Questions and Answers

In this road traffic accident case where there was a claim for psychiatric injury, the two psychiatric experts produced between them 14 reports, including addenda and other admissible communications. The fundamental disagreement was the diagnosis: PTSD or adjustment disorder. It appears that four of the reports by the defendant’s expert were in rebuttal of the opinion of the plaintiff’s expert. This summary does not reflect the considerable extent to which the court had to analyse the evidence as to diagnosis. In the court’s judgment diagnosis hardly mattered. The judge said that more important, in his view, was the impact that the condition had on the plaintiff’s everyday functioning and lifestyle. Then when awarding damages, he said that the psychiatric damage suffered by the plaintiff attributable to the accident could be described as moderately severe whether that be under a diagnosis of post-traumatic stress disorder or psychiatric damage generally. 

Within this update we feature the well-publicised case of WH Holding Limited and E20 Stadium LLP [2025] EWHC 140 (Comm).  The case concerns a successful challenge of an expert’s decision in the context of a concession agreement for sporting events. 

The claim was initiated as a High Court claim for declaratory relief under Part 8 of the Civil Procedure Rules.  The judgment was released in January of this year having been heard by Paul Mitchell KC last December. 

The claimant alleged both negligence and breach of contract by the defendant designer of a container park near Felixstowe Port. The judge set out the reasons why she was not impressed by the claimant’s expert and treated his evidence with significant caution.

MJS Projects (March) Limited v RPS Consulting Services Limited [2025] EWHC 831 (TCC)

There was no dispute about the expert evidence in this case but it is of interest for several reasons. First, it sets out in some detail the evidence of experts in educational psychology and occupational therapy and it therefore provides examples for those healthcare specialties of how to make their bodies of knowledge understandable to a tribunal. Second, it illustrates the role of experts when their evidence is admitted by a specialist tribunal. Third, it sets out the test of which experts need to be aware in cases of alleged disability discrimination arising from a school’s treatment of a pupil with behavioural difficulties. Fourth, although psychiatrists and psychologists are often advised to keep the unconscious out of the witness box, for reasons to do with proof, it is encouraging to find a tribunal accepting such evidence.

B v The Proprietor of St Dominic's Grammar School [2025] UKUT 48 (AAC) 

The claimant brought a clinical negligence claim against two general practitioners alleging that they failed to act on a potential diagnosis of pelvic inflammatory disease. The judge found that one of the GP experts had trespassed on the judicial function to determine the facts and had sought to advocate on behalf of the second defendant.

As in many family cases, the issue here was the cause of the child’s injuries. It includes a distinction to be made between handling in hospital, such as holding of wrists for blood to be drawn, application of masks to assist breathing and holding of head still, to what would be expected in a normal domestic setting. It illustrates how a CMV infection complicated the court’s analysis of the evidence.

N, In the Matter Of [2024] EWFC 378 

For the specialists this case illustrates how the court investigates case of perplexing presentations in children and the importance of considering as many as possible explanations. This was a case where the medical history was complex and where the material events occurred over a 5 months’ admission, so the volume of medical records must have been immense. The court was obviously greatly assisted by the expert factual evidence of one of the child’s consultants, specifically his summary of the child’s medical conditions and his table of medication. The weakness of one of the experts was that he had not sufficiently familiarised himself with the contents of the medical records and was not as familiar as with the chronology of the case as he might have been if he had created a chronology in his own investigation of the case.   

A Local Authority v Mother [2024] EWHC 3511 (Fam)

The claimants, who carried on a business breeding falcons, made allegations of harassment and nuisance against their neighbour, who operated a small farm neighbouring their property. While the judge accepted some of the claimants’ criticisms of one of the defendants’ experts, he also noted that the claimants could not complain about the consequences of their putting in new evidence that was not in accordance with the timetable laid down at the CCMC.

Personal injury claims are being brought by approximately 220 pilots and cabin crew at the High Court in London on the grounds of aerotoxic syndrome (ATS). This group of claimants includes 51 claims which were issued by Thompsons in March 2019 involving pilots and cabin crew working for EasyJet, British Airways, Thomas Cook, Jet2 and Virgin Atlantic. These two claims are not included in these ongoing English collective proceedings. These were claims by two pilots who lost the chance of bringing successful claims as a result of the admitted negligence of a Scottish law practice.

Gough v Cannons Law Practice; Montague-Trenchard v Cannons Law Practice (Court of Session) [2025] CSOH 28 

In short, the case illustrates a very common situation in which, on the basis of what is often an appropriately diagnosed psychological condition or mental disorder, it is asserted that a litigant is not capable of participating in legal proceedings. In criminal cases, in relation to the accused, the issue is usually fitness to plead and stand trial. In civil proceedings the issue is litigation capacity. As is often the case, the court’s decision is influenced by how the litigant has functioned in previous cases or earlier in the instant proceedings.

F v W [2024] IEHC 631

The Claimant claimed he had suffered a substantial loss due to the destruction of two consignments of poppy heads by the Defendants. The parties were given permission to rely on the written evidence of expert accountants. The Claimant made an application to the Court for the accountancy expert witnesses to give oral evidence at the trial and an application to adduce evidence prepared by his son.

If, which is not clear, medical evidence that assists in the application of the adult dependent relative provisions as to entrance clearance for dependent adults to enter the UK is usually provided by doctors in the country in which the dependent relatives reside, this judgment may be of little interest to healthcare experts in the UK. However, it makes a very basic point about the format of an expert report and it illustrates how important it is to know and understand the particular test or rule that is applicable.

Ali v Entry Clearance Officer [2024] UKAITUR UI2024000707

This was a significant and well reported patent case which was determined in the Intellectual Property List within the High Court last autumn.   

The technical aspects of the case required significant expert input from the panel involved.  The cross-examinations performed by leading Counsel for the parties were lengthy and complicated.  This led to confusion over what evidence was given when the transcripts were re-visited on subsequent trial days. The case shows how consideration should be given to experts who are being cross-examined so not to overload them with questions and information on the stand.

Experts are advised, if possible, to avoid expressing opinions on the basis of possibility. The usually applicable stand of proof is the civil standard – the balance of probabilities or more probable than not. The criminal standard of proof is beyond reasonable doubt (and not beyond all reasonable [sic] doubt as it is sometimes misquoted). In this case it was submitted that the expert used the terms "possibility", "high possibility" and "extremely high possibility" interchangeably and that this was insufficient to satisfy the criminal standard of proof. However, when the court analysed the expert’s report as a whole, it was clear that a tribunal of fact could safely conclude that the criminal standard of proof was satisfied.

Government of Japan v Chappell [2025] EWHC 166 

The detail of this case is of relevance to dental experts and attention is drawn to the clarity and particularity with which Professor Harding set out the instances of treatment of the Claimant which was below the standard she could reasonably have expected and then identified the consequences thereof. There is a gastroenterological and pharmacological dimension to the case because it was alleged, and found, that the pain resulting from the negligent dental treatment necessitated treatment with NAISDs which caused ischaemic colitis. 

Bailey v Bijlani [2025] EWHC 175 (KB)

This is primarily a case for cardiologists, cardiac nurses and anaesthetists with a learning point for psychiatric experts. Viewed from outside the jurisdiction the striking feature of the case is that the plaintiff’s general practitioner records documenting a previous psychiatric history, which she had denied when assessed by the two psychiatric experts, were not disclosed to the defendant until five days into the trial.

Tynan v Bon Secours Health System Company Ltd by Guarantee [2025] IEHC 81 

The detail of this judgment is for experts who conduct capacity assessments. Two points arise of more general interest.

First, the expert, who had been involved in the case for six years, changed her opinion. In the language of the court it was a 180^o degree change. The court thought that this called for a greater discussion in the analysis section of the report. This seems to have been that section of the report for which experts use the heading ‘Facts and assumed facts’ or ‘Factual analysis’. Second, the expert suggested that the issues, or some of the issues, in the case could be resolved by invoking the inherent jurisdiction of the court. But there had been no application for the exercise of the court's inherent jurisdiction, it was not referred to in the letter of instruction, and it might not – as a matter of law – have been available. This is a good example of the advice to experts to leave the law to the lawyers.  

Calderdale Metropolitan Borough Council v LS [2025] EWCOP 10 (T3)

This case has a number of important features of general interest. It illustrates the importance of assessing the reliability of a subject’s account. This is not the same as advising the court as to the reliability of the subject. It is the reliability of the account that is being assessed, not the reliability of the person giving the account. This is why it is good practice to open the Opinion section of an expert report with an introductory section sometimes headed ‘Evaluation of evidence’ or sometimes ‘Clinical plausibility’. That there was no challenge to the reliability of the experts’ evidence is not surprising. They explained how they assessed the appellant and the duration of the assessments.

ZA v Cornetu District Court, Romania [2025] EWHC 595 (Admin)

The expert paediatrician in this case misidentified and confused twins when reading the primary medical disclose. This fundamental error was of seminal importance in this case because the twins had very different birth and post-birth experiences, with one being much weaker and more vulnerable than the other.  The judge noted that the cross-examination of the expert was nothing short of a demolition of the expert’s evidence.

LB Croydon v D (critical scrutiny of the paedeatric overview)

Mr Simon Britten, immediate past chair of the British Orthopaedic Association Medico-legal Committee, in his foreword to the forthcoming Expert Musculoskeletal and Orthopaedic Evidence, refers to how giving evidence one Monday in a case of tibial fracture, missed compartment syndrome and subsequent amputation, he was asked when he had last fixed a tibial fracture. Understandably, he said that the judge’s reaction to his answer ‘last Friday’ appeared to be a promising start. However, it is not a hard and fast rule that the healthcare expert should have experience, or recent experience, of performing the procedure or operation in issue. This case illustrates it.

Advanced Hair Technology Ltd v Revenue and Customs (VAT - whether hair transplants to treat androgenetic alopecia are exempt supplies of medical care) [2025] UKFTT 241 (TC)