The instruction arrives as a bundle, not as a sentence. Statements, records, a letter asking for prognosis, sometimes a photograph of a bumper. Someone on the claimant side has already asked whether a short clinic letter would do instead, because the hearing is not far away and letters are quicker. They would not do. They are a different document, with a different duty.
A medico legal report is a bound opinion with a duty to the court, not a GP letter. Civil Procedure Rules Part 35 sits behind civil work. MedCo sits behind many injury reports. It takes time because the documents have to be read, not glanced at. You get an opinion. You do not get a guaranteed outcome for the claim.
The real question is whether you need an expert who has read the papers and examined the person, or whether you need a letter that confirms an attendance.
Chest pain, signs of a stroke, severe breathlessness, heavy bleeding, a severe allergic reaction or symptoms of sepsis need 999 or A&E immediately.
What a medico legal report is for
The short version is this. An expert sets out findings, opinion, and the reasons for that opinion, for a court or a decision maker who was not in the room. The duty is to the court, even when a solicitor is paying the invoice. If those two pull in different directions, the court wins. That is not a slogan. It is the job.
Here is the longer version, because this work gets confused with the everyday supporting letters we also write.
A GP letter after a 30 minute clinic appointment can confirm that someone was seen, what was found, and what was recommended. It can be enough for an employer, a university, or a straightforward confirmation. It is not enough when causation, prognosis, and disability are in issue, or when another party will instruct their own expert to pull the document apart. A report in that setting has to show its working. History. Examination. The records. What is consistent. What is not. What I cannot say. The range of opinion if there is one. A statement of truth.
What I look at, when instructed, starts with the papers. I read them. That is the part people try to skip, and it is the part that takes the hours. GP notes, hospital attendances, physiotherapy, imaging reports, previous claims if they are disclosed, the claimant’s own statement. The pattern matters more than the single reading. A neck that was already in the notes in 2019 is not the same neck as a new injury in 2026, and pretending not to have seen the earlier entries is how reports come apart later. I will not write a report on a handful of pages because the deadline is tidy.
Then the examination, face to face, at Palmers Green, or as a home visit if the person cannot travel. History in their words, then questions I need for the issues in the case. Examination of the relevant systems. What they can do, what they say they cannot do, and whether those two sit together. I am not trying to catch anyone out. I am trying not to be caught out. Overstatement helps nobody, including the person who instructed me. Understatement is a different error: a court cannot use a report that is too careful to say anything.
From our practice, road traffic and whiplash work often comes through MedCo. I am a MedCo registered medical expert, DME9158. That process exists so the examination is independent, not so the report becomes a form. Other civil work comes on direct instruction: longer records, mixed physical and psychological pictures, sometimes clinical negligence where the question is within GP competence and the rest is for another expert. I will not accept an instruction I cannot discharge. We say so. A bad report is worse than no report.
The piece most people miss is time. Reading is not an add on. If the bundle is 400 pages, the fee and the timescale reflect 400 pages. A clinic slot of 30 minutes for £100 is the wrong product, and we will not pretend otherwise to get the work. Injury and accident confirmation letters start from £500 on the published list. A full expert report is confirmed in writing once we have seen the instruction and the volume of records. Nothing is rushed, because medicine done properly takes time, and this is medicine that will be read by someone whose job is to doubt it.
What you get, and what you do not
You get an opinion, written so a judge can see how it was reached. You get the limits of that opinion, named. You do not get a guaranteed settlement, a guaranteed award, or a promise that the other side will accept it. Anyone who sells a report as a result is selling something else.
It is worth saying plainly: I will not change an opinion because it is unhelpful. I will correct a factual error. I will answer Part 35 questions. I will not negotiate the conclusion. If a solicitor wants a more useful paragraph, they may need a different expert, or a different case, not a different sentence from me.
When this comes up in consultation with injured people rather than with solicitors, they often want to know whether I am “on their side.” I am not. I am on the court’s side. That is the only way the document has any weight for them in the first place.
When to come in sooner
Instruct sooner if limitation is running, if a medical window for examination is closing, or if treatment is about to change the picture the court needs to see. Late instructions produce thin reports or declined instructions. We will not invent capacity.
Instruct sooner if the person is still in pain, still off work, or still waiting for imaging, and nobody has examined them for the claim. A records review without an examination is a different, narrower product, and only where that is what was asked.
Do not wait on a report if the person is acutely unwell now.
- Chest pain, stroke signs, severe breathlessness, heavy bleeding, a severe allergic reaction, or sepsis: 999.
- A new head injury with confusion, a first seizure, or they cannot be woken: 999.
- A swollen leg with chest pain or breathlessness after an injury or a long journey: 999.
- You are not safe, or you have a plan to harm yourself: 999 or A&E.
- Cauda equina symptoms after back pain: saddle numbness, new incontinence, rapidly worsening leg weakness. That is an ambulance, not an expert slot.
- A child with a fever who is floppy, or a rash that does not fade: 999.
How we approach this at Clinique Alpa
Solicitors, or individuals where the instruction is appropriate, call 020 8882 8088. WhatsApp enquiry is 447742163571, without sending full records through the chat. Send the letter of instruction, the issues, the deadline, and how the records will arrive. We confirm the fee in writing before any work begins. A 30 minute clinic appointment at £100 is available if someone first needs ordinary GP advice, which is not the report. Home visits £250 day, £450 night, if the examination has to be in the house. Referral letters are £50 after a GP assessment if that is a separate, ordinary clinical need.
I read. I examine at 466 Green Lanes, Palmers Green, unless a visit is agreed. I write. The report is delivered securely. I am GMC 6113670. Clinique Alpa is CQC registered. Independence is the point of the document, not a decorative line at the top.
Ask for this work if that is the report you need. The process sits on the medical reports page. Fees, including the published starting points, sit on appointments and fees. Who writes it sits on about us.
If you wanted a short letter, say so. If you wanted an expert opinion, send the bundle, and allow time to read it.
An independent opinion, written for the court, after the papers have actually been read. Read our fees page, or call 020 8882 8088. Fee confirmed in writing before work begins. Clinic 30 minutes £100 for ordinary GP advice. In an emergency call 999. Subject to availability.
Written by Dr Mitesh Parmar, MBBS MRCGP, GP and founder of Clinique Alpa, 466 Green Lanes, Palmers Green, London N13 5PA. This article is general information, not personal medical advice. In an emergency call 999. For NHS advice call 111 or visit nhs.uk.