Instructing a cardiology expert.
The panel prepares CPR Part 35 cardiology reports for clinical negligence and personal injury. This guide sets out the procedural steps, document requirements and subspecialty selection criteria for instructing a cardiology expert witness.
- CPR 35 compliant reports
- GMC registered consultants
- NHS active clinical practice
CPR Part 35 documents to send.
A complete instruction pack lets the consultant address the clinical issue with precision. Under CPR Part 35 and the Civil Justice Council Protocol, the instructing solicitor sends the relevant clinical materials at the point of instruction.
Core documents
- Chronology A paginated timeline of key clinical events — consultations, investigations, interventions.
- Witness statements Statements from the claimant, family members or clinicians relevant to the cardiology issue.
- Medical records Complete GP and hospital records — clinic letters, discharge summaries, nursing notes.
- Imaging reports Echocardiograms, angiograms, CT coronary angiograms and cardiac MRI reports, with original images where available.
Cardiology-specific materials
- ECG printouts All 12-lead ECGs, including serial tracings where arrhythmia or ischaemia is alleged.
- Device interrogations Pacemaker, ICD or loop recorder downloads for device-related claims.
- Laboratory results Troponin, BNP, lipid profiles and other relevant blood tests.
- Updated materials Documents served after initial instruction must be flagged so the expert can review them as an addition to the original opinion.
Matching the clinical issue to the cardiology subspecialty.
Cardiology is a broad discipline. Instructing a general cardiologist for a subspecialty issue risks an opinion the defendant’s barrister will challenge as outside the expert’s substantive practice. Panel consultants are matched to the clinical question by NHS consultant role, GMC specialist registration and recent clinical practice.
Subspecialty decision tree
Use this framework to identify the appropriate subspecialist for the case:
- Interventional cardiology Percutaneous coronary intervention (PCI), stent complications, structural intervention claims.
- Electrophysiology Arrhythmias, sudden cardiac death, pacemaker and ICD complications, ablation procedures.
- Cardiac imaging Echocardiography, cardiac MRI, CT coronary angiography interpretation.
- Heart failure Chronic heart failure management, device therapy, transplant assessment.
- Valve and structural heart Surgical or transcatheter valve interventions, infective endocarditis, structural heart disease.
- Adult congenital Adult congenital heart disease (GUCH), late presentation of childhood repairs, transition care.
- Paediatric cardiology Childhood cardiac conditions, birth-related cardiac causation, paediatric inherited disease.
- Inherited cardiac conditions Hypertrophic cardiomyopathy, long QT syndrome, Brugada, ARVC, familial sudden death.
- General and acute cardiology Acute coronary syndromes, missed MI, general cardiology presentations on the acute take.
Verifying subspecialty credentials
The expert’s subspecialty focus can be verified through:
- GMC specialist register The expert’s entry confirms subspecialty accreditation.
- NHS consultant job plan Current clinical role aligns with the case issue.
- Publications and presentations Recent peer-reviewed work in the relevant subspecialty area.
- Medico-legal experience Prior reports or court attendance in similar matters.
Confirming impartiality and scope before work begins.
Before the instruction is accepted, the panel runs a conflict check against all parties and any prior involvement. Scope is then agreed in writing, in line with CPR Part 35 and the Civil Justice Council Protocol.
Conflict check
- Parties checked Claimant, defendant, instructing solicitors and any third parties.
- Prior involvement Any previous clinical or medico-legal involvement with the claimant or defendant.
- Disclosure Any potential conflict is disclosed to the instructing solicitor before instruction proceeds.
- Court directions If a conflict arises mid-instruction, court directions are sought under CPR 35.4.
Scope of instruction
- Clinical question Precise definition of the cardiology issue to be addressed (breach, causation, condition and prognosis).
- Report type Breach of duty, causation, condition and prognosis, life expectancy, or combined report.
- Document review Confirmation of the materials to be reviewed and any exclusions.
- Timetable Agreed deadlines for draft and final report delivery.
Draft, review, final delivery.
The consultant prepares the report in CPR Part 35 structure — issue, materials reviewed, reasoning, conclusions, declaration of truth. Drafts are reviewed internally for procedural compliance before delivery.
Draft report
The expert prepares a draft addressing the agreed scope. The instructing solicitor may provide feedback on factual accuracy or procedural compliance; substantive changes to the expert’s opinion are not permitted under CPR Part 35.
Internal review
Every report is reviewed internally for compliance with CPR Part 35, Practice Direction 35 and the Civil Justice Council Protocol, including verification of the declaration of truth.
Final report
The final report is delivered electronically to the instructing solicitor with a signed declaration of truth. The original is retained for future addenda or court use.
After the report: CPR 35.6 questions and joint statements.
Under CPR 35.6 the opposing party may put written questions to the expert within 28 days of service of the report. The consultant responds to questions seeking clarification, and may seek court directions where questions exceed the scope of the report or are disproportionate.
CPR 35.6 questions
Questions must be:
- Proportionate Seeking clarification only, not re-litigating the expert’s conclusions.
- Timely Submitted within 28 days of report service, unless varied by agreement or court order.
- Single set Only one set of questions is permitted, unless the court directs otherwise.
- Solicitor-reviewed The instructing solicitor reviews the proposed questions before they are served on the expert.
Joint statements
Where instructed as a single joint expert, or where opposing experts are appointed, joint discussions may be directed by the court. Panel consultants attend these discussions to narrow issues and prepare a joint statement.
- Agenda Prepared in advance by the instructing solicitors, focused on areas of disagreement.
- Solicitor’s role Facilitating the discussion, not directing the expert’s opinion.
- Joint statement Prepared after the discussion, setting out areas of agreement and disagreement.
Addenda and updates
Where new evidence emerges or the expert’s opinion requires clarification, an addendum may be requested. The addendum is agreed with the instructing solicitor and, where the court has directed timetable steps, the court.
Common CPR Part 35 breaches in cardiology instructions.
Non-compliance with CPR Part 35 carries real consequences — report exclusion, costs sanctions or adverse inferences at trial. The patterns below are the ones the panel sees most often.
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Incomplete document pack Missing medical records, imaging or device data leading to gaps the expert cannot address or to a report vulnerable on cross-examination.
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Subspecialty mismatch Instructing a general cardiologist for a subspecialty issue (e.g. congenital, EP, inherited cardiac conditions) leaves the opinion exposed at trial.
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Scope creep Letting the expert comment on non-cardiology issues or exceed the agreed scope of instruction.
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Unequal access to information The court may direct disclosure under CPR 35.9 where one party holds material the other does not have.
What a CPR Part 35 cardiology report contains.
Every report from the panel meets the requirements of CPR Part 35, Practice Direction 35 and the Civil Justice Council Protocol. The structure addresses the clinical issue, provides reasoned opinions and identifies the cardiology-specific evidence relied on.
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Declaration of truth The expert’s signed statement confirming the report is true to the best of their knowledge and belief.
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Sources of information A list of all documents reviewed — medical records, imaging, ECGs, device data, witness statements.
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Clinical reasoning Detailed analysis of the cardiology issue, including interpretation of ECGs, imaging and laboratory results against the contemporaneous standard of care.
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Conclusions Reasoned opinions on breach, causation or prognosis, with any uncertainties or limitations stated openly.
Send the instruction details.
Send the case essentials — clinical question, records position, deadline, funding route. The panel confirms subspecialty match, conflict-check position and proposed turnaround with the quotation the same working day.
Subspecialty-matched consultants CPR Part 35 compliant reports GMC-registered consultants