Breach & Causation
This assessment is essential in clinical negligence litigation to determine whether a healthcare provider failed in their duty and whether that failure directly caused a psychological injury. We provide robust, court-ready reports with urgent availability for time-sensitive instructions.
Expert Type
- Consultant Forensic Psychologist
- Clinical Psychologist
- Neuropsychologist
- Practitioner Psychologist
Applicable Law
- Bolam v Friern Hospital Management Committee
- Bolitho v City and Hackney HA
- Barnett v Chelsea & Kensington Hospital Management Committee
- Civil Procedure Rules Part 35
- Mental Health Act 1983
When Needed
This assessment is essential in clinical negligence litigation to determine if a healthcare provider failed in their duty and if that failure directly caused a psychological injury.
What Is a Breach & Causation Assessment?
A Breach & Causation assessment is a specialised forensic evaluation designed to assist the court in clinical negligence claims involving mental health care. It involves a two-stage process: considering whether psychological care fell below the accepted standard of care within the instructed psychologist’s expertise (breach) and whether that failure resulted in a documented psychological injury (causation). Where the alleged breach concerns another medical or professional discipline, an appropriately qualified expert from that discipline is required.
Our experts apply the Bolam test to evaluate whether the clinician acted in accordance with a responsible body of medical opinion, as refined by the Bolitho requirement, which requires that such professional opinion be capable of withstanding logical analysis.
- Standard of Care — establishing the level of care expected from a reasonably competent psychological professional
- Breach of Duty — identifying specific instances where care fell below the required professional standard
- Factual Causation — applying the ‘but for’ test to determine if the harm would have occurred anyway
- Legal Causation — assessing whether the breach was a material cause or a significant contributory factor
- Psychological Diagnosis — formal identification of injury using ICD-11 or DSM-5 diagnostic criteria
- Remoteness of Damage — evaluating if the specific psychological harm was a foreseeable consequence of the breach.
The assessment requires a highly experienced expert witness who understands both the clinical complexities of mental health treatment and the legal framework of tort law.
We provide a clear nexus between the evidence found in contemporaneous records and the claimant’s current clinical presentation to offer an objective opinion on liability.
Key Assessment Components
Our assessment evaluates the following areas:
Record Analysis
A meticulous review of medical records to establish a clear chronology of care and identify any deviations from accepted professional standards.
Clinical Interview
A face-to-face or remote psychological examination to assess the claimant’s current mental state and history.
Breach Evaluation
Establishing causation requires demonstrating, on the balance of probabilities, that the psychological injury would not have occurred ‘but for’ the identified breach of duty, or that the breach made a material contribution to the harm where legally applicable.
Causation Mapping
Establishing the causal link between the identified breach and the development or exacerbation of psychological symptoms.
Vulnerability Assessment
Distinguishing between the impact of the breach and any pre-existing conditions or constitutional vulnerabilities.
Prognostic Opinion
Outlining the long-term impact of the psychological harm and the likely response to future treatment.
Conditions That May Affect This Assessment
A range of psychological conditions can affect this assessment. These include:
Our experts are adept at identifying how a breach may have caused a material aggravation of a claimant’s underlying psychological state.
Assessment Process
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Instruction Received
We review the Letter of Instruction and provided medical records to understand the specific allegations of negligence.
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Expert Matched
We assign a practitioner psychologist with expertise in the relevant subspecialty, such as perinatal or forensic psychology.
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Assessment Conducted
A detailed clinical interview is performed alongside a thorough review of witness statements and professional guidelines.
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Report Delivered
A CPR Part 35–compliant report is issued, clearly setting out opinions on breach of duty and causation.
Turnaround Times
| Urgency Level | Timescale |
|---|---|
| Standard Report | 4-6 weeks from assessment |
| Priority Report | 1-2 weeks |
| Urgent Report | 1-4 days |
What’s Included in the Report
Our experts provide rigorous, evidence-based reports and are available for conferences with Counsel and Court attendance.
Frequently Asked Questions
Need a Breach & Causation Report?
Contact our specialists to request expert witness profiles and transparent fee quotations. We provide CVs and detailed fee estimates for clinical negligence assessments within 60 minutes of enquiry.
Related Clinical Negligence Assessment Services
Assessment of the current state of a psychological injury and future outlook.
Expert opinion on professional conduct and adherence to psychological protocols.
Specialist evaluation of trauma-related injuries resulting from clinical incidents.
Comprehensive reports for non-clinical negligence psychological trauma.
Determining if a claimant has the mental capacity to provide instructions in a legal claim.
Preliminary review of records to identify potential merits for a breach of duty claim.