In July 2023, the Ministry of Justice (MoJ) consulted on the medical reporting process for claims that fall within MedCo’s ambit. The response to that consultation was published on 16 December 2024 and can be found here.

The consultation was in 6 parts:

1. Changes to the MedCo Qualifying Criteria (QC).
2. Amended Direct Medical Expert (DME) Rules.
3. Review of the MedCo “offer”.
4. Use of Administration Agencies by DMEs.
5. Review of the fixed cost medical report fees.
6. The Official Injury Claims medical reporting process.

MedCo Operational Issues

Parts 1 to 3 refer to the process by which Medical Reporting Organisations (MROs) and experts engage with MedCo. 

MROs

For MROs, the QC are set by the MoJ and MROs are required to meet these in order to use the MedCo service. The QC will be altered, with the main changes being:

• A reduction in the number of claims a high volume national (tier 1) MRO must demonstrate and that they have capacity to process from 40,000 to 28,000; and
• A decrease in the number of active experts that they must have on their books from 225 to 175.

These changes reflect the reduction in claims volume over recent years.

DMEs

For DMEs, the MoJ will work with MedCo on some proposed minor revisions to the DME Rules. The response also states: “We note the additional comments made in relation to DBS consistency and amendments to rules 1 b) and 1 c) about testing the competency of experts. We will consider these points further and discuss in more detail with MedCo whether additional action should be taken in these areas. In terms of whether a leaflet explaining the medico-legal system to claimants should be produced, the MoJ agree that this would be helpful, but we are unable to provide legal advice. We do, though, recommend that the medical and expert witness representative bodies active in the sector collaborate with each other to produce an agreed document which could be shared with their members as appropriate.”

The ‘Offer’

The MoJ has also confirmed that changes will be made to the current offer of two tier 1 and five tier 2 MROs or seven DMEs for represented claimants and two tier 1 and two tier 2 MROs or five DMEs for unrepresented claimants. The new offer for represented claimants will be two tier 1 MROs, six tier 2 MROs and & seven DMEs. The MoJ noted that “the proposed ‘offer’ has been specifically calculated to reflect the changes in the numbers of operational MROs and to ensure effective and lawful competition both between and across the tiers and provide all MROs with an equal opportunity for selection by users of MedCo.” The offer for unrepresented claimants remains unchanged.

Comment: Overall these seem like sensible changes that reflect the changes in claims volumes.  We particularly welcome the comments around the need to strengthen the existing DME Rules on testing the competency of medical experts.

Administration Agencies

Part 4 relates to the use of administration agencies.

There has been growing concern about the use of administration agencies, especially those who appear to be operating like MROs outside of the MedCo process. The response acknowledged that there are a variety of administration agency models in the market, ranging from those carrying out simple administration tasks to those carrying out more complex management functions akin to a MRO. There was support for the idea that administration agencies should be audited by MedCo with the MoJ noting: “The government agrees that if AAs are operating as de-facto MROs, logically it is appropriate that they should be held to the same standards, criteria and financial commitments as existing MROs registered on MedCo.”

It is accepted that administration agencies should be audited, and the MoJ has committed to working with MedCo to come up with a range of QC that MedCo can audit against that reflect the different types of support activities that different administration agencies provide.

Comment: We welcome the news that administration agencies are to be brought within MedCo’s remit. There are many agencies in existence that are providing a vital service to medical experts.  Others who are operating more like MROs should not be allowed to continue to do so without accountability, oversight and the need to comply with MedCo Rules.

Fixed Cost Medical Reports

Part 5 relates to the fees for Fixed Cost Medical Reports.

The fixed cost medical report scheme was introduced in 2014 and the fees have remained unchanged since then, so, for example, a first medical report is fixed at £180 (+ VAT where appropriate). The figures proposed in the consultation paper increased (for example) the fee for the first medical report to £210  (+ VAT where appropriate). The principle that there should be an increase is now in place and that the increase should be calculated by reference to the Services Producer Price Inflation (SPPI). The final figure is not yet known as the MoJ indicate that due to the passage of time it will need to be recalculated and they will consult again on the new figures before the change is implemented.

Comment: The response does not make it clear what index within SPPI (and there are several) is being applied. This could make a significant difference to the figures.

Official Injury Claim (OIC) medical reporting process

Part 6 relates to the Official Injury Claim medical reporting process.

The MoJ has confirmed that represented claimants must now wait for the defendant’s response on liability before obtaining medical evidence – as is already the position for unrepresented claimants. They will also work with stakeholders to explore the development of options for aligning the processes for obtaining medical reports, so that represented and unrepresented claimants follow the same medical reporting journey. They will also work with MedCo on the accreditation requirements for experts to ensure that they are complying with the requirements of the pre-action protocol.

Comment: There will be benefit in this change. The delay to claimants will not be significant and it should go some way to ensuring that experts have all of the information they need (including the defendant’s version of events). It is disappointing that the processes are not to be fully aligned, but we welcome the MoJ’s commitment to working with stakeholders to explore the development of an aligned process.

For more information or advice, please contact a member of our Strategic Advisory Team.