Expert Medical Reports Services for the Criminal Injuries Compensation Authority (CICA)

CICA is an Executive Agency sponsored by the Ministry of Justice. We are responsible for the administration of the criminal injuries compensation schemes and make payments of compensation to people who have been injured because they were the victim of a violent crime in England, Scotland or Wales. We also administer the Victims of Overseas Terrorism Compensation Scheme.

As part of the assessment process, CICA may commission expert medical reports to provide a diagnosis and prognosis to help determine whether the applicant has a qualifying injury, and the nature of this injury. Assessment may also be required to confirm exacerbation or acceleration of pre-existing conditions, whether applicants have limited capacity for work or whether the disclosure of any medical information, including the report provided may cause serious harm to the applicant. The reports provided will enable CICA to identify the correct injury award-banding and potential awards for loss of earnings.

Through this notice the Authority is looking to engage with the current market regarding this future requirement. The Supplier will undertake medical examinations and provide high quality expert reports where further medical evidence is required to support CICA’s evidence-based compensation decisions.

This includes standard cases, priority cases, tribunal-directed cases (including Appeals), and circumstances where applicants are unable to obtain specialist opinions independently. It should be noted that CICA is not referring applicants for treatment but is seeking independent expert opinion to support decision-making under the Criminal Injuries Compensation Scheme.

A significant proportion of referrals relate to psychological injury, with Clinical Psychologist reports forming a core element of the service. These assessments often support cases linked to trauma and the application of the Serious Harm Test (SHT) and must provide clear diagnosis, prognosis, and functional impact supported by robust clinical evidence.

The Supplier will be required to:

• a.Provide access to a national network of suitably qualified medical professionals, including provision for overseas applicants where required. The experts required can include but is not limited to Clinical Psychologists, Psychiatrists, Neurologists, Paediatrician, ENT surgeon.
• b.Arrange and deliver high-quality expert medical reports to support CICA in making timely and defensible case decisions, including use in appeal and tribunal settings.
• c.Ensure that where psychiatric diagnosis or prognosis is required, reports are completed by:

For overseas applicants, equivalent suitably qualified professionals must be used.

• d.Demonstrate access to an appropriate network of Clinical Psychologists, including the ability to manage increasing and fluctuating demand, and experience of working with vulnerable claimant groups.
• e.Provide both:

• f.Ensure that face-to-face assessments are conducted within 35 miles of the applicant’s home, where possible. Where this is not feasible, alternative arrangements must be agreed with CICA.
• g.Provide virtual assessments where appropriate, including where in-person assessments are not suitable.
• h.Deliver all services in accordance with Data Protection Act 2018 requirements, ensuring the secure handling of sensitive personal data.
• i.Provide and maintain a secure case management system to track the progress of reports from referral through to completion.
• j.Maintain a robust Quality Management System (QMS) to ensure consistent delivery of services that meet contractual requirements.
• k.Provide management information (MI) and performance reporting to support contract management and oversight.
• l.Deliver services in line with agreed service levels and turnaround times, which will be confirmed during the Market Engagement process.