Expert Witness News

AWARD FOR HEALTHCARE EXPERT WITNESS PROVIDERS

2018/2019

The Award Winning Somek & Associates is one of the biggest providers of Expert Witnesses in the UK delivering highly professional trained experts in a range of health professions:

Occupational Therapy / Care experts, Physiotherapy, Speech & Language Therapy, Nursing, Midwifery, and other key health professions

Alison Somek

Alison is CEO of Somek & Associates, which has been established for over 20 years. She a Consultant Occupational Therapist and specialises in orthopaedics, brachial plexus/ Erb’s Palsy, upper limb hand injuries and general medical and surgical cases.

‘An excellent reputation...’

www.somek.com

Somek & Associates is one of the largest providers of Expert Witness services in the UK, delivering highly professional trained experts in a range of health disciplines; the depth and breadth of experience covers all types of personal injury and clinical negligence matters, as well as other medico-legal and regulatory needs.

The consultancy was set up in 1997 by Alison Somek, CEO of Somek and Associates who as an occupational therapist / care expert, had previously worked in the National Health Service for over 20 years. Alison has seen the medico–legal environment change dramatically over this period, but has always been passionate about professionalism and independence in her role as an expert witness, continuing to ensure that the integrity of the expert witness is embodied in the work of the associates and company as a whole. This work is supported by a professional team led by Jessica Thurston, Chief Operations Officer (and also an occupational therapy / care expert with many years’ experience).

Somek & Associates now has over two hundred experts, which include, occupational therapists (care experts), nurses, midwives, physiotherapists, speech and language therapists, and other allied health professions. This is reflective of the growth in need for expert witnesses in a range of health care professions allied to medicine, as well as the high regard for Alison and the team at Somek and Associates.

Experts are selected following a robust recruitment process after which they are required to attend an extensive training programme, covering topics from the role of the expert witness (including CPR Part 35) to Courtroom skills. Somek works with leading expert training organisations to offer in house courses and an Annual Conference for all experts, with specialist speakers including solicitors and barristers.

Different report structures are available, according to the case need.

www.somek.com

Somek & Associates offers competitive fees including deferred payment terms when required. Fee estimates and guidance for costs budgeting is provided upon request.

Alison and the team are passionate about the integrity of the expert witness role, and as a company, they boast a balanced portfolio of claimant and defendant instructions in equal measure. Professionalism, objectivity, independence and understanding of legal principles and tests as well as relevant procedure rules (especially CPR 35), are all key factors that Somek strives for and it is these core values that has led to Somek and Associates’ outstanding reputation in the field.

All experts continue to undertake clinical practice in either statutory or independent settings, and importantly maintain their CPD.

Reports for litigation (liability and quantum) are fully CPR compliant, or for advisory purposes. Reports are frequently commended; they are well written and presented and are relevant to the complexity and size of the case; they are clearly structured with robustly argued opinions and recommendations, summarised conclusions and costings, and above all, meet agreed deadlines.

Somek welcomes feedback and responds with a ‘can do’ attitude to flourish in this ever-changing complex environment. The team members have extensive skills and knowledge and are happy to provide training sessions in their respective fields to lawyers and others, thus promoting the working relationships and building confidence.

Alison and the team at Somek & Associates have a goal to make Somek and Associates the organisation of choice for expert witness services in the UK.

Joanne Caffrey

Expert Witness

I am an Expert Witness for ‘Safer Custody’ and the management of challenging behaviour & use of force. The main sectors I work with are the custody (prison and police) and education sectors. I have also experience of hospitals and security settings.

The use of force in custody, education, care and clinical settings varies greatly with many staff having limited, or no, knowledge of risk associated with certain demographics of service users. Too many injuries and deaths are avoidable in my opinion. I have trained several thousands of staff over the years concerning safer restraints and the managing down of physical interventions.

For Safer Custody, the use of force and the management of challenging behaviour

‘Safer Custody’ refers to the safeguarding of staff and detainees within the custodial system, from the moment of arrest to detention at police custody, court cells, prisons and all associated transport between. I was a custody sergeant from 1996 to 2003 inclusive, then progressed to custody staff training and assessment, and joint police/prison custody planning. In 2012 I received a British Excellence in Performance Award for my contribution to ‘safer custody’ on a national basis.

The Criminal Justice System custody estate has progressed significantly since 1996 when custody was seen as a punishment for detainees. Staffing was usually by newly appointed sergeants, as I was, or sergeants heading towards retirement, or being disciplined.

Safer Custody aims to prevent, or reduce to the minimum, deaths or injuries connected with self-harm, suicide, use of force, underlying medical conditions, head injuries, malicious or accidental incidents. The whole custody process is holistically governed by the principles of ‘Safer Custody’, regardless of which institution, or agent, is providing the service to the detainee. Providing a common framework of understanding and care of the detainee and having the ability to share information via systems such as the PNC. (Police National Computer).

The same principles of ‘safer custody’ can apply to children within the care and custody of the education system, who may also be suffering from special educational needs and disabilities.

Safer custody covers a wide variety of issues for safeguarding the staff, the service users and others, which are applicable for police and prison custody, court cells and contractor transport companies, such as:

• Custody staffing, training levels, and paperwork

• Risk assessment processes for condition of detainee / prisoner

• High risk issues e.g. head injuries, positional asphyxia, excited delirium

• Building risk assessments e.g. ligature points, alarm systems, fire safety

• Information sources e.g. PNC, PER,

• Health conditions and use of the health care providers

• Control & restraint techniques and use of

• Transportation e.g. fleet management issues, PECs (prison escort and custody services),

• Management & supervision e.g. visits and rousing

• Equality & individual needs e.g. females, juveniles, disabilities, foreign nationals

• Healthcare & medication needs

• Cell occupancy

• Out of cells – exercise, showers or interviews

• Hygiene e.g. bedding, toilets, clothing & cleaning

• Food safety – choking assessments, food hygiene

• Dependencies – alcohol, drugs

• Mental health – assessments, medical needs, adaptations

• Technology – CCTV, audio recording

• Deaths or injuries in custody procedures

Custody officers and staff should be familiar with the signs or behaviours of a detainee that may indicate an increased level of risk and/or requirement for a higher level of monitoring. Custody officers need to be aware of the enhanced risk of suicide and self-harm during periods of detention. Detainees who are deemed to be a high risk of suicide or selfharm must be seen by a healthcare professional (HCP) and kept under close proximity supervision. This allows officers and staff to engage with the detainee and intervene if required.

Deaths in custody increase disproportionately during the early days in custody, with younger male prisoners being at increased risk and the larger demographic, however although women prisoners account for only 5.5% of the prison population they account for half of all self-harm incidents.

The governance of the education system may be easier to understand, but there are currently no national restraint techniques or principles of practice for safeguarding children in the education system and use of force on them. The Department of Education leaves it to each school to decide their approach to training and what systems they will implement.

I work with over 200 schools and there is little common understanding or application of systems, unlike the criminal justice custody systems. Schools are under immense pressure to reduce costs and often sub standard training is introduced to a school which is not tailored to the demographics of the child or staff. This makes it unsafe and unfit for purpose. For example a child with downs syndrome is highly likely to have heart disease, respiratory disorders and hyper mobility of joints. Even special schools who should be the most knowledgeable in dealing with these children lack the understanding of risk associated with restraint and conduct too many restraints.

The emphasis in many schools is the application of restraints rather than the avoidance of restraints. A current issue I am concerned with is the increase in creation of ‘calming rooms’ within the care and education sectors. With little national guidance service providers are creating ‘calming rooms’ which are not therapeutic and contain many ligature points plus the adopted practices of such rooms is dubious and potentially abuse and false imprisonment.

The cases I have worked on in the last 12 months include:

• Prison custody suicides and self harm where staff have failed to identify risk factors and control measures for prisoners;

• Prisoners being assaulted by other prisoners despite risks being reported to staff;

• Custody staff being injured in assaults from prisoners due to staff shortages and failure to communicate risk;

• Injuries to staff and service users from hand cuffs and other equipment;

• School staff injured by children due to lack of training in de escalation and inappropriate restraint techniques;

• Children being injured by excessive use of force by staff without any pro active attempts to manage down cases of violence;

• Failure to identify ligature points in custody areas which have allowed the opportunity for prisoners to then self harm;

• Security staff in a hospital restraining a person who died during the restraint

• Inappropriate use of calming rooms

I have worked for coroner, civil and criminal cases and deliver training and consultancy on these topics.

www.joannecaffreyexpert.co.uk / www.totaltrain.co.uk