What Happens If Experts Disagree in Clinical Negligence Claims?

Expert evidence lies at the heart of many clinical negligence claims. Whether the issues relate to delayed diagnosis, nursing care, surgical decision-making, or long-term prognosis, the court relies on expert witnesses to explain complex clinical matters and provide independent opinions on the standard of care.

However, expert witnesses do not always reach the same conclusions.

In fact, disagreements between experts are a common feature of clinical negligence litigation. Medicine is rarely black and white, and experienced clinicians can sometimes hold differing, yet reasonable, opinions about the same set of facts.

For solicitors, expert disagreement does not necessarily indicate a weak case. Instead, it is often part of the normal litigation process. Understanding why experts disagree, how those disagreements are managed, and how the court ultimately resolves them is essential for effective case preparation.

This article explains what happens when expert witnesses disagree and why independent, well-reasoned expert evidence remains central to successful clinical negligence claims.

Why do expert witnesses disagree?

Healthcare is a complex and evolving profession. Clinical decisions are often made under pressure, with incomplete information and multiple treatment options available.

As a result, two experienced clinicians reviewing the same medical records may legitimately reach different conclusions.

Disagreements commonly arise because experts may differ in their interpretation of:

• The appropriate standard of care

• The significance of clinical findings

• Whether earlier intervention would have altered the outcome

• The interpretation of national guidance or local policies

• The likely cause of a patient's injury or deterioration

Importantly, disagreement does not mean that one expert is necessarily wrong. The court recognises that responsible differences of professional opinion can exist.

The key question is whether each opinion is supported by sound reasoning and evidence.

Disagreement often reflects the complexity of the case

Clinical negligence claims frequently involve patients with multiple health conditions, evolving symptoms, or lengthy treatment pathways.

For example, a patient admitted with sepsis may have presented with subtle symptoms that developed over several hours. One expert may conclude that earlier recognition was reasonably achievable, while another may believe the presentation was sufficiently atypical that no reasonably competent clinician would have diagnosed sepsis sooner.

Similarly, in nursing cases, experts may disagree about whether observations were adequate, whether escalation should have occurred earlier, or whether staffing pressures influenced the standard of care.

These differences are often rooted in clinical judgement rather than factual disputes.

This is why courts place such importance on the reasoning behind an expert's opinion rather than simply the conclusion reached.

The exchange of expert evidence

Before any disagreement can be explored, each party will usually instruct their own expert or experts to prepare independent reports.

These reports should comply with Part 35 of the Civil Procedure Rules and clearly explain:

• The expert's qualifications and experience

• The factual material considered

• The relevant standard of care

• Opinions on breach of duty and, where appropriate, causation

• The reasoning supporting those opinions

Once reports have been exchanged, solicitors and counsel can identify where experts agree and where they differ.

In many cases, there will be substantial areas of agreement alongside a relatively small number of disputed issues.

Joint discussions between experts

Where proceedings have been issued, the court will often direct experts to participate in a joint discussion.

The purpose of these discussions is not to persuade either expert to change their opinion. Instead, they are intended to narrow the issues that genuinely remain in dispute.

Following the meeting, the experts prepare a joint statement.

This document identifies:

• Matters on which the experts agree

• Matters on which they disagree

• The reasons for those disagreements

Joint statements often become one of the most important documents in the litigation process because they help focus the case on the issues that genuinely require judicial determination.

It is not uncommon for experts to reach agreement on several issues during these discussions, reducing the scope of the dispute before trial.

Maintaining independence throughout the process

One of the most important aspects of joint discussions is that experts remain entirely independent.

An expert does not attend the meeting to defend the solicitor's case or negotiate a compromise.

Their duty remains firmly to the court.

A professional expert will:

• Listen carefully to alternative opinions

• Be willing to reconsider their conclusions if appropriate

• Maintain their opinion where supported by evidence

• Clearly explain the reasoning behind any continuing disagreement

This independence is fundamental to the credibility of expert evidence.

Courts are far more likely to place weight on experts who demonstrate objectivity than those who appear unwilling to engage with opposing viewpoints.

How the court evaluates competing expert evidence in clinical negligence claims

If disagreement remains after joint discussions, the court will ultimately decide which evidence it prefers.

Importantly, judges do not simply choose the expert with the most impressive qualifications or the longest CV.

Instead, they consider the quality of the evidence presented.

Factors that often influence the court include:

• Whether the expert's reasoning is logical and well explained

• Whether the opinion is supported by the clinical records

• Whether relevant guidance and accepted practice have been considered

• Whether the expert has remained within their area of expertise

• Whether the expert has demonstrated independence and objectivity

A clear, balanced report from a relatively less experienced expert may carry more weight than a poorly reasoned report from a more senior clinician.

Ultimately, the court is persuaded by evidence—not by status.

Why reasoning matters more than conclusions

One of the most common misconceptions about expert evidence is that courts focus primarily on the conclusion.

In reality, judges are often far more interested in how the expert reached that conclusion. For example, an expert who simply states that care was negligent without explaining why is unlikely to assist the court.

By contrast, an expert who carefully analyses the chronology, explains the relevant standards, considers alternative viewpoints, and links every conclusion to the available evidence is far more persuasive.

The strongest expert evidence demonstrates a logical progression from facts to opinion. This is why clear report writing and structured reasoning are such important skills for expert witnesses.

Can experts change their opinion?

Yes - and sometimes they should.

Expert opinions are based on the evidence available at the time they are prepared. As litigation progresses, additional records, witness statements, or investigation results may become available.

A professional expert should always be prepared to reconsider their opinion if new evidence changes the clinical picture. Changing an opinion in response to new information should not be viewed as a weakness.

On the contrary, it often demonstrates professionalism, independence, and a genuine commitment to assisting the court. The key is that any change must be clearly explained and supported by evidence.

What disagreement means for solicitors

For solicitors, disagreement between experts should not necessarily be viewed as a setback.

Instead, it presents an opportunity to better understand the strengths and weaknesses of the case.

Expert disagreement can help solicitors:

• Identify the issues most likely to determine the outcome

• Refine litigation strategy

• Prepare witnesses more effectively

• Focus negotiations on the genuine areas of dispute

• Evaluate the prospects of settlement

In many cases, understanding why experts disagree is just as valuable as understanding where they agree.

How Apex Experts supports high-quality expert evidence

At Apex Experts, we understand that disagreement between experts is sometimes inevitable. What matters is that every opinion we facilitate is independent, evidence-based, and capable of withstanding scrutiny.

Our network of nurse, medical, surgical, psychiatry, and allied health expert witnesses are selected not only for their clinical expertise but also for their ability to provide balanced, well-reasoned opinions.

We support solicitors throughout the litigation process by providing experts who understand the importance of:

• Independence

• Clear clinical reasoning

• CPR Part 35 compliance

• Professional communication

• Constructive engagement during joint discussions

Our focus is on helping the court understand the clinical issues—not advocating for either side.

Final thoughts

Disagreement between expert witnesses is a normal and often unavoidable part of clinical negligence litigation. Medicine involves professional judgement, and reasonable clinicians may sometimes interpret the same evidence differently.

What ultimately matters is not whether experts disagree, but how those disagreements are explained.

Courts place greatest weight on expert evidence that is logical, objective, and firmly grounded in the clinical records. Well-reasoned opinions, supported by clear analysis and professional integrity, are far more persuasive than unsupported assertions or entrenched positions.

For solicitors, understanding the expert disagreement process helps strengthen case preparation and supports informed decision-making throughout litigation. By working with experienced and independent experts, it is possible to navigate areas of dispute effectively while maintaining the credibility of the evidence presented to the court.