Dr Frances Cranfield is a GP, Assistant Coroner, and a founding member of the Expert Witness Institute. With three decades of experience spanning civil and criminal courts, coroners’ inquests, General Medical Council hearings, and major public inquiries, she is one of the most experienced Medical Expert Witnesses in the country. Here, she tells us what drew her to this work, what keeps her in it, and what she thinks the profession needs to face next
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I certainly didn’t start out with the belief that I wanted a medico-legal career.
It was a case of seizing an opportunity that arose at the time. My introduction to the legal side of medicine came during my vocational training – my trainer was a coroner. When I joined my general practice after qualifying, the partners were also police surgeons, so forensic and legal work was simply part of the job from day one. Part of my training took place at Scotland Yard and I was fortunate to be mentored by some of the giants of the forensic world.
I did quite a lot of work around sexual assault victims and police work in those early years.
It was a really exciting time to be doing that kind of work because there wasn’t the structure or systems we have now. I went on to undertake further qualifications – the Diploma in Medical Jurisprudence and the Diploma in Forensic Science – and became active in committee work. About eight years into my career as a GP, I was invited to join a committee. I was the only woman in the room.
It was around ten years before I started writing reports formally.
I became an Assistant Coroner in 1999. In 1996, I was a founding member of the Expert Witness Institute – which is a privilege I reflect on with great pride. It has been remarkable to watch the Institute grow into a genuine voice for the profession.
What attracted me to Expert Witness work was the rigour and the analysis.
It is evidence-based, intellectually demanding work, and I have always been drawn to that. Writing a medico-legal report forces you to examine clinical decisions with a level of precision and objectivity that everyday practice rarely demands and in doing so, it made me a better doctor.
It also taught me a great deal about risk management.
You learn from the cases you review exactly what can go wrong in a clinical setting, and that knowledge feeds back into how you practise and how you teach. I wrote a chapter in a book on risk management in general practice and have used what I’ve learned to educate medical students, junior doctors, colleagues, and even lawyers.
And then there is the personal dimension.
Helping bereaved families get answers – understanding what happened and why – is enormously meaningful. That remains one of the most powerful motivators for everything I do, whether as an Expert Witness, an assistant coroner, or a medical examiner.
The range of cases is one of the great joys of this work.
Over my career I have worked across civil negligence cases, criminal proceedings, coroners’ courts, the General Medical Council, the Parliamentary and Health Service Ombudsman, and a wide variety of tribunals. No two cases are the same.
One of the most significant professional experiences of my career was being instructed during the Shipman Inquiry.
I was asked to review the medical records of some of Harold Shipman’s victims, to identify what might have been learned and detected earlier. That was profoundly important work with real consequences: one of the inquiry’s key recommendations was the introduction of medical examiners – a system I have since been actively involved in developing and embedding nationally.
To be involved in work of that scale and consequence – and to see its recommendations reshape the way this country learns from death – was extraordinary.
I work hard to maintain an even balance between instructions from the defence and the prosecution.
When I write a report, I try not to think about who has instructed me. Independence is everything in this work. I am trained as a Single Joint Expert, though I am rarely instructed in that capacity. In criminal trials and inquests I often find myself as the only GP Expert Witness called to give oral evidence, where the other party has decided not to call their own Expert.
There is no truly typical day, which is partly what makes this career so stimulating.
I practise as a GP on Tuesdays and Thursdays, reserving at least one full day each week for my medico-legal work. Time management is essential – the balance between clinical work, Expert Witness commitments, my coroner responsibilities, and my national college roles must be carefully protected.
On one of my Expert Witness days, I might be reviewing records against a tight two-week deadline for a short-form instruction, or working on a complex criminal case that has been with me for years.
The longest case I have handled ran for eight years, involving multiple alleged victims and a series of trials. Criminal cases can be long, emotionally demanding, and isolating – because you cannot discuss the matter with anyone. That requires real resilience. Civil cases are more often settled before reaching court; criminal cases, by their nature, tend to go all the way.
My most challenging experience was the first gross negligence manslaughter case that I worked on.
I did not know what to expect. Criminal cases are always weighty, particularly those involving alleged sexual assaults by GPs. One case kept me in the witness box for over five weeks. Intellectually and emotionally, that was testing in ways I had not anticipated.
But it shaped a lot of things that came after, in particular that preparation is vital – try to consider every possible question you may be asked – and that one party may want to discredit you as an Expert. Attempts can include a freedom of information request about your work or isolated phrases being read from your practice Care Quality Commission report. I’ve accepted that it’s just part of the job.
Ultimately, it’s rewarding to know that I’m part of the justice system of this country.
It’s important to me to help bereaved families get answers they would not otherwise have.
In many cases, a death had never been properly scrutinised. The reformed medical examiner system means families will increasingly receive those answers far sooner. That matters enormously to me.
The rapid development of artificial intelligence is the defining challenge on the horizon.
That applies to both general practice and Expert Witness work. It will affect how we approach clinical notes, how we produce reports, and how we evaluate evidence. We are already seeing it used in ways that outpace our regulatory frameworks.
We need to understand both the benefits – the speed and breadth of information it can provide – and the very real risks, including hallucinations and unverified summaries. The EWI has begun developing guidance on AI use, and that work is urgent. This is unknown territory that is developing fast, and we must get to grips with it.
We simply do not have enough Expert Witnesses in general practice.
People are not aware of this as a career option. Training opportunities have historically been limited. In my role as Expert Witness Lead Representative for the Royal College of General Practitioners, I am working to establish a special interest group to support GP Expert Witnesses and make the pathway more visible.
We also have a significant gender gap.
Around half of all GPs are women – and that is not remotely reflected in the Expert Witness population. Progress is being made, but it is slow. That is part of why initiatives like the Equal Representation of Expert Witnesses pledge matter so much.
My advice for court is straightforward: prepare.
Make sure that what you write in any report is something you can defend robustly, and that you know the evidence underpinning every opinion you express. You must also understand the legal system you are working within – whether that is the civil courts, the criminal courts, a coroner’s inquest, or a tribunal. They are different environments with different rules and expectations.
It can be daunting at first, especially when there was very little formal training available in the early years.
When I became a founding member of the EWI in 1996, the landscape looked very different. The work the Institute has done to professionalise and support Expert Witnesses since then has been invaluable, and I’m proud to have played a part in that.
If you have the skills and the knowledge, step outside your comfort zone – just make sure you never step outside your field of expertise.
Those are two very different things, and the distinction matters enormously in this work. It is a privilege, and it brings great rewards: intellectual, professional, and personal.
Balance it carefully.
I have always protected one day a week for medico-legal work and have never compromised on that boundary. You cannot serve the courts well if you are overextended.
After three decades, the thing I find most rewarding now is giving back.
Advocating for greater awareness of Expert Witness work as a career path and working to ensure the next generation of GP Expert Witnesses is supported.