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Tag Archives: psychiatrist

“Tales of the Un-experted” (sorry)

CAFCASS have just published a study looking at experts – their use in proceedings, what type is being used, who asked for them, were they helpful?

 http://www.cafcass.gov.uk/media/149859/cafcass_expert_witness_research_6.2013.pdf

 It is interesting, although on their study of whether the use of the expert was beneficial, I think it would have been amazingly helpful, rather than just asking the Guardian in the case if they found them to be beneficial (which is in itself a huge leap forward, we’ve never even done that before)  the study or a subsequent one could ask the Judge

 

  1. Did you find that report helpful in reaching your conclusions?
  2. Looking at things now, after the conclusion, was the obtaining of that report worth the waiting time?  [ie, was it “value for time”]

 

 

This is what I found interesting about it though, in the Guardian’s analysis of whether the report was beneficial or not

 100% of the drug and alcohol tests obtained were found to be helpful

100% of the paediatric reports obtained were found to be helpful

But only 75% of the psychological reports obtained were found to be helpful

 Given that psychological reports are the most cash-expensive AND time-expensive, the fact that even Guardians (who in my view were being a bit generous with how useful they found reports) found only 3 in 4 of these reports to be helpful is STAGGERING

 The report also headlines that since 2009 there has been a massive drop in the instruction of independent social workers – from about 33% of cases then to about 9% now.  (That is probably a lot more to do with them being starved out of doing the job and thus not being available than any reduction in need for them, rather than, as some of the reporting I have seen of the report, that it shows how we have been busy embracing the Family Justice reforms)

 The study also shows that, so far as Guardian’s were concerned, the quality of the pre-proceedings work done by the LA, or the prior involvement of the LA had no impact on whether or not an independent expert was instructed.

 [The report goes on to cite 3 individual cases where Guardian’s had felt that poor social work had been the cause of the instruction, but of a survey of 184 cases this is statistically not significant]

 

Actually, the Court was rather more likely to instruct an expert if there had been historical social services involvement than in cases where little was previously known about the family prior to proceedings. (still scratching my head about that one)

 

The other interesting piece of information from the study (given the drive to cut down experts) was the breakdown of what discipline contributes what proportion of the assessments commissioned

 

The largest by far was psychologists, accounting for 35% of the experts instructed  (and we know now that this means that about a quarter of those were unhelpful, or nearly 9% of all expert reports commissioned by the Courts. You’re welcome)

 

The next largest group was adult psychiatrists – coming in at 20%.  I would suggest that this is going to be a difficult group to screen out of the system. One tends to go to an adult psychiatrist because there is a mental health or substance misuse issue that requires expertise over and above that that a social worker or Guardian can give. Even a talented and skilled Guardian or social worker can’t tell you what the prognosis for mother’s bi-polar disorder will be now that she has switched to different medication.

 

 

[Honestly though, I think that gathering this information has been a really useful start, and I would really really welcome a follow-up study where the Judiciary are asked on those sample cases, whether the expert report was beneficial and represented “value for time” for that child, submitted of course in an anonymised way so that we get the statistical information but that the judical feedback is kept apart from the actual case]

And in case my clunky pun has got you hankering after seeing a silhoutted woman dancing in front of a roulette wheel whilst playing cards are thrown about, and you have been singing “doo-doo-doo, noo-no0-noo doo-doo-doo” during your reading, here it is :-

http://www.youtube.com/watch?v=Oc46Gk-6qrA

 

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When to apply for prior authority (and how long the LSC thinks assessments take)

There has finally been some guidance published about this vexed issue. You may recall previous anguished blogs by me about this, most particularly that the last system (“don’t apply for prior authority as it will be refused, and we may arbitrarily slash the number of hours we will pay you for, but you won’t know that until the expert has actually invoiced you”) wasn’t really that workable if you factored in that (a) experts actually wanted to be paid and (b) solicitors actually wanted to get the money to pay them from the LSC, rather than out of their own pocket. Selfish of both of them, I know.

http://www.justice.gov.uk/legal-aid/newslatest-updates/civil-news/prior-authorities-for-experts-in-family-cases?dm_i=4P,18921,AV9ZJ,45QDV,

1 The LSC’s Standard Civil Contract states that there is a contractual right to seek or obtain prior authority only where: • the rate sought exceeds the codified rates introduced in October 2011, or • the item of costs is unusual in its nature or is unusually large. The guidance includes: • examples of factors that may indicate exceptional circumstances apply • benchmarks of ‘unusual’ hours below which prior authority should not be sought • ranges of hours within which prior authority applications have typically been granted for psychologists and psychiatrists, which represent the most commonly used expert types • details of expert witness information required on detailed assessment.

The guidance also confirms that prior authority is not necessary in relation to drug and alcohol tests – provided that the tests carried out reflect what has been directed in a court order. Case-by-case assessments ‘Typical’ hours outlined in the guidance are not caps. They are intended to help providers make case-by-case assessments about when they can submit prior authority applications. Prior authority itself is not a limit on the number of hours that may be carried out by an expert. Additional expert work hours may be justified on assessment, at the end of the case, to the relevant assessing authority. This may be either the LSC or the court

You are probably already spotting the gap in this new guidance. There is no sentence anywhere that suggests that the solicitor will get paid in full by the LSC for any expert report that comes within hourly rates and the benchmark number of hours. So there is still an element of uncertainty and risk. Hoorah.

But at least we now have the secret benchmarking of hours that the LSC claim to have been using. (I strongly suspect that the actual policy was just ‘cut them in half’, but I am a nasty cynical piece of work and that is just my own opinion based on lots of anecdotal observation)

They consider costs of more than £5000 per funded client to be unusual and need prior authority.

The hours above which prior authority should be applied for are:-

 

Pscychologist  (including child psychologist)  20 hours (for one party)  30 hours (for more)

 

Pscyhiatrist (including child psychiatrist)  15 hours (for one party) 25 (for more)

Independent social worker 30 hours (for one party) 40 (for more)

 

Radiologist (10 hours)

  These benchmarks include all aspects of expert service provision and not just the assessment of parties An item of costs is unusual in nature where, for example, more than 2 parties are to be assessed. The number of hours allowed on prior authority is not a cap on the work that may be done, it is authority for an amount of work based on the known relevant facts of a case at a particular time. Providers are always able to seek to justify on assessment/taxation why a greater number of hours were required

Hmmm, interesting. I’m not sure which psychologists they have identified who can read two lever arch files, assess a parent, prepare a report, possibly attend an experts meeting AND Come to Court to give evidence in under 20 hours, to establish that this is a reasonable level. [Given that most experts a year back were estimating 35 hours to WRITE the report, which I know was egregious padding and part of why they’ve been cut off at the knees, 20 hours seems very low.]

I am also a bit puzzled as to why a paediatric report, which is generally about a tenth of the size gets 75% of the hours, and why it takes an ISW 50% longer to assess a parent than a psychologist.

Also I am intrigued as to how radiologists in many of the cases I have blogged about in 2012 could be expected to have done all of the necessary work in 10 hours.

The guidance also clears up once and for all that Independent Social Workers will only get £30 per hour. You may be aware that there was a separate hourly rate of £65 per hour for “risk assessment” and many had simply attempted to switch over to that. You won’t be able to claim for “risk assessment” now in any cases that aren’t sexual abuse. [This is going to be very problematic for the important role of conducting assessments following findings of serious physical abuse, which is a very specialised piece of work and will now be either £30 an hour or farmed out to expensive and less timeous psychologists]

The Ministry of Justice and the Legal Services Commission have published guidance on how expert services identified as specialist risk assessments will be paid. The guidance highlights the factors that may arise in a case which would point to it being appropriate to pay the risk assessment rate.

Factors that may typically point to the expert service being that of a specialist risk assessment expert include where:

a. The court order specifies that a risk assessment is required; and

b. The work to be done is over and above that requiring independent social work expertise, for example where: • There is a substantiated criminal allegation relevant to the case in the immediate background of the case (such as a conviction or pending proceedings for a sex offence); and • A finding of sexual abuse relevant to the case has been made by a court

c.the report is specifically required to address the risk posed as a result of the above factors.

The guidance also clarifies that in considering claims where independent social work services are provided in non-family matters the LSC will have regard to the rates set out in Community Legal Service (Funding) (Amendment No2) Order 2011. Where there is no comparable rate in the funding order – for example for a social worker providing social work services – the LSC will have regard to the comparable rates for independent social work services in family matters introduced in May 2011.