Difficulties arise when administrative efficiency, commercial relationships or litigation strategy begin to influence the medical evidence. Independence does not prevent communication, but it requires clear professional boundaries.
The Expert’s Duty Is to the Court.
Under CPR 35.3, an expert’s overriding duty is to help the court on matters within their expertise. That duty takes priority over any obligation to the solicitor, MRO, insurer or other person responsible for the instruction or payment.
The expert may be appointed through an MRO and instructed on behalf of a claimant, but neither party owns the medical opinion. The expert must remain willing to give an unfavourable conclusion where that is what the evidence supports. Independence is demonstrated by applying the same clinical reasoning regardless of who provided the instruction.
The Solicitor’s Proper Role.
The instructing solicitor should provide clear and balanced instructions, identify the questions requiring expert opinion and supply relevant documents.
A solicitor may properly ask the expert to correct a factual error, clarify unclear reasoning or address an omitted issue. It is also legitimate to draw attention to medical records or evidence that appear inconsistent with the report. The boundary is crossed when the solicitor seeks a preferred medical conclusion. An expert should not be asked to extend a prognosis because the original period reduces the value of the claim, remove an adverse observation or add a diagnosis unsupported by the evidence. The solicitor may test the opinion, but should not negotiate it.
The MRO’s Proper Role.
An MRO may arrange appointments, obtain documents, manage correspondence, deliver reports, handle complaints and monitor service standards.
These administrative and quality-control functions are important, but they do not permit the MRO to control medical judgment. An MRO may identify a missing prognosis, an inconsistent date or an unanswered question. It should not direct the expert towards a particular diagnosis, causation opinion or recovery period. The expert must personally consider and approve every substantive amendment.
Quality Assurance and Opinion Editing.
Reports should be checked before release, but quality assurance must not become clinical editing.
Formatting, spelling, missing declarations and obvious administrative errors may properly be flagged. Diagnosis, causation, prognosis, treatment and interpretation of medical records remain matters for the expert.
Administrative staff should not insert or rewrite clinical conclusions. Even a seemingly minor correction may affect the wider opinion. For example, changing the date of a previous injury may alter the causation analysis.
The safest approach is for the MRO to identify the concern and return the report to the expert for review.
Commercial Pressure.
Experts, MROs and solicitors may work together repeatedly, and established relationships can improve efficiency. The risk arises when continuing instructions appear to depend on the expert producing favourable reports.
Experts should not feel that they will lose work because their conclusions are unhelpful to the instructing party. MROs should not allocate cases according to an expert’s willingness to give longer prognoses or accept suggested amendments. Solicitors should not select experts because a particular outcome is expected.
Both actual independence and the appearance of independence must be protected.
Requests to Amend Reports.
A request to amend a report is not automatically improper. New records may become available, factual mistakes may be identified or the expert may reconsider an opinion after further information.
The reason for the amendment should be clear. A corrected report or addendum should identify what changed, why it changed and whether any other conclusions are affected.
An amendment becomes concerning where no new evidence is provided and the only apparent reason is that the original opinion is commercially or legally inconvenient. The expert must decide whether the evidence genuinely justifies the change.
Communication and Records.
Important communications about the medical opinion should be documented. Written records help show what was requested, what evidence was supplied and who made the final decision.
A vague telephone request to “review” a prognosis may later be disputed. A written request referring to specific evidence allows the expert to reconsider the issue independently and explain whether the opinion changes.
Where inappropriate pressure continues, the expert may need to refuse the amendment or withdraw from the instruction.
A Shared Responsibility.
The expert is ultimately responsible for the medical opinion, but independence is a shared responsibility.
Solicitors must give balanced instructions and accept conclusions that may not assist the case. MROs must maintain effective systems without interfering in clinical judgment. Experts must resist pressure, acknowledge limitations and change their opinions only where the evidence justifies doing so.
A proper relationship allows each party to perform a distinct role. The solicitor identifies the relevant questions, the MRO supports an efficient and auditable process, and the expert provides an independent and reasoned opinion. Administrative control and professional cooperation must never become control of the evidence.
