally, instruments have been created to solve these cases legally. However, these judicial instruments

work slowly and do not always succeed in discouraging parents from abducting their children. According to a survey by Belgian NGO Child Focus – one of the founders of CBFM – it takes an average of one year for an international child abduction case to be concluded.

Amicable solutions between parents involving alternative dispute resolution, however, are achieved quicker and last longer. Mediation is an excellent instrument to support parents in that process.

The Civil Mediation Council describes mediation as “…an effective way of resolving disputes without the need to go to court. It

involves an independent third party – a mediator – who helps both sides come to an agreement.”

However, mediation in an international setting requires specialised knowledge and skills. Cross-border family mediators must know and understand the relevant international judicial instruments. They must be able to work constructively with different cultures and languages in high conflict situations and facilitate realistic solutions to bridge large distances.

In the UK a number of members of the College of Mediators are members of the network. q

Parliamentarians form ADR group [LAST NOVEMBER a new All Party Parliamentary Group on Alternative Dispute Resolution

was formally launched. The group is an initiative of various members of the ADR community, including the secretary of the Civil Mediation Council Iain Christie, Bar Council ADR panel member John Pugh-Smith and parliamentarians Bob Neill MP and John Howell MP. The objective of the group is to ‘change the climate and culture of dispute resolution in the UK’. The group has set out an ambitious programme of meetings designed to promote awareness of effective dispute resolution processes and how they might be integrated more comprehensively into the system of dispute resolution in the UK to ensure it is meeting current and future needs.

Representatives from the Civil Mediation Council, the Chartered Institute of Arbitrators, the Family Mediation Council, Ombudsman services and other dispute resolution services are working alongside each other to influence government policy across all sectors and departments.

Sir Alan Ward, chair of the Civil Mediation Council (pictured), said: “The CMC has recently been granted charitable status and part of our aim is to bridge the information gap between practitioners, potential litigants and their professionals. This is a major step for us and a significant one. We are delighted to be playing a key role in influencing access to mediation for a greater number of potential litigants in a wide range of cases.” q

Conference will address influences on mediators [THE ANNUAL CONFERENCE of the College of Mediators will

take place on 16th June at Loughborough University. The theme of the conference is Interdisciplinary Influences on Mediation: distinguishing creative innovation from damaging distortion. The programme for the conference includes a plenary address on the theme by Marian Roberts which is sure to inform and challenge mediators from all areas of practice.

Marian Roberts is a qualified barrister and social worker and has been in continuous practice as a family mediator for over 30 years. She is a guest teacher at the London School of Economics and Political Science and professorial research associate at the School of Oriental and African Studies, University of London, where she teaches alternative dispute resolution on their graduate programmes.

In addition the conference features a range of workshops covering many aspects of the daily influences that mediators experience.

In the afternoon there will be a world cafe-style session to maximise delegates’ opportunities to share learning and perspectives.

The conference is open to non-members as well as members of the college. Anyone joining at the same time as booking will receive a further discount on annual membership. q www.yourexpertwitness.co.uk

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So what exactly are my

By CHRIS MAKIN FCA FCMI FAE QDR MCIArb Chartered Accountant, Accredited Civil Mediator and Accredited Expert Determiner

[WHEN I WAS a ‘normal’ accountant in general practice, I would

often be asked by clients what their business was worth. The answer was always another question: “To whom, and for what purpose?” Because there is no doubt that value, as well as beauty, is in the eye of the beholder. Some businesses may be making good profits now, but facing a sad end because their products are becoming obsolete or their patents are due to expire. Conversely, a business with a unique asset but a poor trading history may have a value wildly in excess of its asset value.

To take an extreme example, I acted as shadow expert in a divorce case where the husband’s company had developed a piece of software for international banking. It was making losses of about £1million a year and was about to be shut down due to tax arrears. A US company had a full suite of software for international banking, but for this product. Without that US company, the husband’s company was worthless. With it, the husband was able to sell his company for several million and secure a handsome service agreement. The ultimate special purchaser had been found.

As a forensic accountant I am often instructed to value companies and shares in companies. Typically, this is in divorce cases or petitions under Section 994 of the Companies Act – the unfair prejudice provision. In a divorce situation, on a clean break one spouse may be taking the family company out of the marriage with the other spouse taking the house, savings, pensions etc.

With unfair prejudice, the typical solution is that the Court orders the other shareholders to buy the applicant’s shares at a fair value. In both cases, there is no arm’s length transaction with a third party, so one must consider hypothetical values. How does a valuer set about that task?

Space does not allow a treatise on valuation. My favourite textbook is Tolley’s Practical Share and Business Valuation, which runs to 551 pages; I have only this short article. So all I can

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provide is a bullet-point list of matters to be considered, whilst mentioning that my valuation reports typically run to at least 40 pages, with each step in the reasoning process explained in such a way that the ‘informed layman’ – judge, counsel, solicitor, even the client – can understand how I reach my conclusions.

I will set out the steps in a matrimonial valuation; the Section 994 process is similar. So here goes: • Assemble the basic evidence such as annual accounts for at least three years, Forms E and Questionnaires.

• Learn what one can about the company and its trade from Google searches and elsewhere.

• Chart the accounts in Excel to identify trends, profit rates, unusual expenses etc.

• Prepare a fact-find so as to learn as much as possible about this business – exact trade, competitors, SWOT analysis, top 10 customers, key personnel, key products, responsibilities and hours of work of the directors. Often the husband runs the company and the wife has not played much part in its management in recent years, but each spouse must be given the chance to reply and ‘don’t know’ answers are permitted.

• Decide whether the valuation should be on a dividend yield, asset or earnings basis. Without going into the technicalities, the earnings basis is by far the most common.

• Adjust the trading results, in say the last four years, for unusual or non-recurring items. Adjust also for reasonable management remuneration by adding to profit the actual amounts paid to the directors and deducting the amount one would expect to have to pay for that person’s services to the company if they had not also been a proprietor. Support for this may be gleaned from ASHE (Annual Survey of Hours and Earnings) and from the Croners/IoD Reward Survey.

shares really worth?

• Perform a weighted average calculation so that more regard is given to later years’ results.

• Step back and consider whether the outcome is a fair expectation of future profits, having regard perhaps to ways in which the hypothetical new owner may wish to run the business.

Remember that this mysterious person is buying the expectation of receiving future profits, and that past results give only a guide to those expectations.

• Now for the highly subjective part. How many years’ purchase of expected future profits would this person pay? Here we rely on the BDO PCPI (Private Company Price Index) so that a similar P/E (Price to Earnings) ratio may be found in the FT daily list, with an adjustment to recognise that ours is a private company, or the UK200 Group Valuation Index which provides a multiplier for EBITDA (Earnings Before Interest, Tax, Depreciation and Amortisation). Regard may also be had to the Zephyr Database provided by Bureau Van Dijk, a huge database of actual transactions across Europe – though when one drills down to the UK transactions in a particular trade, the sample sizes are very small.

• Multiplying the expected future profits by the multiplier gives a value for the whole company on an earnings basis. What then is a particular shareholding worth? Regard must be had for the voting rights of different classes of shares. Discounts should be applied for various percentage holdings – less than 25% may be worth very little, whereas 75% or more may represent virtually the whole value.

Interestingly, a 50% holding is worth less than half because of the risk of deadlock, so that two 50% holdings may represent only say 80-90% of the company’s worth.

• But if one has a quasi partnership, as in Ebrahimi v Westbourne Galleries, each shareholding is worth the exact percentage of the whole.

This is all we have time for. The process of valuation is much more complex than the embarrassingly simple steps described above. Two conclusions: valuation is highly skilled and...don’t try this at home! q

About Chris Makin [

CHRIS MAKIN is a chartered accountant with a vast range of experience, firstly as a general practitioner and then for well over 20 years as a forensic accountant and expert witness. He is also the former National Head of Litigation Support in a national firm. He acts frequently for claimants/applicants, defendants/respondents and as a single joint expert and has given expert evidence over 70 times.

For many years Chris was a contributor to the Kemp & Kemp publication The Quantum of Damages. His chapter on Loss of Profits for the Self-Employed & Family Company Director is an admirable summary of how businesses work and is of benefit to lawyers in many fields, not just personal injury. Although it is now out of print, Chris is happy to provide it free on request.

Chris offers an initial review of any case, without obligation to instruct him. If the matter doesn’t proceed, he makes no charge. He destroys the papers and he doesn’t even sulk! If the matter does proceed, the time spent on initial review is included in the fee quoted. Only when terms are agreed is a contractual relationship established.

Chris’s main area of practice now, however, is as a commercial mediator, with expert determinations and forensic assignments added for good measure.

Mediation is now a very important stage in the litigation process and it usually results in a prompt settlement to even the most complex and highly charged disputes. Chris has mediated some very challenging cases – including some where the parties even refused to sit in the same room at the start – yet his personal settlement rate is running at about 80%.

Chris Makin might just be the mediator who could help you and your clients to resolve even the most difficult litigation cases.

As a mediator he has dealt with many types of disputes, including business purchase and sale, partnerships, contractual failings and professional negligence – all the kinds of dispute you would expect an accountant to be able to help with. But he has also mediated in disputes in the fields of construction, sub-contracting, rights of way, boundaries, legal fees, playwrights, fraud, housing disrepair, expensive motor cars, horrendous family probate disputes...and many more.

One of his specialisms is housing disrepair. Many public housing bodies and their tenants have chosen to appoint Chris Makin as their mediator, because he can do much to help both parties in this difficult area. q

www.yourexpertwitness.co.uk

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Tax evasion Bill meets with lukewarm reception [

THE NEW Criminal Finances Bill, introduced in the Queen’s Speech in May, has met with a mixed reception – and, indeed has come under fire both for being unworkable and for not going far enough.

In the speech Her Majesty described the new Bill as legislation to tackle corruption, money laundering and tax evasion, following the anticorruption summit two weeks earlier.

According to the government: “Last year over 350,000 suspicious activity reports (SARs) were filed with the UK Finance Unit in the National Crime Agency (NCA). The Bill will enhance the operation of the SARs regime to ensure resources are targeted against the highest threats and will give the NCA new powers.”

Political analysts deHavilland commented: “In the aftermath of the Panama Papers scandal there has been a rapid acceleration in the government’s anti-tax evasion agenda, and this

is yet another step in that direction.

“However, the measures are unlikely to satisfy many, with some in the industry arguing that these measures do not go far enough and the opposition chastising the government for taking insufficient action.”

The most commented on element of the Bill was the measure to make it an offence for companies to fail to stop their staff facilitating tax evasion. There are also proposals to extend the measure to include money laundering.

The Chartered Institute of Taxation (CIOT) warned that the legislation must have effective guidance so that companies know when they are taking adequate measures to guard against rogue members of staff facilitating tax evasion or money laundering.

John Cullinane, the CIOT’s tax policy director, said: “We are concerned about this proposal because we believe there is enough law in

relation to corporations in this area already. As with individuals facilitating offshore evasion, it is very problematic to hold a company responsible for an individual’s actions.

“If the government believes that criminal sanctions need to be strengthened in this area then the new offence must not only be phased in gradually to allow businesses time to familiarise themselves with the regime and implement appropriate procedures so that they can comply with it, but it must also be subject to a clear defence of reasonable care being available.

“The key to this whole issue is clearly drafted legislation, supported by guidance containing practical examples, so that companies understand the practical steps expected of them which will actually help combat tax evasion and money laundering – as well as enabling the compliant to effectively protest their innocence.” q

Whose profits are hit by fire and flood?

By DEREK WILLIAMSON of Goddards Accountants

[

WHEN DISCUSSING LOSS OF PROFITS, what spring to mind immediately are issues connected with fire or flood damage. It should also be remembered, however, that such events can lead to a breach of contract: nothing could be worse than suffering the close down of a factory due to fire or flood and then having your customer or supplier sue you for their loss of profits resulting from a breach of contract.

Both customers and suppliers should carefully word their contracts if they are to effectively include or exclude claims for loss of profits.

In any event, firms should regularly review their insurance cover – and more especially any exclusions – to ensure that their cover is adequate. Too often firms go bust after a fire or flood because of inadequate or non-existent insurance cover.

Assuming that one is adequately insured, what action has been taken to minimise or mitigate the loss? Can the firm continue to trade from an alternative address; was all the computer based data backed up and off site? We constantly advise clients to create and update a ‘disaster recovery’ procedure to be kept out of office. The more a business does to protect itself, the better its chances of having any Insurance claim met in full.

In addition, if the company’s accounting records are up-to-date and can be shown to be accurate and reliable – including stock control – the greater the reliance that can be placed upon them when making a claim.

Another area often not considered is whether the business is holding third-party stock and/or assets. If so, how are they insured and is any insurance agreement suitably documented? Unfortunately, that is an area that is often ignored or forgotten by businesses.

When making the insurance claim a number of considerations arise. Has the claim been meticulously detailed, or is it vague and amorphous? If the latter, the insurance company will reject or downvalue that part of the claim.

Finally, has it been prepared and submitted by, or with the approval of, a firm of accountants who will stand by their workings in a court of law? q

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Govt watchdog criticises Land Registry proposals [

THE ANNOUNCEMENT IN the Queen’s Speech on the privatisation of the Land Registry, and the consultation on the issue by the Department for Business, Enterprise and Skills, has elicited a critical response from its own competition watchdog.

In its submission to the consultation, the Competition and Markets Authority (CMA) argued that “…public sector information, including property price data held by the Land Registry, has huge value to consumers and the economy when made widely available for re-use in apps, websites and other commercial products.

“Government’s preferred option would create a privatised vertically-integrated business engaged in both monopoly and commercial activities.”

That situation would create an anomaly, the CMA says.

“The CMA believes that, as a result, the business may fail to maintain or improve access to its monopoly data, and may seek to weaken competition to its own commercial products, despite the best efforts of oversight bodies to regulate prices and impose safeguards.” q

FMB welcomes court decision on affordable housing [THE APPEAL COURT’S decision on 11 May to uphold a

Government initiative to waive affordable housing requirements for small developments was hailed by the Federation of Master Builders (FMB) as a boost for SMEs and housebuilding.

FMB chief executive Brian Berry commented: “Nearly one-in-two SME housebuilders know of sites they would otherwise be interested in developing, but which they believe would be unviable because of the likely combination of Section 106 and the Community Infrastructure Levy charges. These contributions are prohibitive for many smaller developers, killing off thousands of otherwise viable schemes, and acting as a serious barrier to expansion.

“The threshold’s reinstatement will protect the very smallest developments from being lumbered with unaffordable requirements, allowing them to bring forward smallscale, sustainable developments which will ultimately be of huge benefit to everyone, local councils included.” q

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Welcome to our A to Z guide of the websites of some of the Expert Witness field’s leading players.

If you are one of our many online readers simply click on any of the web addresses listed below and you will be automatically directed to that particular website.

To get your website listed on this page just give us a call on 0161 710 3880 or email ian@dmmonline.co.uk Expert in Mind Translations and Interpreting for the Legal Profession since 1997.

Specialists in Personal Injury and Clinical Negligence.

Providing high quality medico-legal reports within the field of mental health

www.abc-translations.co.uk

www.expertinmind.co.uk

Dr Asef Zafar MBBS MRCGP

FHDI - Kathryn Thorndycraft

GP and experienced Expert Witness specialising in reports for clinical negligence, personal injury and accident claims

Examining documents & handwriting – to determine authenticity • to expose forgery • to reveal aspects of origin

www.uk-doctors.org.uk

www.fhdi.co.uk

British Weather Services

Forensic Accounting Solutions

• Legal weather reports • Weather data • Site investigations • Expert witness in court • Call: 07860 912216

Forensic accountants specialising in investigating, advising and reporting on quantum issues

www.britishweatherservices.co.uk

www.fas-partnership.co.uk

Mr Chris Makin

Fusion Corporation R&D

• Chartered Accountant • Accredited Civil Mediator • Accredited Expert Determiner

Independent analysis, authentication & transcription of evidence and recordings related to speech, audio, video, mobile phones and computers

www.chrismakin.co.uk

www.fusioncorporationrd.co.uk

Coates-Greetham Forensic Meteorologist

Jeffrey AC Meek LLP

Interpreting the weather for the Legal and Insurance Sectors. Civil and criminal cases welcome

Forensic Accounting Reports: • Personal injury • Valuations • Commercial disputes • Divorce • Fraud • Proceeds of crime • Negligence

www.coates-greetham.co.uk

www.jeffreyacmeek.co.uk

D & HB Associates Ltd

Dr Joshua Adedokun

Experts in Road Traffic Offences • Accident investigation • Stolen vehicles • Tachograph analysis

Chronic pain expert following personal and occupational injuries. Wide experience in medical negligence claims.

www.dandhb.com

www.expertpainreports.co.uk

Professor David Warwick

Mr Kim Hakin FRCS FRCOphth

Expert on the entire range of hand and wrist conditions seen in medico-legal practice with over 4,500 reports written over 20 years

Consultant Ophthalmic Surgeon and Expert Witness on ophthalmological matters

www.handsurgery.co.uk

www.kimhakin.com

DentoLegal

Mr Marcus Ornstein

Specialising in the preparation of evidence-based Breach of Duty & Causation and Condition & Prognosis Dental Reports

Recently retired general surgeon with expertise in general surgery, breast disease, hernia and abdominal trauma.

www.dentolegal.com

www.marcusornstein.co.uk

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Mr Mark Duxbury

Professor Roger James

Consultant Surgeon – medicolegal work relating to general surgery and specialist liver and pancreatic surgery

Independent Health Consultant and Expert Witness in the field of cancer services.

www.markduxbury.info

www.independenthealthconsultant.co.uk

MD5 Ltd

Sector Forensics Ltd

Expert analysis of digital evidence stored on computers, phones and other digital devices

• Computers • e-Disclosure • Compliance • Indecent Images • Mobile Phones • e-Discovery • Intellectual Property • Fraud

www.md5.uk.com

www.sectorforensics.co.uk

Medical Illustration UK Ltd

Mr Simon Bramhall

High quality photography for personal injury claims and other medico-legal requirements

Consultant General/Upper GI and HPB Surgeon. Significant medico legal work undertaken in his area of expertise.

www.migroup.co.uk

www.simonbramhallhpbsurgeon.co.uk

Mr. Michael Hodge

Stockport Psychology Services

Maxillofacial and Oral Surgeon.

• Personal Injury • Criminal Cases • Clinical Negligence

Specialising in Public & Private Family Law, Personal Injury, Clinical Negligence & Criminal cases

www.consultantoralandmaxillofacialsurgeon.co.uk

www.sps.uk.net

Mr Michael Thompson

Dr Thomas C M Carnwath

Specialist in bowel cancer and the effects of delay in diagnosis on survival.

Consultant Psychiatrist and expert witness in medical negligence and personal injury cases.

www.expertcolorectalsurgeon.co.uk

www.psycholegal.org

Munro Consulting

Mr William Stuart Hislop

Expert Witness services relating to the design, construction and maintenance of highways

Consultant Oral and Maxillofacial / Head and Neck Surgeon.

Specialist in ablative and reconstructive surgery.

www.munro-consultants.co.uk

www.wshislop.co.uk

www.yourexpertwitness.co.uk

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MEDICAL NOTES [

THE MEDICAL COMMUNITY seems to have sailed into calmer waters these past couple of weeks, after a sustained period of turbulence. The seemingly-endless succession of scandals over patient care at NHS trusts has paused and there has at last been agreement in the dispute over junior doctors’ contracts.

There has been an opportunity, consequently, to review a few issues. Around 18 months ago the Civil Justice Council issued new guidelines for the instruction of experts. The bewildering range of specialisms in the medical field – all with their own experts – can be a minefield for lawyers, who need to be acutely aware of the necessary procedures for instructing them. A timely reminder to swat up is never a loss.

• One area where NHS trusts are still coming under fire is the treatment of obese patients and smokers. The Royal College of Surgeons (RCS) has claimed that some trusts are targeting those two groups to deny or delay routine surgery until they stop smoking or lose weight. While few would disagree that encouraging patients to manage their weight and to quit smoking is a good thing, clinical guidelines offer no justification for the withholding of treatment, according to the RCS. In fact, it may be uneconomical as surgery to correct conditions is cheaper than the drugs to treat them.

• Meanwhile, attention has shifted away from the NHS to issues involving private practice. The number of settlements involving sums in excess of £1m is rising at an alarming rate, according to the Medical Defence Union. According to the indemnity provider, the cost of settlements in medical negligence claims is rising at an annual rate of 10%, leading to the fear that doctors will shy away from certain treatments because of the unaffordable cost of indemnity.

• Private practice is also the theatre, so to speak, of much cosmetic surgery. Following a number of scandals and an investigation by Sir Bruce Keogh, guidelines have now been issued by the GMC. At the same time the RCS has published its own professional standards and will be launching a certification system. It had hoped that the government would include statutory certification in the Queen’s Speech in May, but was to be disappointed.

• The compensation process when an injury has taken place – whether from an accident, negligence or assault – begins immediately following the injury and involves initiating the process of rehabilitation. All parties in the personal injury field – lawyers, insurers, medical practitioners – agree that rehabilitation is the most effective remedy and should be embarked upon as a matter of urgency.

New commissioning guidelines have been issued by NHS England. They have been hailed by the College of Physiotherapy as potentially ‘giving people their lives back’.

• The body that hears cases of fitness to practice, the Medical Practitioners Tribunal Service, will have a new chair next year. His Honour David Pearl is stepping down after five years in the post – since the formation of the body in 2012. He has steered the system of hearings through much change and brought it into the modern era. The identity of his successor will be announced in the autumn. We wish him well. q

www.yourexpertwitness.co.uk

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Surgeons accuse CCGs of ‘targeting’ smokers and obese patients [

THE ROYAL COLLEGE OF SURGEONS (RCS) has issued a warning that smokers and overweight patients are becoming soft targets for NHS savings. A report published by the RCS in April found that over one in three Clinical Commissioning Groups (CCGs) in England are denying or delaying routine surgery such as hip and knee replacements to patients until they stop smoking or lose weight – in contravention of national clinical guidance.

The report Smokers and overweight patients: soft targets for NHS savings? explored how widespread the practice of restricting surgery on the basis of weight or smoking status has become by examining the commissioning policies of CCGs in England. It compares its findings against guidance produced by the National Institute for Health and Care Excellence (NICE), RCS and surgical specialty associations.

The RCS found that over a third (34%) of the 200 CCGs that responded to FOI requests have one or more policies on BMI level or smoking status which stop patients being referred for routine surgery. More than a fifth (22%) are placing mandatory weight thresholds on referral to hip and knee replacement surgery.

RCS president Clare Marx said: “Public health programmes that assist healthy weight management and quitting smoking are fully supported by the college. Affected patients should be

encouraged to attend these services while awaiting surgery.

However, blanket bans that deny or delay access to surgery are wrong. NHS surgical treatment should be based on clinical guidance and patients should be dealt with on a case-by-case basis. In some instances a patient might need surgery in order to help them to do exercise and lose weight.

“While it is difficult to categorically prove such policies are aimed at saving money, it is unlikely to be a coincidence that many financially challenged CCGs are restricting access to surgery. Our worry is that smokers and overweight patients are becoming soft targets for NHS savings.”

Tim Wilton, president of the British Orthopaedic Association, added: “There is no clinical or value-for-money justification for refusing to fund hip or knee replacements based on BMI or smoker status. Good outcomes can be achieved for patients regardless of whether they smoke or are obese, even at BMIs of over 50, and these surgeries are highly cost effective.” q

MPs criticise NHS staffing management [

IN MAY the House of Commons Public Accounts Committee reported on its inquiry into managing NHS clinical staff numbers.

According to the report, over 800,000 clinical staff work in the NHS and effectively managing the supply of these staff is vitally important as they are on the front line – doctors, nurses and others directly involved in treating and caring for patients.

However, the report notes that in 2014 there was a shortfall of around 50,000 between the number of clinical staff that healthcare providers said they needed and the number in post.

The report states: “The Department of Health and its arm’s length bodies have provided

ineffective leadership and support, giving trusts conflicting messages about how to balance safe staffing with the need to make efficiency savings.”

In particular, the committee warned that no coherent attempt had been made to assess the headcount implications of major policy initiatives such as the ‘7-day NHS’.

The chair of the PAC, Meg Hillier MP, said: “There are serious flaws in the Government’s approach to staffing the NHS and without urgent action the public will pay for it on multiple fronts.

“Frontline staff such as doctors and nurses are the lifeblood of the service, yet the supply of these staff in England is not keeping pace with demand.

“It is unacceptable for the Government to blame staffing agencies for the growth in spending in this area when its own mismanagement is a major contributor to the size of the bills.”

Responding to the report, BMA council chair Mark Porter declared: “At a time when there is growing evidence casting doubt on a ‘weekend effect’ – the basis for the government’s plans for expanding sevenday services – this report further underlines the government’s failure to consider how it will staff and fund additional services when the NHS is struggling to provide existing services.” q

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Experts make recommendations on NHS safety [

THE independent Expert Advisory Group (EAG) report, advising the Secretary of State for Health on the creation of the Healthcare Safety Investigation Branch (HSIB), has made the case that there is room for improvement in investigation capability throughout the NHS. The EAG’s advice is that HSIB should be an exemplar for the whole health system on how to undertake learning-oriented safety investigations, helping those in the system to improve rather than taking on the majority of investigations itself.

The report makes 13 recommendations including that the HSIB must be – and be perceived to be – independent and have that fact written into its legislation.

Investigations must be led by experts, says the report, and all information collected solely for the purposes of safety investigation

must be protected, while making sure safety information continues to be provided and has the confidence of healthcare professionals. Safety information must be provided to investigators with the understanding that it will not be used inappropriately, while hiding or interfering with evidence is unacceptable and should be made an offence.

Significantly, it recommends that patients, families and staff must be active participants in the process of investigation and must be engaged with and supported compassionately and respectfully. The HSIB must provide families and patients with all relevant information relating to their care, reflecting the responsibilities of healthcare providers.

In addition, HSIB must publish reports that explain the causes of safety issues and incidents, and issue recommendations for improving patient safety across the system. q

Forensic provision enters a new age

By JAMES CLERY of Clery Forensic Research and Consultancy

[IT IS UNDENIABLE that the provision of forensic services in the UK

has undergone significant changes over the past decade. Having been involved in forensics as an expert witness for nearly 20 years – being based in the USA, South Africa and UK – I have seen those changes first hand.

Some have been in the form of advances in technology and systems, such as the relatively recent upgrading to DNA17 technology to bring increased sensitivity and discrimination in DNA profiling; others have been interpretational, such as a better understanding of how easy it is to transfer DNA from one surface to another. Of course, both aspects will impact on the forensic strategy of how a case is managed, as well as the subsequent presentation of such findings to court.

Here I want to focus on changes in the form of the structure of forensic provision, for both the Crown and defence. The most significant change for the Crown was the closure of the GovCo Forensic Science Service and subsequent privatisation, with the inevitable loss of investment in world-class forensic research. The UK – historically seen as the global leader in forensic sciences – is now driven to catching up with our European counterparts, such as in the implementation of DNA17 technology.

In the case of the defence, changes have taken the form of companies closing or being absorbed into larger Crown providers. In my opinion this is due largely to changes in legal aid and how this has impacted on a solicitor’s ability to instruct forensic experts. Of course, price was always a consideration, but latterly it is the primary focus.

Prices have been driven down to the point where larger companies with overheads have become unsustainable. They cannot compete with recently-graduated forensic experts, who have never worked in a forensic laboratory, running operations from a bedsit. There is no provision for experience and the wealth of knowledge, not only of providing the technical forensic service, but also in the understanding of the way the legal system works in order to assist the court in streamlining the process by focusing on relevant issues. For instance, the recent increase in requests to provide a joint report to save court attendance by both experts is a skill of negotiation footed on in-depth knowledge of past casework and empirical data.

The situation is not beneficial to anyone, neither the defendant nor the court. Clery Forensic Research and Consultancy (CFRC) was created out of necessity: a necessity to streamline costs and reduce infrastructure overheads by making the operation paperless, and a believed necessity to put the focus back on forensic research – research to help address the questions asked by the courts that are unanswerable

simply because no one has done the research, as well as creating a competitive advantage.

By expanding the forensic knowledge base a more extensive consideration can be made of the evidence, which has been extremely well received. Often the simplest questions are the hardest to answer. When dealing with DNA transfer, for instance, it is easy to create a report outlining how DNA can be transferred between surfaces and leave it for the jury to assess the merits; but it is harder to weight scenarios, through consideration of the total and relative amount of DNA present to help indicate the source the DNA may have come from, whether it be skin cells or a body fluid, based on what sampling procedures were used and body fluid tests employed, or the quality of the DNA result, where degradation can indicate how old the DNA is.

The primary focus at CFRC is purposely on sexual based cases, because this area is the most under-researched and therefore, the most subject to subjective expert opinion. I regularly see varying opinions on the same issues from experts both from within the same Crown provider (intraspecific variation) and between them (interspecific variation). By drawing on 20 years of working with the various Crown providers, these variations can be successfully highlighted and addressed. q

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Guidance helps those instructing experts [WHEN THE NEW Guidance for the instructions of

experts in civil claims from the Civil Justice Council (CJC) came into force at the end of 2014, it replaced the former Protocol for the instruction of experts to give evidence in civil claims, which was removed from Practice Direction 35 of the Civil Procedure Rules.

According to one commentator at the time: “The overriding difference between the Protocol and the Guidance is that the latter mirrors the changes to civil litigation introduced by the April 2013 Jackson reforms, recognising the courts' increased focus on costs management.”

In the guidance, the CJC states: “The purpose of this guidance is to assist litigants, those instructing experts and experts to understand best practice in complying with Part 35 of the Civil Procedure Rules (CPR) and court orders. Experts and those who instruct them should ensure they are familiar with CPR 35 and the Practice Direction (PD35).”

The guidance makes particular mention of single joint experts, stating: “The parties should try to agree joint instructions to single joint experts, but in default of agreement, each party may give instructions. In particular, all parties should try to agree what documents should be included with instructions and what assumptions single joint experts should make.”

A further document relating specifically to personal injury claims is the Pre-Action Protocol for Personal Injury Claims. Annex D of that document contains a template for a letter of instruction to medical expert.

The British Medical Association sums up the duties of a medical expert thus: “Expert evidence should be – and should be seen to be – independent, objective and unbiased. In particular, an expert witness must not be biased towards the party responsible for paying his or her fee. The evidence should be consistent regardless of who is paying for it.” q

‘Hot-tubbing’ comes under CJC scrutiny [

A NEW CJC WORKING GROUP has been set up to consider and review a series of discrete topics relating to civil litigation. The group’s work will ultimately feed into the Ministry of Justice’s PostImplementation Review of the Jackson reforms, which is due in early 2018. The group is chaired by Rachael Mulheron of Queen Mary University of London and the deputy chair is Maura McIntosh of Herbert Smith Freehills.

According to a report by lawyers Herbert Smith Freehills: “The first topic being considered by the group is the procedure of concurrent expert evidence, also known as hot-tubbing. This was introduced as part of the reforms as an optional procedure to be adopted at the direction of the judge.

“It involves hearing evidence concurrently from the experts in a particular discipline, with the judge leading the questioning and discussion, rather than having each expert give evidence and be cross-examined separately.” q

Medical experts must have appropriate expertise [THE CONTROVERSIAL DECISION by the GMC’s Medical Practitioners Tribunal Service (MPTS) to ‘erase’ Dr Waney Squier from the medical register has thrown into stark detail the pitfalls that can befall medical experts.

Dr Squier was struck off in March for offering expert witness opinion on matters in which, the tribunal decided, she did not have sufficient expertise.

In its explanation of the judgement, the tribunal said: “You repeatedly gave evidence both in your reports and in court that fell outside your own field of expertise and competence.”

GMC chief executive Niall Dickson explained: “A doctor giving evidence in court is bound by the same standards as a doctor in clinical practice and by additional rules set down by the courts. They have a duty to act with honesty and integrity at all times, their work should be rigorous and their opinion presented objectively and fairly.”

The case reiterates the fact that doctors claiming to be experts must ensure that they have the required expertise to offer an opinion, not only in court but in GMC tribunal hearings themselves. Medical legal service Doctors

Defence Service quote a 2014 High Court judgement which, they say, has ramifications for doctors who act as experts in other proceedings beyond GMC fitness to practise proceedings, in court or elsewhere.

According to the article: “A doctor appealed against a MPTS panel’s findings that he was not suitably equipped to hold himself out as an expert in adult psychiatry. The GMC panel had also found that the doctor had inadequately assessed the complainant on whom he was providing an opinion. That finding was also appealed.” q

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DO’s and DON’Ts for medicolegal experts [In this brief article, consultant urologist CHRIS DAWSON MS FRCS LLDip, suggests some ways to keep the relationship between instructing solicitor and medicolegal expert running smoothly.

The DO’s...

• Invest in some advertising, at least to begin with. When starting out in medicolegal work it will pay to invest in some advertising. A number of websites exist where you can advertise your details and the nature of your expertise. Some are better than others, both in terms of quality and value for money, so it pays to shop around.

With time, and with increasing reputation, the majority of your work is likely to come from ‘word of mouth’ enquiries or further instructions from people you have worked with before.

• Reply to enquiries quickly - instructing solicitors and some medical agencies often send out details of cases to more than one expert asking for replies with an expression of interest. If you are slow to reply to such enquiries you may find that someone else has got there before you!

• Make sure to clarify the nature of the instruction. In my opinion this is a crucial point as instructions can vary in quality and precision.

If you are not clear what is being asked of you then be sure to clarify this before accepting the instruction. This will save a lot of time and effort later as your original report may come back with further questions and clarifications required.

• Make sure that the instruction falls within your area of expertise. This is another vital area to establish before you embark on the case. The GMC has strong views about this point. Straying outside of your area of expertise and professing an opinion on a subject with which you are not familiar is likely to lead you into problems.

• Make sure that you inform the instructing solicitor of your Terms and Conditions. It is important to set out your fees in advance. This includes fees for the report, travel expenses, court attendance etc. Examples of these are available on the internet. A bit of time spent drafting your own version will pay dividends.

Where possible it is a good idea to send this back to the instructing solicitor when you reply to the initial enquiry and ask for it to be signed before any work is started. This will avoid any doubt or confusion later and is particularly important if you take on work outside the UK where different laws may apply to how you are paid.

• Make sure that you clarify when the report is due. In my experience negligence cases often run on a very tight deadline with everything happening at a fast pace up to the

Court case. If you are taking on a number of cases it will help with your planning if you know exactly when the report is due. As you approach the deadline you are likely to get a number of reminders anyway!

...and the DON’Ts

• Don’t forget that you may be called upon to attend Court. A lot of cases are settled prior to Court but you may be summonsed to attend.

Make sure that this fits in with your other work and home commitments and plan accordingly.

• Don’t forget to send your invoice in promptly and be prepared to chase up payments. As part of your Terms and Conditions it is helpful to stipulate when you expect payment – eg 30 days. However be prepared to accept that payment may well not arrive at this time and you may have to chase up the finance department of the firm in question to ask when payment is due. Some firms like to withhold payment until the claim or case is settled. Make sure that your Terms and Conditions state that the firm in question is responsible for your fees. In all things the detail is important and getting it right at the outset will save a lot of time and effort later on. q

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Doctors’ disciplinary body to get new chair [

IN SEPTEMBER THE General Medical Council (GMC) is expected to announce the identity of the new chair of the Medical Practitioners Tribunal Service (MPTS) – the body that hears cases of alleged negligence and misconduct by doctors. The current chair, His Honour David Pearl, is stepping down next year after five years in the role and the new incumbent will take over in early 2017.

The MPTS was set up in 2012 in the biggest shake-up of fitness to practise hearings since the GMC was established in 1858. It plays a critical role in the protection of patients by making independent decisions about a doctor’s fitness to practise, measured against professional standards set by the GMC. The MPTS is operationally

Cost of private practice claims rockets [

COMPENSATION CLAIMS FOR multi million pound sums against GPs and consultants in private practice have risen three-fold over the last decade, according to figures released in March by the Medical Defence Union (MDU).

In 2015, the MDU settled 12 compensation claims for more than £1m on behalf of its GP and consultant members. By contrast, in 2005 just four settled claims exceeded the £1m mark and in 1995 only one patient received over £1m in compensation from the MDU. Over the past three years alone more than £100m has been paid out by the MDU to compensate patients and pay legal costs in 36 medical negligence claims that exceeded £1m. The highest amount paid out by the MDU was £9.2m to compensate a patient rendered tetraplegic after spinal surgery and to pay legal costs. In another case, involving a GP, £8.5m in compensation and legal costs was paid for a missed diagnosis of a subarachnoid haemorrhage.

Dr Michael Devlin, head of professional standards and liaison at the MDU, said: “We are seeing disturbing rises in the cost of clinical negligence claims and a surge of multi million pound damages awards against our GP and consultant members. These payments are no reflection on clinical standards, which remain high, but rather a result of a combination of economic pressure and an outdated legal system meaning compensation costs are calculated on the basis of private, rather than NHS care.

“Medical claims inflation is running at 10% each year and the size of claims is doubling every seven years. A claim costing £9m today is likely to cost at least £18 million by 2022.

“The combination of the increases in the size and number of compensation claims is leading to a toxic mix in which some GPs say indemnity is becoming unaffordable for them. If doctors are deterred from the profession or from taking part in certain work, that will be bad for the NHS and bad for patients.

“While GPs are acutely aware of the rising cost because they have to pay for their own indemnity, the high cost of claims is also a problem for the wider NHS. The NHS Litigation Authority pays out compensation claims on behalf of NHS trusts in England and is facing total estimated liabilities of £28.3bn which will have to be met by the taxpayer.

“The cost of compensation is unaffordable throughout the NHS and needs to be addressed by the government through legal reform. This is the only effective way to relieve the pressure on individual GPs and on the wider health service. The reforms the MDU advocates would see patients compensated appropriately but in a fairer and more affordable way.” q

separate from the GMC but is accountable both to Parliament and the council of the GMC for delivery of its objectives.

Under David Pearl’s leadership the MPTS has continued to improve the way it works. It now has the discretion to appoint legally qualified chairs in tribunals. Recent changes to the Medical Act have also strengthened its operational separation, underlined by the GMC’s new right of appeal against tribunal decisions.

The majority of cases before the MPTS are also now subject to pre-hearing case management. It is hoped that robust, proactive case management will reduce further the average length of hearings. Significant efficiency savings have also been made – since the MPTS was established the cost of running hearings has been reduced by 18.5%.

GMC chair, Professor Terence Stephenson, said: “David Pearl has played a vital role in the creation of the MPTS and making it the successful organisation that it is today. He has helped to build a highquality, efficient and modern adjudication service that is fair and meets the needs of doctors, patients and the public. Our new chair will need to build on the excellent work that David has started.” q

Law Society renews offensive on fixed costs for negligence claims [

LAST YEAR, the Department of Health announced its intention to consult on the introduction of a fixed-costs regime for some clinical negligence claims. The consultation is expected to be published this summer.

In its response to the department’s pre-consultation document, the Law Society argued that there should be a review of the Legal Aid, Sentencing and Punishment of Offenders Act 2012 (LASPO) before any fixed-fee scheme was implemented.

The society stated that, if the government was determined to introduce the scheme, it should apply to non-complex, low-value clinical negligence cases up to £25,000, where the issues are straightforward.

It also argued for costs to be fixed at a rate that is reasonable and that there should be exemptions for complex or unusual cases.

The society reiterated its views at the annual conference of the Association of Personal Injury Lawyers in May. Law Society chief executive Catherine Dixon told delegates that the best way to bring down the cost of clinical negligence claims to the NHS is to reduce the harm caused to patients by negligent NHS care. She said that all effort should be put into making patient care safer. q

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Rehabilitation programmes for chronic pain

By DR CHRISTOPHER JENNER MB BS FRCA FFPMRCA, consultant in pain medicine at Medicolegal Associates Ltd

[PAIN MEDICINE CONSULTANTS often recommend the services

of a multi disciplinary rehabilitation programme to help manage chronic pain. The aetiology of chronic pain syndromes are not as well understood as acute pain problems where the symptoms are generally associated with a well-defined organic cause, can be identified by a physical examination or diagnostic imaging and then treated. Inadequate understanding of the complexities of chronic pain can result in either under or over-diagnosis of the condition.

Possible mechanisms of chronic pain range from persistent scar tissue around nerve roots, neuropathic pain, improper balance of serotonin or norepinephrine receptors, central spinal sensitisation and psychogenic causes. Social and psychological factors often play a strong role in the presentation of chronic pain for many patients or it can arise secondary to chronic musculoskeletal pain and neuropathic pain.

Unfortunately single modality treatment, such as physiotherapy or pain medication, is rarely effective and multiple medical and surgical treatments can be complicated to deliver, resulting in a fragmented treatment plan for the patient. Additionally, the cost to either the healthcare provider or patient can be extremely high. Therefore, a pain medicine consultant may recommend a rehabilitation programme to deliver unified multiple treatment and therapies to treat a patient with chronic pain. A good provider will provide a seamless and cost effective programme of treatment. The purpose of rehabilitation is to restore an injured or chronically ill person to as productive and independent a lifestyle as possible through the use of medical, functional and vocational intervention A pain rehabilitation programme will consist of a range of health care providers of different disciplines and usually includes a consultant in pain medicine, a specialist pain physiotherapist and a clinical pain psychologist at the core of the team. The programme is usually underpinned with cognitive behavioural therapy to help deal with the many areas of life chronic pain affects – physical, emotional and practical daily living.

Patients are assessed for their suitability for a programme by a consultant in pain medicine and a clinical pain psychologist, assessing the patient’s medical, psychosocial and other developmental circumstances. In complex cases where physical disability is significant a clinical specialist, occupational or physiotherapist or clinical nurse specialist may be involved. Following assessment, a multidisciplinary pain rehabilitation programme will be created specifically for the patient.

However, despite the proven benefits of effective early rehabilitation to chronic pain patients, specialist residential multi disciplinary programmes can be difficult to access on the NHS and prohibitively expensive privately. In addition, pre- and post-centre support may not be available to ensure continuity of progress. Poor access to services may cost more in the long term than the cost of the rehabilitation process and undoubtedly leads to much poorer outcomes in terms of the patient’s likelihood to return to work or play an active role in society and their family, potentially adding ongoing pressure to the NHS. December 2015 saw the third version of the Rehabilitation Code being unveiled. The code provides a framework by which personal injury legal practitioners can start to make a difference for their injured clients and their families from the outset of the post-accident period. The guiding principles of the code are that ‘it should be the duty of every claimant’s solicitor to consider, from the earliest practical stage, and in consultation with the claimant and/or the family, whether it is likely or possible that early intervention, rehabilitation or medical treatment would improve their present and/ or long term physical or mental wellbeing.’ This duty is ongoing through the early life of the case but is of most importance in the early stages.

Given the potential benefit of rehabilitation, APIL members are now encouraged to consider whether rehabilitation is appropriate in every case.

Also, the pre-action protocol for personal injury claims and the Rehabilitation Code place obligations on personal injury lawyers to achieve this. q

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IT statins error prompts response from MHRA and GPs [

THE Medicines and Healthcare products Regulatory Agency (MHRA) announced on 12 May that it is investigating an issue involving a digital calculator used by some GPs to assess the potential risk of heart disease in patients.

The QRISK2 Calculator is a predictive algorithm used to support medical practitioners, mainly in GP practices, to help assess the potential risk of cardiovascular disease in patients, as part of their overall evaluation. The issue has resulted in incorrect results being produced for a limited number of patients.

In a statement, the MHRA said: “The MHRA is working with TPP, the software provider, as a matter of urgency, to make sure the identified issue is resolved and that any affected patients are identified.

“Clinical advice received by the MHRA is that the risk to patients is low and only a limited number of patients are potentially affected. GPs have been informed and they will contact individual patients should any further action be necessary.”

The MHRA said that patients should continue to take prescribed medicines and if they have any questions should ask a nurse or doctor at their next routine review.

Dr Imran Rafi, chair of clinical innovation and research at the Royal College of General Practitioners, said: “Our patients trust the information and advice we give them about their health, so it is essential that the tools we use to inform this is accurate. Our patients should be reassured that the MHRA have said that the risk to patients is low – but any error in the technology we use to inform the advice we give our patients is very serious.

“We look to the MHRA for more information about how many patients are affected, and how they propose to minimise any risk to their safety. With statins being such a controversial treatment, amongst both doctors and patients anyway, the seriousness of this error is particularly pronounced. The decision to prescribe statins to patients is never taken lightly, and those who are prescribed them will undertake regular medication reviews.

“We would advise our patients who take statins, and those who have cardiovascular problems but don’t, not to panic as a result of this news. But if they are concerned they should make a non-urgent appointment with their GP to discuss this.”

The British Heart Foundation added: “The issue with the digital calculator means that some patients’ risk of heart attack could have been over or understated. We advise anyone who is worried about their statins prescription or CVD risk in light of this news to make an appointment to see their GP and flag this with them.” q

New guidelines on heart failure published by European society [

GUIDELINES FOR THE diagnosis and treatment of acute and chronic heart failure have been published by the European Society of Cardiology (ESC). They were presented at the Heart Failure 2016 conference, incorporating the 3rd World Congress on Acute Heart Failure, in Florence.

According to ESC, around 1-2% of adults in developed countries are living with heart failure. At 55 years of age the lifetime risk is 33% for men and 28% for women. During one year, 17% of hospitalised and 7% of stable/ambulatory heart failure patients will die, primarily from sudden death and worsening heart failure.

The new guidelines include a number of additions, including the drug LCZ696. Professor Adriaan A Voors, co-chairperson of the guidelines task force, said: “Used in the right patients, LCZ696 will have a positive effect on prognosis. Adoption of LCZ696 may however be a challenge because patients and doctors are usually reluctant to change a drug they have used for decades. The cost of the swap will be relatively small compared to the new cancer drugs that extend life for just a few months.”

The concept of ‘time is muscle’ in acute heart failure, adopted from acute coronary syndrome, is included in the guidelines for the first time and demands urgent diagnosis and treatment.

“Acute heart failure is a life-threatening condition and earlier appropriate treatment may prevent organ damage,” said Professor Voors.

His fellow chairperson, Professor Piotr Ponikowski, said: “Heart failure is becoming a preventable and treatable disease. Implementing these guidelines will give patients the best chance of a positive outcome.” q

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New guidance and standards welcomed, but surgeons want statutory change as well [

IN APRIL THE General Medical Council issued its new guidance for doctors who carry out cosmetic procedures, in response to calls from cosmetic surgeons’ bodies, as well as politicians and patient organisations for regulation of the specialty. At the same time the Royal College of Surgeons published its own Professional Standards for Cosmetic Surgery to underpin the guidance.

The new GMC guidance comes into force from June and covers both surgical and non-surgical procedures. It has been produced following a review of the cosmetic industry in England by Professor Sir Bruce Keogh. His report highlighted the risks associated with cosmetic interventions and how patients needed greater protection.

The new guidance was welcomed by the British Association of Aesthetic Plastic Surgeons.

Consultant plastic surgeon and former BAAPS president Douglas McGeorge said: “This initiative for greater patient safety has been one that the association has been driving for for over a decade. We look forward to advancing the process of enforcement of these guidelines, so that all patients will be properly counselled and treated and able to make informed decisions about their healthcare – without being pressurised by unscrupulous practitioners and financial inducements.”

The guidance says that doctors must: • Advertise and market services responsibly.

Any advertising must be clear, factual, and not use promotional tactics such as ‘two-forone’ offers to encourage patients to make illconsidered decisions. It also includes a ban on offering procedures as prizes. Doctors must not allow others to misrepresent their services.

• Give patients time for reflection. Doctors must make sure they have the time and information about risks, to decide whether to go ahead with a procedure. Patients should not feel rushed or pressured.

• Seek a patient’s consent themselves. The doctor carrying out a cosmetic procedure is responsible for discussing it with the patient, providing them with the information and support

they need, and for obtaining their consent. This responsibility must not be delegated.

• Provide continuity of care. The doctor must make sure patients know who to contact and how their care will be managed if they experience any complications. They should have full details of any medicines or implants.

• Support patient safety by making full and accurate records of consultations, using systems to identify and act on any patient safety concerns and contributing to programmes to monitor quality and outcomes – including registers for devices such as breast implants.

Professor Terence Stephenson, chair of the GMC, said: “Cosmetic interventions should not be entered into lightly or without serious considerations. Above all, patients considering whether to have such a procedure need honest and straightforward advice which allows them to understand the risks as well as the possible benefits.

“Most doctors who practise in this area do so to a high standard but we do sometimes come across poor practice, and it is important that patients are protected from this and that doctors understand what is expected from them. Our new guidance is designed to help drive up standards in the cosmetic industry and make sure all patients, and especially those who are most vulnerable, are given the care, treatment and support they need.”

Catherine Kydd has campaigned for better regulation of the cosmetic industry after she was given breast implants which ruptured, and which have since been banned because they contained industrial silicone. She welcomed the new guidance, saying: “Patients have a right to expect to be safe at the hands of any doctor carrying out a cosmetic procedure. The GMC’s new guidance will significantly strengthen the protection patients have, and make it easier for them to seek action if things do go wrong. It’s a big step forward for patients.”

Launching its professional standards, the Royal College of Surgeons went on to call

on the Government to introduce legislation to protect patients. To help make the regulation of cosmetic surgery as robust as possible, the RCS said, the government should also give the GMC a new regulatory power to highlight to the public and employers which surgeons have been certified by the RCS to carry out cosmetic surgery.

Mr Stephen Cannon, chair of the cosmetic surgery interspecialty committee and vice president of the Royal College of Surgeons, said: “Cosmetic surgery is a booming industry, but the law currently allows any doctor – surgeon or otherwise – to perform cosmetic surgery in the private sector. This can make it difficult for patients to identify an experienced, highly-trained surgeon from someone who should not be practising.

“To correct this, we will launch a new system of certification later this year which will help patients to find a certified surgeon, who has the appropriate training, experience and insurance to carry out a procedure - such as a tummy tuck or nose job.

“Giving the professional regulator, the GMC, the power to annotate its register of doctors, will give our certification system extra teeth and regulatory backing.

“Our message to surgeons and doctors working in the cosmetic surgery industry is simple: if you are not working to the surgical standards we have set out and published today, you should not be treating patients at all. We, and the regulators, will do everything within our powers to protect patients and stop unscrupulous individuals from practising.” q www.yourexpertwitness.co.uk

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Male circumcision and the worldwide legal controversy

By DR BASHIR QURESHI FRCGP FRCPCH Hon FFSRH-RCOG AFOM-RCP Hon MAPHA Hon FRSPH • Expert Witness in Cultural, Religious & Ethnic issues in Litigation • Expert Witness in GP Clinical Negligence • Author, Transcultural Medicine

[

AS WITH ANY OPERATION, male circumcision is usually successful, especially if it is performed by an experienced surgeon. In the West this is usually by a doctor using local anaesthetic, however in the East it could be carried out by a barber using shaving knives as the fees will be lower. It is an operation often performed in infancy, when it is easier to do and quick to heal, and can be part of a religious ceremony with the family in attendance.

Legally, however, it is a very controversial procedure worldwide.

The origins

By impartially reviewing literature in my role as an expert witness, I learnt that the ritual of circumcision, both male and female, began before Judaism, Christianity and Islam. The three Abrahamic religions came into being in ancient Egypt and the surrounding areas where the Pharaonic belief was that gods were bisexual. The people wanted to please their gods who they believed controlled their life, health, disease and death. They believed that the feminine soul of a man was located in his prepuce (foreskin) and that the masculine soul of a woman was situated in her clitoris, and covered by the prepuce.

Thus, for a healthy, wealthy, happy and long life, they had to choose circumcision. In this way a man became a pure man and woman became monosexual. Mimicking the gods by remaining bisexual was considered as an insult to them. This was the same population who later followed Judaism, Christianity and Islam and spread throughout the world.

Religions – for and against

The oldest religion in the world is Hinduism, which originated in India, and the founders of Buddhism and Sikhism were previously holy Hindus.

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As India was later occupied and ruled firmly by Muslims and Christians for centuries, mutual animosity was inevitable. This fact affects their belief in circumcision and it is important to remember for legal reasons that Judaism and Islam strongly support male circumcision whilst Hinduism and Sikhism are strongly opposed. Christians and Buddhists are neutral on the subject and some Christians in the USA and Africa may undergo male circumcision.

Seculars, agnostics and atheists only approve of it on health grounds. To the best of my knowledge, male circumcision is not illegal anywhere.

In the UK the National Health Service pays for male circumcision for medical reasons, such as phimosis, but not on the grounds of religious belief. Muslims and Jews have to pay privately, both in the UK and worldwide, and are happy to do so because it becomes a family event.

None of the six major religions either recommend or openly oppose female circumcision. It is estimated that about three million women in North Africa and the Middle East adhere to this ancient custom which is essential for an arranged marriage, inheritance and proof of monogamy in their extended families. In the UK and a few other countries it is illegal and described as ‘female genital mutilation’. These countries mainly follow the ‘nuclear family’ custom.

Proof of identity

Riots occurred between Hindus and Muslims in the Punjab Province of India, just after independence from the British Empire in August 1947. It was estimated that 60,000 Muslims and Hindus along with some Sikhs were killed. Train passengers were also targeted and the rioting gangs were going into each compartment and forcefully checking the men as to whether they were circumcised or not, before killing them. This was to

determine their identity as they were all from the same Indian race and only religion divided them.

All Muslims from East Punjab were eventually forced to migrate to West Punjab and all Hindus and Sikhs from West Punjab had to migrate to East Punjab. If a mother in law and her daughter in law cannot live together, then they have to live upstairs and downstairs in the same house. In the UK, Hindus, Sikhs and Muslims live happily together – they have just voted, along with the white British, for a Muslim Mayor of London. Unity brings strength and so long live community harmony in the British nation.

Health benefits and side effects

Sexually transmitted diseases, including HIV, are prevented by male circumcision while phimosis, balanoposthitis and other such diseases are treated by circumcision as the prepuce is a type of cap which can shelter viruses and bacteria. In Pharaonic times there were no antibiotics to cure vaginal infections and female circumcision was a source of prevention, although the reason for this was unknown without medical science.

The side effects may include the fact that prepuce protects the glans penis from local injuries by scratch or trauma. A patient once asked me if any medication existed which did not have side effects and, with my acquired British sense of humour, I replied that it would put doctors out of jobs – they might even not go on strike! As doctors, we take a balanced view and respect every patient’s choice. In life nothing is 100% right or wrong.

Legal cases in Britain

As an expert witness in cultural, religious and ethnic issues in litigation, I have written a few reports where parents from different religions disagreed on the subject of circumcision. My advice has always been that boys should make their own decisions when they become adults – which religion they choose and then whether or not they wish to have a circumcision by an experienced surgeon. They could even pay for it themselves. Every religion advises its followers to obey the law of their country as passed by its parliament and, in my opinion, a child born in Britain should not be taken to another country

for circumcision. The right to choose for oneself is paramount.

Another legal factor is that the responsibility for child care in Britain is shared equally between both parents together and the state. Child benefits, nurseries, schools and other facilities are provided by the government and a child could be taken into care if either or both parents neglected or abused it in any way. In disputes like this, British courts intervene and place appropriate orders, whereas in some other countries the parents alone have responsibility for the child and its care with the extended family providing financial support. When I was a public health medical officer working in child health clinics and schools in London between 1972 and 1998, I experienced these issues personally and gave impartial evidence in child abuse cases which went to court.

In April 2016 a top Family Division Judge, The Hon Mrs Justice Roberts, made a suggestion, when dealing with a parental disagreement case, that young children in Britain should not be circumcised until they are old enough to make the decision for themselves. She decided that this should be 18 years of age in the case which she was dealing with, where the father was a 36 year old Muslim Algerian and the mother was non Muslim. The boys were aged four and six years at the time and the parents later split up. Article 9 of The Human Rights Act 1998 grants everyone the freedom to practice their own religion – and this applies to the father, the mother and each child individually.

This case attracted the attention of the media and the day after the judgement I was asked to comment live on LBC Radio London. I explained the origins of circumcision and why Judaism and Islam accepted male circumcision. The producer and some of the callers were interested to learn the origin and to hear my impartial view. In fact, BBC Radio 4 were considering including it in their Religious Hour but other issues took up their time. They may well revisit the subject as it an on-going national and international issue of religious freedom and of legal importance. In my capacity as a long standing guest broadcaster since 1989, I do my best to inform and to generate positive discussion on such topics. Criticism is a positive activity in science, politics and the media and is one way in which we learn new facts. Learning has a beginning – but no end! q

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Rehabilitation forms part of compensation claims [

IN 1880 Lord Blackburn said the purpose of damages was to “… put the party who has been injured… in the same position as he would have been if he had not sustained the wrong for which he is now getting his compensation.”

Nowadays it is recognised that bringing about that situation often involves a process of rehabilitation to allow recovery from injury and that this process forms part of the compensation.

According to the Association of Personal Injury Lawyers (APIL): “Rehabilitation is designed to help injured people regain the closest possible level of mental and physical ability which the person possessed prior to being injured. It helps an injured person to regain their independence as much as possible.”

Section 4 of the Pre-Action Protocol for Personal Injury Claims states: “The parties should consider as early as possible whether the claimant has reasonable needs that could be met by medical treatment or other rehabilitative measures. They should discuss how these needs might be addressed.”

In 1999 APIL, the Forum of Insurance Lawyers and other industry bodies developed the Rehabilitation Code, which was subsequently updated in 2007 and again last year.

Section 4 of the protocol continues: “The Rehabilitation Code is likely to be helpful in considering how to identify the claimant’s needs and how to address the cost of providing for those needs.”

Before costs can be assessed, of course, the nature and extent of the rehabilitation needed must be assessed.

Personal injury lawyers Sintons have a helpful section on their site.

They say: “The assessment should be undertaken by a specialist nurse, occupational therapist or an individual holding similar professional rehabilitation qualifications. It may also identify the need for other experts to become involved at an early stage in order to

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ensure that rehabilitation is effective. In more complex cases a case manager may be required in order to co-ordinate the implementation of a rehabilitation plan. This should be reviewed on a regular basis.”

According to APIL, rehabilitation will ensure that an injured person achieves optimal physical, psychological and social function and, where appropriate, helps them to stay at or return to work. q

Brain injury issues [

ONE OF THE most complex rehabilitation processes following injury is after traumatic brain injury. That could be following a traffic accident, an accident at work or even a brutal assault.

The brain injury charity Headway describes the process: “Unlike most other cells in the body, brain cells do not regenerate when they are destroyed. However, this does not mean that no recovery can occur. The brain is somewhat flexible and is able to reorganise itself, to an extent, in order to regain lost function.

“Rehabilitation aims to help the brain learn alternative ways of working in order to minimise the long-term impact of the brain injury.

Rehabilitation also helps the survivor and the family to cope successfully with any remaining disabilities.”

Again, assessment of the rehabilitation needed and where to access those services needs careful thought.

Headway states: “Choosing which rehabilitation unit to refer someone with a brain injury to should involve the clinical team, the patient and their family. Once a referral has been made, the rehabilitation unit will usually carry out an assessment to make sure their service is suitable.”

They go on to advise: “It is important to ensure that whoever is likely to have to fund the rehabilitation is aware that a referral has been made.

The rehabilitation service will not be able to accept an admission until funding has been authorised.”

In addition to the professional team, a victim’s family can provide vital support and information.

According to the British Society of Rehabilitation Medicine: “Families can provide valuable insights into the patient’s character, choices and ambitions, as well as important information on the presentation of difficulties in the home setting. This is essential in initial assessment, and in the monitoring of rehabilitation gain, to minimise under-reporting of difficulties when the brain-injured person lacks insight.” q

Physios say new guidance can help ‘give people back their lives’ [NEW NHS GUIDANCE for rehabilitation

is a chance to ‘give people back their lives’, according to the Chartered Society of Physiotherapy (CSP).

The document, Commissioning Guidance for Rehabilitation, was published in April by NHS England as an online, interactive tool that sets out what is considered best practice while making the economic case for rehabilitation for individuals and society as a whole.

The tool is intended for use by Clinical Commissioning Groups when designing services for the 15 million people who need access to rehabilitation each year for a longterm condition or following injury or illness.

Ruth Ten Hove, head of development and research at the CSP and a member of the working group that developed the guidance, said: “Rehabilitation can make a huge difference to a person’s quality of life – supporting their independence, keeping them in work or enabling them to return to their normal everyday activities.

“This new guidance offers us the chance to give people back their lives and I strongly urge commissioners to make available to all high-quality rehabilitation that can make such an enormous difference.”

Lindsey Hughes, the lead of NHS England’s Improving Rehabilitation Services

Programme, said: “The new guidance sets out an economic case for rehabilitation for the individual and society as a whole.”

She pointed out that, while the document is directed at CCGs, it also contains important information for patients, their families, clinicians and provider organisations. q

Speech and language therapy involves more than talking [

ANOTHER IMPORTANT MEMBER of the multidisciplinary team working towards rehabilitation after brain injury is the speech and language therapist (SLT). Together with other health professions such as doctors, nurses, psychologists, physiotherapists and occupational therapists, they aim to provide a holistic care package to best suit an individual’s needs.

A description of the role played by SLTs in rehabilitation after brain injury appears on the site of the charity Brain Injury is Big. According to the charity, SLTs are responsible for the assessment, diagnosis and management of disorders of speech, language,

communication and swallowing. They work with adults with brain injury (ABIs) during the acute phase in hospital, throughout rehabilitation and as outpatients or in the community. ABIs may require speech and language therapy intervention in a number of areas, such as communication, swallowing difficulties and tracheostomy management.

Often sensation can be affected after brain injury and may affect the face and mouth leading to hypersensitivity where the individual is extra sensitive to touch. This can affect ability to resume eating and drinking again and can make it difficult to perform oral care which is very important to reduce risk of infection. q

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Mind condemns number of mental health patients sent ‘out of area’ [

ON 20 MAY the BBC website led with a report revealing that nearly 5,500 people with mental health problems in England had to travel out of their area last year because of a lack of hospital beds.

The report was prepared in conjunction with Community Care magazine and prompted a response from Social Care Minister Alistair Burt that it was ‘unacceptable’.

In response to the figures, Paul Farmer CBE, the chief executive of mental health charity Mind, said: “The mental health beds crisis has been an on-going issue for a long time and it is truly a sorry state of affairs that the numbers have risen, despite repeated commitments from government and the NHS to improve the care of people in crisis. It is completely unacceptable that so many people are being sent miles away from their

loved ones in search of a hospital bed, at a time when they are often scared, vulnerable and most in need of the support of family and friends and familiar surroundings.

“That some trusts have made significant progress in reducing the number of out of area placements shows what can be done when commissioners and clinicians decide that this practice is intolerable, take action and make the necessary resources available to tackle it.

“The mental health taskforce has set out plans to eliminate out of area placements by 2020/21 and many, including Mind, are calling for this to happen as a matter of urgency. The number of suicides among people sent out of area has risen recently, so the catastrophic consequences of not addressing this issue can’t be underestimated.” q

New funds will take mentally ill people out of police cells [A £15M FUND has been unveiled by the

government to create ‘safe places’ to avoid keeping people with mental health problems in police cells. The cash will be available in 10 police force areas and is expected to be used to build new facilities or refurbish existing ones.

The money can also be used to create mental health ‘crisis cafes’ or provide ambulance transport to places of safety, to ensure police cars aren’t used.

The move follows a BMA campaign that called for the government to commit to

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provide appropriate mental health facilities and urged action to tackle police vans being used to hold people experiencing mental health crises.

Home Secretary Theresa May said: “I have always been clear that people experiencing a mental health crisis should receive care and support rather than being held in a police cell. While progress is being made, in some areas there is still a long way to go to improve outcomes for people with mental health needs.”

Last year the BMA raised concerns over the issue after new guidance – which recognised the treatment wasn’t in the best interests of patients – showed police cells were still being used as ‘places of safety’.

BMA medical ethics committee chair John Chisholm said: “While there will be circumstances in which some individuals will present a serious risk of harm to others that may require the temporary involvement of police and possibly police cells, this must be in exceptional circumstances.” q

Finding the right psychiatric expert – a new approach

When a database is not enough

By ZOFIA LUDWIG, Director at Expert in Mind

[

HOW DO YOU identify the appropriate expert for your case, whether personal injury or medical negligence? While there are ways of finding an expert with appropriate qualifications from expert databases, going to an expert witness service such as Expert in Mind can save time and money and offers significant advantages.

Finding the right expert, when you do not have one to hand or have a particularly unusual or challenging case, is not easy.

So, where do you start? Looking at the research literature may offer some guidance, but an academic expert may not always be capable of preparing the right report. General databases may give you a list. Personal recommendation may also be helpful, but often in medical negligence cases, it is necessary for the expert to have no connection to the hospital where the negligent act took place.

The approach taken by Expert in Mind is to build close working relationships with all our experts so that following an enquiry and discussion we can advise a potential instructor on the right expert for a particular case. Factors to take into consideration, in addition to the required professional qualifications, are the expert’s interpersonal skills, their experience in talking to patients suffering from trauma, their location and their reliability.

Clients who have suffered initially with physical injury, and then

develop secondary psychiatric sequelae, may baulk at the suggestion that they need a psychiatric assessment.

Shame and fear of stigma may dominate their reaction to the suggestion and it is import that the good work a legal representative has done in getting to that point is built on. It is essential that they are handled sensitively at all times by the support team and by the expert. If you tell Expert in Mind of your concerns in this regard, then we will endeavour to find an expert with whom the client will feel comfortable.

Each expert on the Expert in Mind panel is allocated their own personal assistant, which in itself provides added benefits to instructing via the company. This means that if an instructing party calls to discuss a case, they will speak to the expert’s assistant who is familiar with their entire caseload, the intricacies of each case as well as its current status.

Personal and efficient service is imperative at Expert in Mind, ensuring that the ‘call centre’ approach is avoided. So, whether you are a prospective expert or client, Expert in Mind would be delighted to hear from you. q

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Pennies from heaven

The life and times of a forensic meteorologist

By MR JIM N R DALE, Senior Meteorological Observer at British Weather Services

“And now for the weather...” well, perhaps not as you know it [AS AN ADVENTUROUS kid

growing up in and around what was then a grimy, grey and pretty tough world in and around Manchester in the 1960’s and 70’s, I had a dream.

My waking dream was to turn my hobby into a profession.

My hobby, if you can call it that, was of all things weather. Observing it, feeling it, smelling it, loving it.

Sunshine, rain, wind, frost, snow, dew and thunderstorms – oh yes, particularly those magnificent captivating thunderstorms!

You see, the weather for me was something very special, never to be simply endured or ignored, but instead something to be studied, appreciated and savoured for all its majesty and assortment of shades and colours. In short, whilst my friends were collecting cards, stamps and such like, I was ‘collecting’ the earth’s living breath.

It’s fair to say that I wasn’t particularly academic at school – I messed around too much and got distracted too often to make it beyond a handful of O Levels. But my natural writing skills and my lovely hobby helped me to achieve decent grades in English language and geography. Both were to serve me well in the future.

My immediate future arrived with a bang at the age of 16. My passion for weather nurtured in me an urge to travel and experience life beyond our shores. So it was to the Royal Navy I turned and, with much ado about nothing, I applied and was accepted into the catering branch – it was the only vocation that mildly interested me, given a limited choice.

Following a couple of ‘lost’ years trying to be something I wasn’t cut out to be, I discovered by pure chance that there was a new career option that had become available – a Royal Navy meteorological observer. Wow! Talk about luck, I had just found a pot of gold at the end of a rainbow!

With unbridled passion and gusto I applied for the 2-year course, which included a year in the field (well actually on ships) which I subsequently passed with flying colours. My boyhood dream had come true!

The next five or so years were spent travelling the vast open world, observing and forecasting the weather for aircrews and sailors alike. It was very special and my natural instincts and professional prowess were tested to the absolute limits at times, none more so than two three-month stints in and around the fantastic Falklands and stunning South Georgia – the weather is simply something else in those crazy parts of the world!.

But all good things come to an end and although to this day I query why I quit the Royal Navy, I did so. For two years I was like an albatross without a compass, surfing from one bad job to another, none of which had anything to do with the weather.

But then my luck changed again. Newly formed private marine companies

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in central London were on the hunt for quality meteorologists – and quality meteorologists tend to not grow on trees. I was in, but it wasn’t to last. Despite what I could see as open goal commercial opportunities, the two directors bungled it and, following a two year occupation, redundancy followed via a phone call taken in my newly mortgaged home (as it does).

However, by now I had gained vast amounts of global meteorological experience and enough commercial awareness to make it on my own. In August 1987, much to the annoyance of the monopolistic Met Office, British Weather Services (BWS) was formed. I was smiling again, rather like the sun does as it emerges from the grey shadows of a cold, foggy soulless morning.

In the quarter century or so to follow, my company largely operated (and still does) in niche areas, those areas where weather impacts commercially, and it’s our job to help maximise profits or minimise losses.

To this day, it includes the provision of historical and forward-looking weather information to bookmakers, sports teams and stadia, logistics firms, insurers, film companies, media concerns and so many more.

But of all the requirements for weather impact, none have been so intriguing and challenging than those for the legal fraternity. You see, weather is invasive and it can also be costly in many ways and a subject of conjecture and argument. Enter the BWS forensic meteorologist – one of those niche areas which the Met Office doesn’t operate in.

On a personal basis, I have written countless legally framed weather reports which have sorted the wheat from the chaff and, akin to a modern day Miss Marple, I’ve attended many site investigations, scouring the earth and sky for clues at the scene of the ‘crime’. Following suitable training, I have also had the pleasure of honing my skills in court, in the guise of an expert witness, something I thoroughly enjoy as I’m able to truly explain the ‘nuts and bolts’ of a case to those not having my expertise but needing to know.

Murder, manslaughter, indecency cases, road traffic accidents, slipping cases, environmental disputes, spoilage, property damage – you name it, my company and I have covered it.

You see, that very natural affinity to the weather, that I have held close to my breast since I was a small boy in murky Manchester, has served me well to this day. It’s as if I had opened a certain silver cloud all those years ago and pennies have been raining down ever since. I am so very grateful. q • For further information email legal@britishweatherservices or visit www.britishweatherservices.co.uk.

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