EWJ 60 April 2025 web - Journal - Page 64
The NHS in England follows specific guidelines like
the Care Act 2014 and the Children and Families Act
2014 that influence how OT reports are structured
and the content they include.
The role of Occupational Therapy in medicolegal
work
In the United Kingdom, the role of Occupational
Therapy Expert Witnesses in legal cases, including
personal injury and medical malpractice claims likely
started to emerge in the mid-20th century, similar to
developments in other countries such as the USA.
However, the formal recognition and integration of
OT as distinct field within medicolegal contexts took
longer to establish compared to some other medical
specialties.
• Northern Ireland: Similar to England, occupational
therapy in Northern Ireland is regulated by the
HCPC. However, Northern Ireland follows its own set
of legislation, such as the Health and Social Care (Reform) Act (Northern Ireland) 2009 and the Children
(Northern Ireland) Order 1995, which may influence
how reports are written, especially regarding care
provision and child protection.
In the 1970s, as personal injury claims and workers’
compensation cases began to increase in the UK, OTs
were consulted more frequently to assess the functional impact of injuries or illnesses. This was particularly important in cases involving disability and
long-term rehabilitation needs, where OTs could provide crucial insights into an individual’s ability to perform daily tasks and engage in work or leisure
activities.
2. Policy Differences
• England: OT reports often need to reflect the
guidelines set by the NHS, including local authority
policies, regional differences in funding and specific
programmes such as the Personal Health Budgets or
Direct Payments that can affect how services are
allocated.
• Northern Ireland: Occupational therapy reports in
Northern Ireland are governed by Health and Social
Care (HSC) Trusts and may incorporate regional policies under the Department of Health (DoH). The
HSC model is somewhat different from the NHS
structure in England, and the way reports are used in
decision-making may also differ. The process for accessing services might involve slightly different documentation or assessments, influenced by the local
organizational structure.
The 1980s began to see the formalization of the
expert witness role within many healthcare professions including OT, as a result of increased legal recognition and the need for details assessments of
functional impairment. OTs began to be called upon
to assess how injuries, disabilities, or medical conditions impacted the person’s ability to engage in
activities of daily living and work.
Today OTs are an established part of the UK legal
system and they play a crucial role in cases involving
personal injury, medical negligence, workplace
injuries and compensation claims.
3. Health and Disability Benefits
• England: Reports often tie into Disability Living
Allowance (DLA) or Personal Independence Payment
(PIP) assessments, which have a distinct process in
England. Occupational therapy reports in these cases
may need to address how a disability impacts daily
living and work activities.
What’s unique about an OT expert care report?
OTs take a holistic approach to health. This means
they look at a person as a whole, taking into account
both mental and physical health, alongside independence and wellbeing. The aim of OT is to help person
gain greater independence and increase satisfaction
in all areas of their life.
• Northern Ireland: Northern Ireland also has PIP
and DLA assessments, but the process might differ in
certain aspects, such as eligibility criteria or how
reports are considered by decision-makers.
Due to the holistic nature of the OT role, OTs are
therefore well-placed to provide an in-depth understanding and perspective into someone’s experiences,
thoughts and motivations. They play a crucial role in
medicolegal work by assessing individuals’ functional
impairments and disabilities, rehabilitation potential
and ongoing care needs, the cost of past, present and
future care, aids and adaptations and assistive devices,
and the impact of injuries and/or negligence upon
their quality of life and psychosocial factors.
When writing care reports for clients in Northern
Ireland compared to the rest of the UK for personal
injury litigation, there are a few key differences to
keep in mind:
Pre-Action Protocols: Northern Ireland has its own
Pre-Action Protocol for personal injury litigation,
which aims to ensure that parties are on an equal
footing, save expenses, and deal with litigation
proportionately
Expert Care OT Reports: Northern Ireland v
England
The main differences between expert OT reports in
England and Northern Ireland are often related to
specific legislatives frameworks, guidelines and local
policies governing healthcare services in these regions.
Here are some of the key differences:
This protocol emphasizes early exchange of information and encourages settlement before litigation.
1. Legislative and Regulatory Framework
• England: OT practices in England are regulated by
the Health and Care Professions Council (HCPC).
This is different from the procedures in England and
Wales, where the courts are stricter on non-compliance with pre-action requirements
EXPERT WITNESS JOURNAL
Case Management: In Northern Ireland, clinical
negligence cases are listed for review before a Master
13 months after the issue of Writ, and case management directions are issued to progress the case
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