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Have your say on how the CQC assess and rate health and care services
You still have time to take part in the CQC consultation on proposals to improve how they assess health and care services, make judgements, and award ratings.
They want to hear from providers, professionals, and members of the public - about the changes they are proposing.
Proposed changes aim to address the concerns raised in external reviews of current ways of working from Dr Penny Dash, Professor Sir Mike Richards, and the Care Provider Alliance. The changes aim to create a clearer, simpler, and more trusted framework, built through engagement, collaboration, and co design with those who deliver and use services.
The consultation closes at 5pm on 11 December.
Read more: https://www.cqc.org.uk/about-us/how-we-involve-you/consultations/better-regulation-better-care
Letby case has highlighted again that medical testimony in criminal cases needs reform
Concerns about the use of medical expert evidence in UK criminal trials highlight the lack of formal regulation and the incentives within the adversarial system that can lead to "expert shopping". Any expert witness should be aware that their duty is to serve the Court and not to be partisan, and they must only give evidence in their own area of expertise. Historical cases, such as the wrongful conviction of Sally Clark, involving flawed expert statistical testimony from paediatrician Sir Roy Meadow, who incorrectly stated the odds of two children from the same family dying of Sudden Infant Death Syndrome were 1 in 73 million, demonstrate how the misuse of statistics and unreliable testimony have resulted in miscarriages of justice.
Suggested reforms include stricter admissibility criteria, a regulated register for experts, and the use of joint expert reports or multidisciplinary panels.
Read more: https://www.bmj.com/content/bmj/391/bmj.r2260.full.pdf
If you are interested in becoming a medical expert witness, then SpecialistInfo run accredited CPD courses at all levels, which are recognised by law firms, insurance companies and medico-legal agencies. Training ensures full membership of the SpecialistInfo Faculty of Expert Witnesses panel (The FEW):
Read more: https://www.specialistinfo.com/course-calendar-2026
Read more: https://www.specialistinfo.com/faculty-of-expert-witnesses-panel
Foreign Doctors guilty of serious misconduct abroad working in the UK
Doctors guilty of serious misconduct abroad are still able to work in the UK due to systemic failures in the vetting process, including inadequate international information sharing and a reliance on doctors to be honest about their past. A recent investigation by The Times found that at least 22 such doctors were working in the NHS with no record of their sanctions on their GMC licences.
Following the investigation, Health Secretary Wes Streeting ordered an urgent review of vetting procedures for foreign-qualified doctors, describing the findings as a "serious failure".
The GMC has committed to several actions including enhanced verification, improved International sharing, through its active membership in the Physician Information Exchange (PIE), an international resource for sharing information about disciplined doctors, and reviewing cases of concern.
The Professional Standards Authority (PSA) is also closely monitoring the GMC's actions and contacting other UK health regulators to ensure risks are managed and public safety is protected.
Hillsborough Law Bill
The proposed "Hillsborough Law" (Public Office (Accountability) Bill) is UK legislation introduced to Parliament on September 16, 2025, aimed at preventing state cover-ups in public tragedies and ensuring accountability for officials. Key provisions include a statutory duty of candour for public officials, criminal sanctions for misleading the public or obstructing investigations, and expanded legal aid for bereaved families.
In the recent Budget, Rachel Reeves pledged to exempt payments for the Infected Blood Compensation Scheme from inheritance tax, “regardless of the circumstances in which those payments are passed down.” She said that she had allocated funding for compensation after the scandal and accused the Tories of having failed to budget for it. “That is how we should be spending taxpayers’ money” on dealing with injustices, she said.
Read more: https://www.hempsons.co.uk/news-articles/the-hillsborough-law-bill/
The state of medical education and practice in the UK. GMC Workforce report and Budget 2025
The General Medical Council's (GMC) 2025 workforce report has just been published, and highlights a critical period for the NHS, marked by increased departures of internationally qualified doctors and significant challenges in career advancement for both international and UK graduates. The report notes a record number of internationally qualified doctors leaving the UK in 2024 and a levelling off in new international recruits, while locally employed doctors often feel undervalued and lack development opportunities.
The Budget this November has not raised moral amongst resident doctors.
Tom Dolphin, chair of BMA council, said, “There has been no allocation given in this budget on restoring pay and ending disputes with doctors, a measure which would have not only prevented further disruption but kept doctors in the country, making the most of the skills we have already invested in. Four thousand doctors left the country to practise abroad last year. Without a financial plan to keep them, these budgets represent a penny-wise, pound-foolish attitude.”
Read more: https://www.gmc-uk.org/cdn/documents/wfr25-report-251117_pdf-112967442.pdf
Judicial Warning on Surveillance Misconduct
The case of Perrin v Walsh resulted in a substantial costs award for the claimant due to the defendant's surveillance evidence being tainted by "extremely poor" conduct, although the evidence was not excluded from trial. The judgment highlights the serious consequences for impropriety in evidence gathering.
Case Summary
The claimant suffered serious injuries in a motorbike accident and alleged ongoing symptoms. The defendant admitted liability but disputed the extent of her injuries and hired a surveillance company (TSG).
The surveillance company provided edited footage and witness statements asserting no footage of the claimant had been omitted, which was demonstrably untrue. They also failed to retain original SD cards for forensic examination.
In ruling, HHJ Grimshaw found the conduct of the defendant's agents to be "extremely poor" and that false statements had been put before the court. However, because the evidence was highly probative and the claimant was unable to prove specific prejudice, the judge allowed the evidence to be used at trial, but with a strong warning to experts and the trial judge about the weight to be attached to it.
While the evidence was admitted, the defendant was ordered to pay 80% of the claimant's costs for the application, summarily assessed at £40,000. The case serves as a warning that courts will use costs sanctions to deter improper litigation conduct, even if the evidence itself is not excluded.
Access to Public Domain Documents Pilot to Include Expert Reports
The Public Domain Documents Pilot is a two-year scheme launching on January 1, 2026, in specific commercial courts to increase transparency and public access to court documents. This initiative shifts the default position so that certain documents used in public hearings are automatically made available to the public, rather than requiring a separate application.
Key Details
Courts Covered: The pilot will run in the Commercial Court, the London Circuit Commercial Court of the King's Bench Division, and the Financial List.
Documents Included: "Public Domain Documents" will include skeleton arguments, written submissions, witness statements (excluding exhibits), and expert reports (including annexes and appendices).
Timeline: The pilot is scheduled to operate from January 1, 2026, to December 31, 2027, with a review planned after the first six months.
This Pilot implements the Supreme Court decision in Cape v Dring and is likely a sign of future requirements across all civil courts.
What This Means for Expert Witnesses:
The report you write for court may soon be available to anyone. This raises immediate concerns about professional practice, confidentiality, and expert safety.
Review Guidance: Read the Pilot Practice Direction and the accompanying Guidance Note, especially if working in the pilot courts.
Discuss with Instructing Parties: Coordinate with the instructing party about when the report will be used in a public hearing and how to handle confidential material.
Protect Personal Information: Do not include personal contact details (telephone number, email, home address) in reports or joint statements beyond what is strictly required by procedural rules.
Be Aware of Scrutiny: Understand that expert reports may be subject to media attention or public scrutiny, and consider reviewing personal information on public profiles or social media.
Mazur Judgment may impact on experts
The Mazur case (formally Mazur & Anor v Charles Russell Speechlys LLP [2025] EWHC 2341 (KB)) is a significant High Court judgment in England and Wales that clarifies who is legally entitled to conduct litigation. The ruling confirmed that an individual must be personally "authorised" under the Legal Services Act 2007 (LSA), and that this right is not automatically granted to non-authorised employees (such as paralegals, trainees, or certain legal executives) simply because they work for an authorised law firm or are supervised by a qualified solicitor.
Key Takeaways from the Judgment
Supervision is Not a Substitute: A non-authorised person cannot lawfully conduct litigation "under the supervision" of an authorised person. The employer's authorisation does not confer entitlement on the employee.
Assisting an authorised person (e.g., drafting documents, gathering evidence, performing mechanical filing tasks) is permitted.
Conducting litigation (e.g., issuing proceedings, filing formal statements of case, making strategic decisions, assuming responsibility for the case) is a reserved activity and can only be done by an authorised individual. The key test is who "has assumed responsibility for the conduct of the litigation and exercises professional judgement in respect of it".
Potential Consequences for Firms that have relied on non-authorised staff to conduct litigation risk include inability to recover costs for work performed unlawfully and professional indemnity insurance issues.
The Mazur decision has been described as a "bombshell" and a "watershed moment" for the legal profession, particularly for firms that use high volumes of non-qualified staff in areas like debt recovery and personal injury. It has forced many firms to urgently review and restructure their working practices, policies, and supervision models to ensure compliance. An appeal is currently in progress. In the meantime, expert witnesses should question who is instructing them before accepting work from law firms.
Read more: https://www.criminalbar.com/wp-content/uploads/2025/11/CBA-note-re-Mazur-judgment-v.3.pdf
BMJ metareview of paracetamol safety in pregnancy
An umbrella review published in the BMJ concludes that existing evidence does not definitively link maternal paracetamol use during pregnancy with autism or ADHD in offspring. The review suggests that observed associations in some studies are likely due to confounding factors, and current medical guidelines continue to recommend paracetamol as a safe option for pain relief in pregnancy, when used as directed.
Meanwhile, in the USA, the manufacturers of the painkiller Tylenol (acetaminophen; paracetamol in the UK) are being sued by Ken Paxton, attorney general of the US state of Texas over allegations that they hid unproven links between the drug and autism in children from pregnant women.
The move comes after unproven claims by the Trump administration of links between acetaminophen use in pregnancy and autism in children.
J&J and subsidiary Kenvue responded by stating, “Rigorous, independent research, endorsed by leading medical professionals and global health regulators, confirms that there is no proven link between taking acetaminophen and autism. We stand firmly with the global medical community that acknowledges the safety of acetaminophen and believe we will continue to be successful in litigation as these claims lack legal merit and scientific support.”
Read more: http://bit.ly/48GYgnN
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