On 1 October 1996 a judge-led medical negligence litigation pilot scheme became operational in Birmingham County Court.

It is intended to speed up cases as well as providing an affordable remedy in what are notoriously expensive areas to litigate.

The pilot was inspired by Lord Wo olf who said in his final report: 'It is in the area of medical negligence that the civil justice system is failing most conspicuously to meet the needs of litigants in a number of respects.'The scheme is available for all medical and dental negligence claims where the value of the claim is likely to exceed £1000, but does not exceed £10,000 (or is limited to that figure), and there is to be one plaintiff and one defendant.Issues must be capable of resolution in a trial lasting no more than two days with no more than two expert witnesses per side.

Thus the pilot is suitable for cases of modest value, uncomplicated by multiplicity of parties, in which there are a small number of areas of controversy between experts.

Cases with added complications are unlikely to be suitable for resolution within the scheme.The scheme is characterised by:-- A voluntary opt-in by both parties-- A pre-issue protocol requiring that clear and concise details of the claim are given to the defendant-- A waiting period before process can issue to give the defendant time to investigate the matter, make admissions and offer to settle-- The listing of a case management hearing (CMH) automatically on issue of proceedings and the need for a fully pleaded defence to be delivered well before that hearing-- Pro-active judicial involvement in ensuring that the issues are identified early-- The fixing of a final trial date before the parties leave the CMH-- Standard form directions tailored to clinical negligence claims-- A limitation on costs recoverable inter partesThe consent of both parties to submit to the pilot is essential.

Additional front end loading is placed on the preparation of the plaintiff's claim.

In exchange for this and a three-month breathing space before proceedings can be issued, the defendant must be ready to answer the claim within 28 days of issue of proceedings.Lord Woolf's draft rules on the defendant's duty to set out his or her case have been incorporated wholesale into the pilot.

At the CMH the district judge will expect to see the conducting solicitors and clients.

A final hearing date, in a three month window, 12 months on from the CMH, will ensure that cases cannot become moribund.

No pilot case will be adjourned to a fixed date.

For all parties there will be an end in sight.To satisfy the pre-issue stage, when records are requested from the potential defendants, they will be asked to confirm whether, if the case proceeds and turns out to be eligible, they will submit to the scheme.

When a pilot case is given the green light by the expert the plaintiff must provide:-- a letter of claim supported by a synopsis of the case on breach of duty, causation and damage, signed by the plaintiff's solicitor or his expert, and stating the name and specialism of the expert;-- a paginated bundle of the core records;-- an unpaginated bundle of unused material and a chronology of the relevant event constructed by reference to the core bundle.The plaintiff must give the defendant two months to investigate.

He or she may then issue proceedings out of Birmingham County Court not before three months after the date of the letter of claim.

Issue is by fixed date summons.

Copies of the letter of claim and supporting documents are filed.

The CMH date is endorsed and the process served promptly.

A fully pleaded defence will come in.

Hearings will be returnable before full time district judges who will have been allocated reading time.

Witness availability is agreed in advance of the CMH.

The district judge will ensure that th e issues have been identified.The defendant will identify any documents not already in the core bundle which are relevant.

A timetable based on standard directions will be fixed to allow both parties to be ready for trial one year on.

Attempted duplication of experts will attract censure.One question is whether a medical negligence case can be tried in two days -- considerably longer than the three hours mooted in Lord Woolf's issues paper.

Trials will be before circuit judges.

Listing will ensure a clean start without the intervention of other business.

Because of the selection criteria, pilot cases will not involve a multiplicity of medical specialties, issues or experts.The pilot provides that:-- The costs recoverable inter partes are limited-- Such costs are fixed rather than taxed-- Costs accrue in bands as key stages of the case are reached.Solicitor and own client costs will be open for agreement in the usual way.

Any solicitor whose predicted costs are wholly disproportionate to those recoverable inter partes will not get the job or, in the case of the defence, keep the client for long.Concern has been voiced that defendants with deep pockets may out-resource plaintiffs by over-spending on case preparation, notwithstanding that only part of such costs will ultimately be recoverable.On the other hand, the costs regime assumes that the solicitors will be efficient, competent in the area of work and guided by impartial and competent experts.Early formulation and disclosure of the nature of each side's case will encourage settlement.

In the meantime, preparations for trial will have been on-going from day one, with documentation such as the chronology and core bundle being produced even before issue.

Advisers can give more certain advice on costs.At two conferences held at Warwick University the pilot was well received by potential experts.A pack consisting of: the scheme rules (including costs schedule); guidance notes; answers to frequently asked questions; standard directions and specimen documents, is obtainable from Birmingham County Court.

It will be updated from time to time to ensure that solicitors have the current version.The first cases suitable for resolution under the pilot have already been notified to defendants and are continuing to come in.

Process will not issue for some months to come.

Trials will not take place until 1998.If the obligation to set out and respond to the real issues in the case at an early stage bears fruit, then there may not be any trials.

In the meantime, this may be one of the last chances to demonstrate that our present civil litigation tools merely need honing, rather than consigning them to the waste bin.