What is the Istanbul Protocol?
The Istanbul Protocol is the United Nations manual for investigating and documenting torture and other cruel, inhuman or degrading treatment or punishment. It sets standards for how a clinician examines a person, records what they find and writes it up, and it is used to support a medico-legal report in asylum and immigration claims, and in wider international human rights investigations. This article is general background information sourced from the primary materials cited below, not legal advice, and it covers a separate area of work from anything Expert Medical does.
Some people search for this document as a "medical legal report". In UK legal and medical use, the term is "medico-legal report", with the hyphen. Both phrases mean the same thing: a report written by a suitably qualified clinician for use as evidence in a legal or administrative process, rather than for treatment.
What an Istanbul Protocol report contains
A medico-legal report prepared to Istanbul Protocol standards typically records a detailed clinical history, a physical examination looking for scarring or other physical evidence, and, where relevant, a psychological or psychiatric assessment. The clinician records their findings using recognised consistency terminology, for example whether a scar or symptom is consistent, highly consistent or not consistent with the account given. Because the person is often describing a traumatic experience, this work also depends on informed consent, confidentiality, appropriate interpreters and safeguarding around the risk of retraumatisation.
In a UK asylum claim, this kind of report is typically commissioned by an immigration solicitor or another legal representative, and it may be submitted to the Home Office or the First-tier Tribunal (Immigration and Asylum Chamber) as part of the claim. The Protocol is also used outside any single country's asylum system, in broader international human rights investigation and documentation work.
Is the Istanbul Protocol legally binding?
No, it is not legislation. Home Office guidance says that where a report documents medical evidence of torture, the clinician should use a recognised standard and framework, and gives the Istanbul Protocol as an example; the guidance describes it as guidelines rather than a fixed checklist. In one Supreme Court case, the court said an expert asked to investigate an allegation of torture should treat the Protocol as carrying authority comparable to the tribunal's own practice direction on expert evidence, for that kind of case. Whether any individual report is given weight is still decided by the Home Office or the tribunal, on the facts of the case.
How this differs from a personal injury medico-legal report
A report for a road traffic accident, workplace injury, clinical negligence or public liability claim, the kind Expert Medical arranges, addresses causation, condition and prognosis, not consistency with a history of torture or ill-treatment. Before proceedings start, these reports are usually obtained under the relevant Pre-Action Protocol. Once proceedings are underway, CPR Part 35 and Practice Direction 35 govern the report, and a party needs the court's permission to call the expert or put the report in evidence.
For the first fixed-cost report in a low-value road traffic soft-tissue claim, the process runs through MedCo, the Ministry of Justice-backed portal. MedCo returns a random shortlist of either accredited Direct Medical Experts or audited Medical Reporting Organisations, depending on which the authorised user searches for. MedCo has no role in asylum or immigration medico-legal reports.
Expert Medical's work sits outside the Istanbul Protocol
A Medical Reporting Organisation, or MRO, arranges and administers medico-legal reports: matching an instruction to a suitably qualified expert, booking the appointment and managing records, without giving the medical opinion itself. The instructed clinician is the expert. Only the clinician examines the claimant, forms and signs the opinion, and owes the expert's duty to the court; that duty cannot be passed to the MRO.
Expert Medical Examination Ltd is a MedCo-registered MRO. Separately from that MedCo registration, our medico-legal reports work also covers workplace injury, clinical negligence and other personal injury claims under CPR Part 35. We do not provide or arrange Istanbul Protocol reports, and we do not accept asylum or immigration instructions. Anyone who needs a report in that area should speak to an immigration solicitor.
This article summarises official guidance and case law. It has not been independently reviewed by a specialist in asylum or Istanbul Protocol practice, and it is not a substitute for advice from an immigration solicitor.
Sources
United Nations Office of the High Commissioner for Human Rights, Istanbul Protocol (2022 edition). Home Office, Medical evidence in asylum claims (published guidance). KV (Sri Lanka) v Secretary of State for the Home Department [2019] UKSC 10. Civil Procedure Rules Part 35 and Practice Direction 35. MedCo, How does MedCo work (medco.org.uk).
Contact Expert Medical Examination
For personal injury or clinical negligence instructions under CPR Part 35, visit www.expertmedical.co.uk, call 0203 8233 222 or email info@expertmedical.co.uk. You can also get in touch directly.