If you are a consultant or GP considering expert work, this is what it involves, why it matters, and where the time actually goes.
Things go wrong in medicine. Most of the time it is bad luck, or a bad disease, and no one is at fault. Sometimes it is a failure: a missed diagnosis, a delayed referral, a complication that should have been caught. The law lets a patient ask which it was.
Only a small fraction of patients who are actually harmed ever bring a claim. This is not a system running hot. It is a system trying to work out, case by case, whether harm was avoidable. The scale of it is easy to underestimate.
Around 14,400 new clinical negligence claims are brought against the NHS in England each year: roughly one every forty minutes. They cost £3.6bn in a single year to settle, against a total liability estimated at £60bn. The number has more than tripled in two decades, and the demand for expert opinion has grown with it.
Most claims never reach a courtroom. The expert opinion is what moves them.
A patient believes they were harmed. They go to a solicitor, who obtains the records.
The solicitor cannot tell whether the care was reasonable. No lawyer can. They need a doctor.
A doctor in the same specialty is instructed. You read the records and say what you think: first whether there is anything in it at all, then, if there is, on the substance.
Most claims stop there or settle early. An honest opinion that the care was reasonable ends a case before it costs anyone anything. An honest opinion that it was not is what gets a patient answered.
An early opinion before anyone commits to litigation. Often short, often the most useful thing you do. Most claims are stopped here.
The most demanding work, and the point on which a claim usually turns.
This drives what a claim is worth. Asked in personal injury and industrial disease as much as in negligence.
Your duty is to the court, not to whoever instructed you, and that cuts both ways. A patient who was genuinely failed gets nowhere without a doctor willing to say so. A doctor who did nothing wrong is defended by exactly the same honesty: most claims are stopped by an expert saying the care was reasonable.
Not what would I do now, but should this have been done then, and what would have followed if it had. Forensic, counterfactual, and quite unlike day-to-day clinical work.
No clinic, no list, no waiting room. Your own time, your own pace, as many instructions as you want and no more.
Well paid, with far less overhead than private practice: no rooms, no privileges, no secretary, no out-of-hours. What limits most doctors is the hours each report swallows. That is the part Iuvara is aimed at.
Saying a claim has no merit is as valuable as saying it does.
A consultant or GP in active practice in the specialty the case concerns. Current practice is the foundation; subspecialty depth, research and publications add authority under cross-examination.
Anyone willing to be told, in writing, that they are wrong, and to hold their position or change it honestly.
The volume. A bundle can run to a thousand pages. Before you can form any opinion you have to read all of it, build a chronology from nothing, and tie every fact back to the page it came from.
The first one is the worst. Hours disappear into work that isn't judgement. It is why so many first reports are also last reports.
Iuvara reads the bundle, builds the chronology, and puts the source next to the text, so checking a fact is a click, not a search.
It does not form the opinion. That is yours and it stays yours — the only part of the work that actually needed a doctor.
Two hours a week is a realistic commitment. The question is whether those two hours go on reading, or on thinking.