We’re delighted to be featured in the Spring 2026 issue of Wave, the Royal College of Radiologists’ membership publication.
The following article explores the realities of expert witness work for clinical radiologists and clinical oncologists, including the responsibilities, rewards, and the importance of specialist training. As highlighted by our Director of Expert Witness Training, Adam Millward, understanding the rules, duties and procedures is essential to supporting the courts and avoiding miscarriages of justice.
An intellectual challenge. An opportunity to ‘give back’. A fascinating insight into a different environment.
These are just some of the reasons clinical radiologists and clinical oncologists choose to take on expert witness work alongside their clinical practice.
For Dr Katharine Halliday, a senior consultant paediatric radiologist at Nottingham University Hospitals Trust and past president of the RCR, it was an activity that helped shape her career.
‘I found it to be one of the most satisfying things I did,’ she says. ‘Everybody goes into medicine because they want to contribute. And, for me, I feel it’s the area where I’ve made the most contribution; I became known because of it, and I think it’s the path that ultimately led me to the RCR presidency.’
As medical expert witnesses, clinicians bring their professional judgement into the legal arena, offering independent, evidence-based opinions to help courts navigate complex medical evidence. This work most commonly sits within civil litigation, including clinical negligence and personal injury claims, although it can extend into criminal proceedings.
While clinical oncologists act primarily in civil cases (around delayed diagnosis, failure to refer or chemotherapy mismanagement), clinical radiologists play a vital role in criminal cases to evaluate suspected physical abuse, although the majority of their work still relates to civil cases, focusing on issues such as diagnostic errors.
In both specialties, the role requires a sufficient level of clinical experience – ‘at least 10 to 15 years in the field’ recommends the Medical Defence Union, although this is guidance rather than prescription – and investment in the relevant training, plus separate professional indemnity.
For the right people, expert witness work can provide an interesting sideline and a supplementary source of income – but it is also a demanding role which carries significant responsibility.
Transferable skills
As a paediatric radiologist, Dr Halliday’s expert witness role (which she put on hold when taking up her RCR presidency in 2022) meant acting in both family law proceedings (around determining child arrangements) and criminal investigations. Suspected physical abuse cases are heard in both courts and require the radiologist to provide an objective interpretation of medical imaging to help determine whether children’s injuries were accidental or non-accidental.
It can be intense and harrowing work – navigating large quantities of data (from hospital records and scans to police interview transcripts with carers) – then writing a formal report expressing an opinion based on the evidence.
While clinical negligence and personal injury claims rarely end up in court, she notes that ‘with this suspected physical abuse work, they frequently do’; either in family court (for child protection and care arrangements) or crown court for criminal cases.
‘Some of the stories are very sad,’ she says. ‘And it’s made me a lot less judgemental. But one of the things you’re doing in court is demonstrating that you’ve looked at the case thoroughly, that it’s not the authorities taking children away from their parents on a whim, but that they have got relevant experts in who have really considered the evidence.’
This brings a sense of satisfaction – plus a raft of transferable skills. ‘The role has taught me to be more analytical and to communicate more clearly,’ says Dr Halliday. ‘And if it’s a difficult case, you meet other experts and learn lots from them.’
Testifying in court can be intimidating, but also insightful. ‘I quite liked being tested on what I thought and why I thought it; I found that rigour very helpful in my professional life,’ she admits. ‘Sometimes, there’s sparring with lawyers, which can be stimulating!
‘Whether or not they think I’m a fool is only important insomuch as it affects the child and the family. If you concentrate on that, it becomes much easier. People often feel they’re being criticised, because they do challenge your opinion. But I’m quite comfortable with it – and there have been times in court where I’ve had to change my opinion [in light of further evidence or clarification].’
She emphasises that it’s vital to stay within your area of expertise. ‘If you’re not sure what the answer is, that’s really difficult, but you just have to say so.’
Navigating risk
Dr Suprio Ganguly, a consultant radiologist at Mid Yorkshire Teaching NHS Trust, echoes this opinion, highlighting the need for expert witnesses to ‘approach each case with an open mind’, modifying their position if presented with fresh evidence.
As well as family and criminal law, his own expert witness work spans personal injury claims (for example, assessing the extent, severity and causes of injuries) and medical negligence (such as misread images or delayed diagnoses) both within the UK and in other jurisdictions.
He stresses that a core tenet of the expert witness role is to remain impartial, rather than acting as an advocate for either party.
‘Remember that an expert witness’s overriding duty is to the court – and that you are obliged to provide an impartial and honest report, irrespective of who has instructed you,’ he says, advising witnesses to ‘express their honest opinion, politely but confidently’ and to ‘engage respectfully with other experts, legal professionals and litigants’.
This work is not about case-building but providing objective and accurate evidence, which means that even ‘negative’ reports can be helpful to solicitors, adds London-based consultant clinical oncologist Dr Matt Williams. ‘If you provide a detailed, evidence-based report about why the care that was offered was not negligent (for example), it makes it easier for them to close the case,’ he says.
Dr Williams, who is based at Charing Cross Hospital, takes on medical negligence and insurance work around his specialist area of neuro-oncology, taking care to stay within his clinical comfort zone. ‘My underlying question is: If this patient came into clinic, would I treat them as part of my routine practice?’ he explains.
Remaining independent, objective and within one’s scope of expertise is widely recognised as key to managing the inherent risks that come with the expert witness role – such as judicial criticism, sanctions with professional bodies and regulators, and court-ordered fines.
Expert witnesses do not have the benefit of immunity and may also be sued for professional negligence.
The dangers of the role are brought into sharp focus by high-profile cases in which medical expert witnesses have faced intense public scrutiny. However, appearing in court is actually rare for most medical expert witnesses – and some may never go to court.
Most risks can, in any case, be mitigated by responsible practice, reassures Simon Berney-Edwards, CEO of the non-profit Expert Witness Institute (EWI) which represents experts from across disciplines: ‘If you follow the rules, remain independent and declare conflicts of interest, you’re not going to have those problems,’ he argues.
Rewards and opportunities
Expert witness work is, nevertheless, a challenging sideline which requires ‘reading the case notes - which may be voluminous - conducting research, meticulously scrutinising the evidence and preparing a lucid report which is comprehensible to the legal profession,’ says Dr Ganguly.
Stressors ‘are often around timelines and access to records,’ adds Dr Williams. ‘Particularly in oncology, we might want to look at detailed information - such as radiotherapy plans - which most firms don’t understand and are not set up to deal with.
‘The other big issue is that some claimants feel that the fact that disease has behaved badly is the fault of the treating clinician. In reality, many cancers behave badly, irrespective of what we do, and it is rare that treatment is so poor that we can blame it for what happened to the patient.’
But both also point to tangible rewards and benefits.
‘It makes you think about cases hard, and in every case I have had to go back to the literature and read it in detail,’ says Dr Williams. ‘In that sense, it’s an excellent form of CPD. It makes you ask yourself not only what the standard of care should be but whether the care that was delivered materially affected the outcome. Did the dose used reduce response? Were the margins used reasonable - and is there any evidence for those margins?
‘I enjoy writing the detailed reports. It’s one of the few times where you actually have space to design and lay out an argument about the pros and cons of a case, with supporting evidence.’
Dr Ganguly relishes being able to contribute to delivering justice - as well as the opportunity to learn and grow in his profession. ‘Radiological expert witnesses routinely participate in conferences with experts from other faculties and with barristers, who may question and challenge them,’ he says. ‘These sessions can be a learning experience and intellectually stimulating.’
While ‘parleys with the expert radiologist from the other side are always tense as each expert is expected to defend their position (in a courteous manner)’, he admits there is ‘a sense of satisfaction’ when the courts uphold his position.
A distinct positive for many is that, unlike going into private medical practice, this kind of work presents an opportunity to do something a little different to the ‘day job’.
There is also flexibility when it comes to choosing how much medico-legal work you do. For example, while Dr Ganguly works part-time, ‘devoting the non-contractual hours to expert witness work’, Dr Williams has a more limited commitment.
‘Adult neuro-oncology is quite niche, and I only take on cases that fit within my clinical practice,’ he says. ‘Medico- legal work is quite flexible, so I do it in the evenings and weekends.’
Berney-Edwards notes that ‘the more niche you are and the more complex the cases, the more financial reward that you’re going to get out of it’.
But he adds that ‘the people I see who are really successful are the ones who engage in the challenge and the feeling that they’re contributing to justice. It isn’t an easy stream of cash. You need to know what you’re doing, and you need to prepare.’
Training and starting up
While in the past doctors may have drifted into expert witness roles, it’s now a more intentional process, requiring an upfront investment in training and indemnity insurance.
In addition to having sufficient clinical experience, expert witnesses need to be skilled communicators able to give evidence under pressure and produce well-structured, court-compliant reports. They also require a solid understanding of the rules, duties and responsibilities underpinning their role.
Both Dr Williams and Dr Ganguly took accredited expert witness courses and continue to participate in ongoing CPD. As Dr Williams explains: ‘I did two whole days of online courses before taking on my first case and I keep an eye on some of the medico-legal updates; I aim to do about a course per year as CPD.’
Training options range from free sessions provided by organisations such as the Family Justice Council to paid courses via the EWI and other private providers.
‘Our core training is having an understanding of the legal system and the regulatory framework,’ says Berney- Edwards. ‘It’s about report writing, taking part in a “meeting of experts” and preparing joint statements. We leave out giving oral evidence, because the majority of people don’t go to court.’
Though training isn’t mandatory, it’s ‘actively encouraged in guidance by the Academy of Medical Royal Colleges, which is endorsed by the majority of medical and healthcare professional bodies and regulators,’ asserts Adam Millward, director of the expert witness division at training provider Bond Solon.
‘Expert witness work requires a completely different set of skills to a person’s main professional role,’ he stresses. ‘It’s essential that experts understand how to comply with the rules, duties, law and procedure governing their work. If an expert fails in their duty, it can result in miscarriages of justice.’
When starting out, it can be simplest to gain work through a (reputable) agency, potentially transitioning to independent contractor status once you’re established; this, of course, involves marketing your services, joining relevant listings and setting pay rates.
‘You need to have really good terms and conditions in place,’ says Berney- Edwards. ‘Think about your day rate. What are people paying for your expertise on a day-to-day basis? And then work from that.’
Addressing shortages
For those with an interest in taking on medico-legal work, there’s plenty to go around. As society becomes increasingly litigious and pressures on the NHS continue to grow, demand for expert witnesses is rising. This means there is a dearth of medical expert witnesses, particularly in specialties such as paediatric radiology.
Efforts are being made to address this by enhancing the experience of expert witnesses within the justice system.
For example, between 2019 and 2021, to tackle the shortfall in the Family Division of the High Court, Mr Justice David Williams led a working group to look into the barriers to clinicians becoming experts. This led to 22 recommendations and the establishment of a national committee to achieve and sustain change.
Solutions included better treatment from the family justice system. There was a perception ‘that it didn’t really have regard to the fact that being an expert was the second string to their clinical careers’, reports Mr Justice Williams.
‘A lot of the things within our gift to do have been done,’ he says, explaining that judges have received training and best practice advice, more medics are able to give evidence remotely and improvements have been made in the way experts are instructed and paid.
The message he is keen to share is that the family justice system ‘relies heavily on experts to tell us about things we just can’t know. And we value their expertise greatly,’ he says. ‘I think because of the training we’ve done, the experience an expert would have would be a good one - and they would want to do more of it.’
While being an expert witness is not for everyone, it’s clearly a highly valued role that is much in demand within the UK justice system. For the right clinician, at the right time in their career, it provides a unique blend of intellectual, professional and financial rewards that may well be worth investigating further.