AMRO : Association of Medical Reporting Organisations


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AMRO’s purposes are to:

1. promote professional standards in medical reporting and maintain good practice in the presentation and use of medical reports;

2. ensure that the conduct of medical experts in the context of legal proceedings is in accordance with the overriding objective of enabling the Court to deal with cases justly and in accordance with the duties and responsibilities of expert witnesses as set out in Part 35 of the Civil Procedure Rules recognising that the experts duty is to help the Court in matters within his or her own expertise and that this duty is paramount and overrides any relationship with those from whom instructions are received or by whom he or she is paid.

(a) Expert evidence presented to the Court should be, and should be seen to be, the independent product of the expert uninfluenced as to form or content by the exigencies of litigation;

(b) An expert witness should provide independent assistance to the Court by way of objective unbiased opinion in relation to matters within his expertise. An expert witness in the High Court should never assume the role of an advocate;

(c) An expert witness should state the facts or assumptions upon which his opinion is based. He should not omit to consider material facts which could detract from his concluded opinion;

(d) An expert witness should make it clear when a particular question or issue falls outside his expertise;

(e) If an expert’s opinion is not properly researched because he considers that insufficient data is available, then this must be stated with an indication that the opinion is no more than a provisional one. In cases where an expert witness who has prepared a report could not assert that the report contained the truth, the whole truth and nothing but the truth without some qualification, that qualification should be stated in the report;

(f) If, after exchange of reports, an expert witness changes his view on a material matter having read the other side’s report or for any other reason, such change of view should be communicated (through legal representatives) to the other side without delay and when appropriate to the Court

(g) Where expert evidence refers to photographs, plans, calculations. analyses, measurements, survey reports or other similar documents, these must be provided to the opposite party at the same time as the exchange of reports

3. keep under review Court procedure in relation to the conduct of medical experts in the context of legal proceedings;

This Association will be operated for the benefit of clients and it is of critical importance that Members recognise that their service should conform to the standards set out in this Protocol

B:

AMRO members agree to:

1 Abide by Part 35 of Civil Procedure Rules in the use of experts.

2. Implement this protocol.

1. At the outset, the following terms will be agreed between the expert and the Member:-

1.1 An estimate of the time likely to be required and the fee for the services.

1.2. Cost of travel (if any) and likely disbursements.

1.3 Fee for attendance at Court and any fee in the event of late notice of the cancellation of a Court hearing.

1.4 questions to be addressed;

1.5 the history of the matter, identifying any factual matters that may be in dispute;

1.6 details of any relevant documents stating which (if any) the expert may refer to in the report and if not, why not;

1.7 whether proceedings have been commenced or are contemplated;

1.8 details of the location of the medical reports;

2. Members shall ensure that any expert instructed is able to produce a report within a reasonable time of instruction, having regard to the timetable of the case. On receiving notice that the expert cannot meet the agreed time limit Members shall notify the client within 2 days.

2.1 When instructing experts, Members shall give clear instructions providing the following details (as far as available):

2.1.1 Basic information such as names, addresses, telephone numbers, dates of birth and date of incident.

2.1.2 The type of expertise required.

2.1.3 The purpose for requesting the report and a description of the matters to be investigated, including clear instructions on whether the report may be disclosed in legal proceedings.

2.1.4 Questions to be addressed.

2.1.5 The history of the matter, identifying any factual matters that may be in dispute.

2.1.6 Details of any relevant documents stating which (if any) the expert may refer to in the report and if not, why not.

2.1.7 Whether proceedings have been commenced or are contemplated and updates to the expert as regards relevant Court Orders or other deadlines.

2.1.8 Details of the location of the medical records.

2.2 Members shall instruct the expert to compile the report in accordance with the following:-

2.2.1 Part 35 of the Civil Procedure Rules and the Practice Direction accompanying that Part.

2.2.2 The report shall avoid cross reference to external documents if possible.

2.2.3 The style is to be concise and text is to be arranged in short sentences and paragraphs.

2.2.4 The report is to be in the first person singular and the Statement of Truth shall be signed personally by the expert preparing the report.

2.2.5 Appendices are to be used where the inclusion of material in the main body of the report would render it less clear.

2.2.6 Conclusions are to be given in a final section of the report before appendices and are to be cross-referenced to the text which supports them.

3. Members shall ensure that in compiling the report the expert has not expressed an opinion outside the scope of his/her competence and has identified any unfamiliar aspects of the instruction (if necessary). Members shall endeavour to provide the expert with further information or guidance where appropriate.

4. Members shall ensure that they instruct an expert who has the knowledge, experience, academic qualifications, or professional training appropriate for the assignment and has the resources to complete the matter within the timescale and to the standard required for the assignment

5. Members shall ensure that they instruct an expert who has the relevant expertise, knowledge, experience, academic qualifications and professional training appropriate for the assignment and has the resources to complete the matter within the timescale and to the standard required for the assignment as per Part 35 of the Civil Procedure Rules.

6. Members shall ensure that the experts report complies with the Road Traffic Act Protocol from time to time adopted and the Personal Injury Protocol from time to time adopted and subject so that it includes the following:

6.1 The expert’s qualifications;

6.2 The purpose of the report;

6.3 Basic information, for example names and dates of birth in a personal injury action;

6.4 A chronological history of the matter;

6.5 A statement of the methodology employed;

6.6 Details of the documents or any other evidence upon which any aspect of the report is based;

6.7 Matters of fact and opinion clearly distinguished and kept separate;

6.8 The source of statements of fact relied upon clearly identified;

6.9 An indication of whether the report is provisional

7. Members shall ensure that the report complies with Part 35 of the Civil Procedure Rules as set out in Practice Direction 2 accompanying that part:-

7.1 The report shall avoid cross reference to external documents if possible

7.2 The style is to be concise and text is to be arranged in short sentences and paragraphs

7.3 The report is to be in the first person singular and signed personally by the expert indicating the truth of the report

7.4 Appendices are to be used where the inclusion of material in the main body of the report would render it less clear

7.5 Conclusions are to be given in a final section of the report before appendices and are to be cross-referenced to the text which supports them

FORM AND CONTENT OF EXPERT'S REPORTS
2.1	An expert's report should be addressed to the court and not to the party from whom the expert has received his instructions.

2.2	An expert's report must:
	(1) give details of the expert's qualifications;
	(2) give details of any literature or other material which the expert has relied on in making the report;
	(3) contain a statement setting out the substance of all facts and instructions given to the expert which are material to the opinions expressed in the report or upon which those opinions are based;
	(4) make clear which of the facts stated in the report are within the expert's own knowledge;
	(5) say who carried out any examination, measurement, test or experiment which the expert has used for the report, give the qualifications of that person, and say whether or not the test or experiment has been carried out under the expert's supervision;
	(6) where there is a range of opinion on the matters dealt with in the report
	(a) summarise the range of opinion, and
	(b) give reasons for his own opinion;
	(7) contain a summary of the conclusions reached;
	(8) if the expert is not able to give his opinion without qualification, state the qualification; and
	(9) contain a statement that the expert understands his duty to the court, and has complied and will continue to comply with that duty.

2.3	An expert's report must be verified by a statement of truth as well as containing the statements required in paragraph 2.2(8) and (9) above.

2.4	The form of the statement of truth is as follows: " I confirm that insofar as the facts stated in my report are within my own knowledge I have made clear which they are and I believe them to be true, and that the opinions I have expressed represent my true and complete professional opinion."

2.5	Attention is drawn to rule 32.14 which sets out the consequences of verifying a document containing a false statement without an honest belief in its truth.

	(For information about statements of truth see Part 22 and the practice direction which supplements it.)

8. At the outset, the following terms will be agreed between the expert and the Member:

8.1 An estimate of the time likely to be required and the fee for the services

8.2 Cost of travel (if any) and likely disbursements

8.3 Fees for attendance at Court and any fee in the event of late notice of the cancellation of a Court hearing

9. Members must always retain their professional independence in particular (and without limiting this obligation) payments to an expert witness contingent upon the nature of the evidence given or upon the outcome of a case must not be offered, accepted or made;

10. Members are required to settle the fees of the expert within the agreed terms of payment. Experts may make a complaint to the Honorary Chairman of the Association for any repeated or serious breach of this obligation by any member and members shall upon request advise experts in writing of this right.

D:

Members will:-

1. deal with correspondence and reply as soon as practicable, or at least within five working days save in exceptional circumstances

2. return telephone calls if unavailable as soon as practicable, or within 1 working day save in exceptional circumstances

3. be polite, courteous and punctual

4. answer all matters raised and advise in detail where required

5. advise clients when any expert is instructed

E:

Members of AMRO are required to respond positively and quickly to complaints from clients or third parties. The following procedure is to be followed by every Member, unless a complaints procedure has already been adopted by the Member but it is envisaged that the matter will be dealt with in the following manner:

1. The complainant should be invited to detail their complaint in writing and the complaint should be submitted to the person nominated by the Member

2. The matter must be investigated and replied to in writing to the complainant within 5 working days of the complaint being received

3. If the matter cannot be resolved then the Member should advise the complainant of alternative remedies

4. Any complaint should be referred to the Management Committee

5. In the case of a serious complaint involving a Member the Chairman may recommend to the Management Committee that a Member be expelled in accordance with the Constitution

F:

The AMRO Protocol may be amended by the agreement of a two-third majority of the Members in general meeting subject to notice of the change having been given to the Members at the same time as the general meeting is convened. Alternatively, it may be amended by the agreement of a two-thirds majority of the Members in a postal ballot.


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1. The name of the Association is the “ASSOCIATION OF MEDICAL REPORTING ORGANISATIONS” (“the Association” and “AMRO”)

2. Subject to the matters set out below the Association shall be administered and managed in accordance with this Constitution by the Members of the Management Committee constituted by Clause 6 of this Constitution (“the Management Committee”)

3. The objects for which the Association is established are:

3.1 To promote professional standards and good practice in the presentation and use of medical reports and ensure that the conduct of medical experts in the context of legal proceedings is in accordance with the overriding objective of enabling the Court to deal with cases justly and in accordance with the duties and responsibilities of expert witnesses as set out in Part 35 of the Civil Procedure Rules recognising that the experts duty is to help the Court in matters within his or her own expertise and that this duty is paramount and overrides any relationship with those from whom instructions are received or by whom he or she is paid.

(a) Expert evidence presented to the Court should be, and should be seen to be, the independent product of the expert uninfluenced as to form or content by the exigencies of litigation;

(b) An expert witness should provide independent assistance to the Court by way of objective unbiased opinion in relation to matters within his expertise. An expert witness in the High Court should never assume the role of an advocate;

(c) An expert witness should state the facts or assumption upon which his opinion is based. He should not omit to consider material facts which could detract from his concluded opinion;

(d) An expert witness should make it clear when a particular question or issue falls outside his expertise;

(e) If an expert’s opinion is not properly researched because he considers that insufficient data is available, then this must be stated with an indication that the opinion is no more than a provisional one. In cases where an expert witness who has prepared a report could not assert that the report contained the truth, the whole truth and nothing but the truth without some qualification, that qualification should be stated in the report;

(f) If, after exchange of reports, an expert witness changes his view on a material matter having read the other side’s report or for any other reason, such change of view should be communicated (through legal representatives) to the other side without delay and when appropriate to the Court

(g) Where expert evidence refers to photographs, plans, calculations, analyses, measurements, survey reports or other similar documents, these must be provided to the opposite party at the same time as the exchange of reports

3.2 To do all such other lawful things as are incidental to, or conducive to, the attainment of the object mentioned above

4.1 Membership of the Association shall be open to any agency or any organisation carrying out the business of sourcing and providing medical reports for use in litigation (any such body being called in this Constitution an “Eligible Organisation”) and which the Management Committee is satisfied meets the following conditions or should be admitted pursuant to paragraph 4.3:

4.1.1 it has been trading for a period of three years;

4.1.2 it has a minimum turnover of 12,000 medical reports per annum;

4.1.3 it makes use of a minimum of 500 experts nationwide, of all medical disciplines

4.1.4 it has a minimum of ten clients which are not associated organisations of it;

4.1.5 it has its registered office or principal place of business in the United Kingdom;

4.1.6 it has been recommended by at least 3 members of the following organisations: Motor Accident Solicitors Society (MASS), the Association of Personal Injury Lawyers (APIL), the Forum of Insurance Lawyers (FOIL);

4.1.7 it is willing to accept the AMRO Constitution and to comply with the AMRO Protocol;

4.1.8 It is willing to conduct its business in accordance with the Civil Procedure Rules and the Personal Injury Protocol from time to time adopted.

4.1.9 it is willing to provide a representative to attend a minimum of one meeting per annum

4.1.10 it acts independently of solicitors and insurers.

4.1.11 it will lodge with the General Secretary each year audited abbreviated accounts as soon as is practicable after the relevant Members end of accounting period. It will also provide to the General Secretary by 30 April in each year a statement confirming that the provisions of the AMRO Protocol and Constitution are being followed.

4.2 In determining whether or not any Eligible Organisation meets the above conditions the
Management Committee may require such evidence of compliance as they consider appropriate and where they consider it necessary shall consider the spirit and intent of the conditions. In this Constitution unless the context otherwise requires “Member” or “Member Organisation” refers to any organisation which is for the time being a member of the Association

4.3 The Management Committee may in their absolute discretion admit as a Member any Eligible Organisation which in the opinion of the Management Committee furthers the objects of the Association notwithstanding that the Eligible Organisation fails to satisfy any or all of the conditions set out in paragraph 4.1

4.4 Should the circumstances of a Member Organisation at any time so change that in the opinion of the Management Committee it would not satisfy the requirements for membership if it were to apply at that time for membership the Management Committee may in its absolute discretion suspend or terminate its membership. The Management Committee may require such evidence of continued compliance with the requirements of membership as they consider appropriate and the Members shall lend all such reasonable assistance to the Management Committee in connection with such purpose.

4.5 Subject to Clause 18 any Eligible Organisation which wishes to be considered for membership of the Association shall submit an application to the Honorary Chairman. The application shall be considered by the Management Committee at the Management Committee’s next meeting. Following the receipt of such an application the Management Committee shall advise members of the applicant’s details and indicate whether or not the Management Committee propose to accept the application before determining whether or not to accept such application

4.6 The decision of the Management Committee shall be final and they shall not be obliged to give any reason for their decision

4.7 Immediately upon being admitted to membership the Member Organisation shall pay within 14 days its first subscription and joining fee

5.1 There shall be an Honorary Chairman, Honorary Vice-Chairman Honorary Treasurer and Honorary Secretary (“the Officers”) who shall be appointed by the Members immediately following the adoption of this Constitution and thereafter shall be elected annually by the Association at the annual general meeting and who shall hold office until the next following annual general meeting when they shall retire from office. The office of Honorary Chairman shall not be held for more than two years consecutively. The other elected Officers shall be eligible for re-election. Candidates for office must be Officers or employees in a Member Organisation. Any office other than Honorary Chairman may be held jointly.

5.2 Officers will at all times act in the best interests of the Association and in particular ( but without thereby limiting this obligation) shall not use their office or Membership of the Association to seek to promote the separate interests of their own organisation

5.3 Members shall bear the costs of their representatives attending Management Committee Meetings

6.1 The Management Committee shall comprise of the Officers as appointed by the Members from time to time in accordance with Clause 5 of the Constitution together with the retiring Honorary Chairman who has retired from office pursuant to Clause 5 (“the Retiring Chairman”) and such additional representatives of the Eligible Organisations as the Members shall determine. The Retiring Chairman shall only be a member of the Management Committee until such time as the existing Honorary Chairman retires from office at which time, such person shall become the Retiring Chairman.

6.2 The Management Committee shall meet as and when required providing that all the members have been given more than 48 hours notice of the proposed meeting. Four members of the Management Committee shall constitute a quorum.

6.3 Each member of the Management Committee shall be entitled to one vote and the Honorary Chairman or in his absence the Honorary Vice Chairman, in the case of equality shall have second or casting votes

7. At every general meeting 4 Members or a majority of all Members entitled to attend and vote at general meetings shall form a quorum. Each Member shall have one vote, and except in the cases otherwise specifically provided for by this Constitution, all questions shall be decided by a majority of the Members present and voting whether in person or by proxy, and the Honorary Chairman or in his absence the Honorary Vice-Chairman, in case of equality, shall have a second or casting vote

8.1 The Association shall in each year hold a general meeting as its annual general meeting in addition to any other meetings in that year and shall specify the meeting as such in the notices calling it. At least 21 clear days’ notice of every annual general meeting shall be given

8.2 At the annual general meeting the report of the Management Committee and the accounts of the previous year shall be considered; the Officers and other elected Members of the Management Committee for the following year shall be elected; and such other business shall be transacted as the Management Committee thinks fit. All general meetings other than the annual general meeting shall be called extraordinary general meetings

9.1 The Management Committee may, whenever it thinks fit, and it shall upon a requisition made in writing by any 3 or more of the Members or by Members representing not less than one-fifth of the total voting rights of all Members at the date of the requisition, whichever shall be the less, convene an extraordinary general meeting by giving at least 14 days’ notice

9.2 Any such requisition shall set out the object of the meeting proposed to be called, and shall be forwarded to the Honorary Chairman

9.3 On receipt of such requisition the Management Committee shall proceed to convene an extraordinary general meeting; if the Management Committee does not proceed to convene the meeting within 21 days from the date of the requisition, the requisitions or any 3 Members may themselves convene such meeting

10.1 The Management Committee may if it deems necessary appoint an auditor and any such appointment shall be confirmed at the next following annual general meeting

10.2 The Honorary Treasurer shall keep an account of the income and expenditure of the Association and of its assets and liabilities and shall submit such accounts at the annual general meeting

10.3 The bank account shall be in the name of the Association and withdrawals shall be made on the signature of the Officers in accordance with the mandate from time to time agreed by the Management Committee.

11. Every Member shall pay to the funds of the Association an annual subscription at such times and according to such scales as shall from time to time be determined by the Management Committee

12.1 Any Member who does not comply with the provisions of the Constitution including the AMRO Protocol may forfeit membership and be struck off the roll of Members by resolution of the Management Committee

12.2 Any Member who shall not have paid his subscription or any special levies for three calendar months after the same shall have become due may forfeit membership paid and be struck off the roll of Members by resolution of the Management Committee

12.3 Any Member struck off the roll of Members in accordance with Clause 12.2 shall be eligible for re-admission on payment of all arrears due from the Member

13. The Management Committee may unanimously and for good reason terminate the membership of any Member PROVIDED THAT the appointed representative of the Member Organisation concerned shall have the right to be heard by the Management Committee before a final decision is mad

14. Minutes of the proceedings of every general meeting of the Association and of every meeting of the Management Committee shall be recorded in a minute book or books to be kept for that purpose, and be signed by the Chairman of that or the next following meeting

15. The Constitution of the Association including the AMRO Protocol and the AMRO Mission Statement may be amended by the agreement of a two-thirds majority of the Members in general meeting subject to notice of the change having been given to the Members at the same time as the general meeting is convened. Alternatively, the Constitution of the Association the AMRO Protocol and the AMRO Mission Statement may be amended by the agreement of a two-thirds majority of the Members in a postal ballot

16. Members of the Association shall be entitled to use on their stationery any logo adopted by the Association from time to time. Use of such logo other than on stationery must have the prior written consent of the Management Committee

17. All the costs of and incidental to the preparation and execution of this Constitution and any further documents necessary to carry it into effect shall be paid out of the subscription monies and joining fees

18. The first Members of the Association be those who have completed an application form and whose signatures appear at the bottom of this document shall be “Founder Members ”
This Constitution was adopted on the date mentioned above by the persons whose signatures appear at the bottom of this document

Medico-Legal Reporting
Doctors Chambers Limited
Mobile Doctors Ltd
Micrah Services Ltd

Signed ____________________
Name _____________________
Position ___________________
For Mobile Doctors Limited

Signed ____________________
Name _____________________
Position ___________________
For Personal Injury Medical Services Limited

Signed _____________________
Name ______________________
Position ____________________
For Doctors’ Chambers

Signed _____________________
Name ______________________
Position ____________________
For Micrah Services