Dr. Oliver Quick’s research included the very first study to explore prosecutorial decision making in cases involving health care professionals and informed national prosecution policy on the instruction of expert witnesses. This was important given that the very basis of liability (whether the negligence is gross) is contested and difficult to measure, and the considerable professional anxiety about the claimed negative effect of criminal law on patient safety.

Quick initially analysed how prosecutors constructed culpability in medical cases, undertaking interviews with senior prosecutors from the Special Crime and Counter Terrorism Division. He found that they relied on gut instinct and individual discretion and identified the absence of a meaningful objective system for classifying mistakes as gross. At the same time, Quick observed a strong reliance on expert evidence.

A subsequent study looked at how experts exercised their freedom to interpret key questions of culpability and causation. The research, based on first-hand accounts from those that had previously provided expert evidence in such cases, observed that experts went beyond providing medical opinion and performed tasks associated with investigators and lawyers - enjoying too much freedom in terms of applying their own tests of culpability. Quick also questioned the consistency of the process for instructing experts in the Criminal Justice System.

Lack of guidance for prosecutors and expert witnesses contributed significantly to delays in proceedings. In response, Quick was given exclusive access to Crown Prosecution Service (CPS) files on medical manslaughter cases. The resulting research, produced in collaboration with Dr Danielle Griffiths (Sussex), was the first to measure the time taken to investigate and prosecute these cases. Reducing the length of time between the patient’s death, and the formal decision about whether or not to prosecute, can significantly reduce both the stress for families of the deceased and the suspects - and the financial costs, in terms of police and prosecutorial resources.

Quick’s research has since informed the creation of new national policy and changes in the terms of reference for instructing experts. Oral and written evidence was presented to the Independent Review of Gross Negligence Manslaughter and Culpable Homicide, commissioned by the General Medical Council. The  CPS responded by significantly reforming its legal guidance in relation to gross negligence manslaughter through the creation of a 12 page document. Such detailed offence-specific guidance is highly unusual and highlighted the merits of working in collaboration with senior prosecutors at the CPS on areas not previously explored.

According to the CPS, Quick’s research helped inform    the  assurance process, ensuring experts reached decisions based on a full and accurate understanding of:

• The law;
• The considerations they were properly required to assess; and
• The factual basis upon which the prosecution case would be put.

The research has also helped shape recommendations around the need for a shared understanding of gross negligence and a reformed memorandum of understanding between key organisations working within the criminal justice system, informing the Department of Health Rapid Policy Review into Gross Negligence Manslaughter in Healthcare. This recommendation, which has been accepted by Government, will enhance the consistent application of the law by the police, prosecutors, and coroners and enhance efficient decision making in such cases.