Expert Witness Journal Issue 67 June/July 2026 - Flipbook - Page 48
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what the consequences of inaction might be.
In routine GP consultations, that level of explicit
understanding is often assumed rather than
con昀椀rmed—and that assumption rarely holds up
well in court.
Expert evidence must re昀氀ect real practice: not
retrospective idealisation.
Expert Witness Role
Acting as a GP expert isn’t just about reading the
notes and commenting on clinical decisions. It’s
about understanding how general practice really
works:
The reality of a routine GP consultation
What’s striking is how unremarkable this all is from
a clinical point of view.
the pace of consultations,
the habit of completing tasks after the patient has
gone,
the way electronic systems shape work昀氀ow,
and the points at which communication can
realistically break down
This is standard general practice:
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a busy clinic with limited time,
•
a reasonable clinical decision to investigate,
•
the usual 昀氀urry of admin after the patient has
left,
That context is essential when forming an opinion
on what is, and isn’t, reasonable.
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and a system that depends on the patient taking
the next step
Final Re昀氀ection
From a GP standpoint, this isn’t a case about getting
the medicine wrong.
There’s nothing unusual in any of that. It’s how most
of us work every day.
It’s about something much more familiar—
communication in a system that assumes patients
will understand and act, but doesn’t always make
that understanding explicit.
The risk sits in a very small space—the gap between
deciding to act and making sure the patient knows
what to do.
In a system where investigations are often patientled, that gap matters more than we sometimes think.
If the patient leaves without a clear understanding
of what’s been arranged and what they need to do,
the pathway is already vulnerable.
The reality is simple, but not always easy in a busy
clinic:
If the next step depends on the patient, the job isn’t
昀椀nished when the test is ordered. It’s 昀椀nished when
the patient knows about it, understands it, and there
is a clear record of that.
So the practical lesson is simple, if slightly
uncomfortable:
That’s why this case feels so close to home.
If an investigation depends on the patient doing
something afterwards, then the communication
needs to be explicit, and the record needs to re昀氀ect
it.
There’s nothing unusual here:
a routine consultation,
a sensible decision to investigate,
and just a small gap in communication.
Not because GPs are failing to do their job—but
because in a digitised, fragmented system, the
record is often the only thing that survives the
passage of time intact.
And that small gap is exactly where the risk sits – a
small omission which proved pivotal.
From an expert witness point of view, this isn’t
really about knowledge or clinical judgment. It’s
about what happens at the join between the GP, the
patient, and the system we’re all working in.
Why This Case Matters for
Instructing Solicitors?
For practitioners in clinical negligence, the case
highlights recurring evidential themes:
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Chronology is decisive: audit trails often
determine factual 昀椀ndings;
•
Internal consistency matters: variation within
records can undermine “usual practice”
evidence;
Communication failures are highly litigable:
particularly in patient-led pathways;
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EXPERT WITNESS JOURNAL
Modern general practice is busy, digital, and
increasingly reliant on patients to take the next
step themselves. Most of the time that works
昀椀ne—but when communication isn’t clear, or isn’t
documented, that’s where the risk sits.
None of this is new. It’s the sort of thing we’ve all
been told before.
46
JUNE 2026
