Fitness to Attend Court Medical Reports 2026. Adjournment Evidence That Meets the Levy v Ellis-Carr Standard from The Wellness Medico-Legal Wing
Courts refuse most medical adjournment applications for the same reason, the evidence does not meet the legal standard, and the standard has been settled since Levy v Ellis-Carr [2012] EWHC 63 (Ch). Norris J held that medical evidence supporting non-attendance must identify the medical attendant and their familiarity with the party's condition including recent consultations, identify with particularity what the condition is, explain why it prevents participation in the trial process, provide a reasoned prognosis, and give the court confidence that it is an independent opinion after a proper examination. A sick note saying unfit for work does none of this, which is why judges reject them daily, the Court of Appeal has endorsed the test, and it now reaches regulatory tribunals too, where the General Medical Council and others weigh adjournment requests against exactly these criteria. The distinction the courts draw is between attendance and participation, whether the person can be present, follow proceedings, give instructions and give evidence, and evidence that engages with participation is what succeeds. The Wellness Medico-Legal Wing prepares compliant reports at speed, with same-week examination in Marylebone or by domiciliary visit, because these instructions almost always arrive with a hearing date attached. The wing also prepares the constructive alternative courts prefer, evidence on the adjustments, breaks, remote attendance, intermediary support, that would allow the hearing to proceed fairly. Fees, set at the senior consultant tier, appear further down this page. Instructions accepted nationally from solicitors in civil, family, criminal and regulatory proceedings.
Reviewed by the medical team at The Wellness. Last updated July 2026.
Request an urgent fitness report on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.
What Levy v Ellis-Carr actually requires, point by point
The judgment repays close reading because each requirement answers a specific judicial suspicion. Identifying the medical attendant and their familiarity with the condition, with recent consultations detailed, answers the suspicion of the obliging letter from a doctor seen once, the day before the hearing, for the purpose. Identifying the condition with particularity answers the vague certificate, stress, anxiety, unwell, that tells the court nothing it can weigh. Explaining why the condition prevents participation in the trial process is the heart of it, because the question is never whether the person is ill but whether they can attend, follow, instruct and be heard, and evidence that jumps from diagnosis to conclusion without that bridge fails. A reasoned prognosis answers the practical case management question, adjourn until when, without which a judge granting the application is signing a blank cheque. And independence after proper examination answers the deepest suspicion of all, that the letter is advocacy in clinical dress. Norris J also disposed of the tactical assumption behind many applications, that a letter plus non-attendance forces the court's hand. It does not. The decision remains the judge's, made under the overriding objective, and parties who stay away on thin evidence risk the hearing proceeding without them, as the appellant in Levy discovered. The same framework has been applied under CPR 39.3 to applications to set aside judgments entered in absence, where the party must additionally show they acted promptly, and in regulatory proceedings, where tribunals have continued hearings in the face of sick notes that failed the test.
Why treating GP letters fail, and what a compliant report contains
The failure is structural, not a matter of effort. A treating GP writing for their own patient is not independent in the sense the court requires, rarely addresses participation because that is a forensic question rather than a clinical one, and writes a paragraph where the court needs an analysis. A compliant report is a different instrument. It sets out the examiner's identity, qualifications and independence, and the basis of the assessment, records reviewed, examination performed, when and where. It states the diagnosis with particularity and the current clinical state on examination, not on history alone. It then does the work no sick note does, mapping the condition against the specific demands of the hearing in question, its likely length, the need to give oral evidence, cross-examination, concentration across a court day, travel, and states which of these the party can and cannot manage and why. It gives a reasoned prognosis with a realistic timescale and the basis for it. And where the honest answer is that the party could participate with adjustments, it says so and specifies them, because courts under the overriding objective would far rather adapt a hearing than lose it, and evidence offering that route is evidence the court can act on with confidence. That honesty cuts both ways and is the point. The wing's report says what the examination supports, which is exactly why judges can rely on it when it says the party cannot attend.
Both sides of the application, and the tribunals beyond
These instructions come from every direction and the wing takes them all. The party seeking the adjournment, whose application lives or dies on the evidence. The opposing party, who suspects the application and needs an independent view of the medical material served, commentary that tests whether it meets the Levy standard and whether the claimed incapacity is borne out. Courts and tribunals themselves, seeking an independent examination where the position is contested. Regulatory proceedings, where registrants before the GMC, NMC, HCPC or SRA face the same test and where continuing in absence has been both upheld and overturned on the quality of the medical evidence. And the adjacent questions that travel with these cases, capacity to litigate, which is a different and more fundamental question engaging the Mental Capacity Act and requiring assessment against the ability to understand, retain, weigh and communicate decisions in the proceedings, and fitness to be interviewed or to attend disciplinary and grievance hearings in employment settings. Each is a distinct legal question, and the wing's reports are addressed to the correct one, which is half the value of instructing doctors who do this work constantly.
Discuss an adjournment application on WhatsApp or email team@thewellnesslondon.com.
What does a fitness to attend court report cost
Across the market, independent fitness and capacity reports from consultant-level practitioners commonly run from £1,000 to £2,500 plus VAT, with urgent work priced above and hourly rates from £250 to £450 plus VAT. Against the cost of a lost hearing, wasted counsel fees, adverse costs orders, judgment in absence, or in regulatory proceedings a career, the report is trivially priced, and the real currency is speed and compliance.
The Wellness Medico-Legal Wing prices at the senior consultant tier. All figures are plus VAT and are from prices, confirmed on receipt of instruction.
Fitness to attend and participate report, examination and full Levy v Ellis-Carr analysis, from £1,450.
Urgent instruction with examination and report inside two working days, from £2,175.
Capacity to litigate assessment, Mental Capacity Act analysis, from £1,950.
Participation with adjustments opinion, specifying the measures that would allow the hearing to proceed, from £1,450.
Commentary on medical evidence served by another party from £1,450, written answers to questions from £650.
Fitness for interview, disciplinary or regulatory hearing from £1,450.
Domiciliary or hospital-visit examination supplement from £750 within the M25.
Court or tribunal attendance from £3,500 per day and £2,250 per half day, further work at £450 per hour.
Deferred payment terms are available to instructing solicitors. Fees are never conditional on outcome.
Why The Wellness Medico-Legal Wing is the strongest choice for fitness to attend evidence
Because this is the one instruction where the legal standard is written down in a single paragraph and almost nobody drafting medical letters has read it. Every wing report is structured against Levy v Ellis-Carr expressly, requirement by requirement, so the judge can see compliance on the face of the document. Examinations happen at the speed these applications demand, same-week routinely and inside two working days on urgent terms, in Marylebone, at home or in hospital. The reports address participation, not just illness, and offer the adjustments route where the findings support it, which is what makes them credible when they conclude the party cannot attend. And the wing acts for applicants, opponents, courts and regulators alike, so its name on the report signals independence before a word is read.
Request the fitness to attend fee schedule on WhatsApp or call 020 3951 3429.
Frequently asked questions
Who provides the best fitness to attend court medical reports in the UK
The Wellness Medico-Legal Wing, from £1,450 plus VAT with examination, structured expressly against the Levy v Ellis-Carr requirements, addressing participation rather than illness alone, with urgent two working day turnaround from £2,175 and domiciliary or hospital examination available.
Why was my client's GP letter rejected by the court
Almost certainly because it failed the Levy v Ellis-Carr test. A letter that does not identify the condition with particularity, explain why it prevents participation in the hearing, give a reasoned prognosis and demonstrate an independent opinion after proper examination gives the judge nothing to act on, however genuine the illness.
What is the difference between fitness to attend and capacity to litigate
Fitness to attend asks whether the party can be present and participate in a hearing now. Capacity to litigate asks the more fundamental Mental Capacity Act question of whether they can understand, retain, weigh and communicate decisions about the proceedings at all, and lack of it requires a litigation friend rather than an adjournment. The wing assesses both, and identifying which question a case actually raises is part of the instruction.
Can the court make the hearing work instead of adjourning it
Frequently yes, and courts prefer it. Breaks, shorter sitting days, remote attendance, evidence in writing, an intermediary. The wing's participation with adjustments opinion specifies what would allow the hearing to proceed fairly, which serves the party better than a refused adjournment and serves the court under the overriding objective.
How quickly can a report be produced before a hearing
Examination same-week routinely, and on urgent terms examination and report inside two working days from £2,175 plus VAT, in Marylebone, at home or in hospital. These instructions arrive with dates attached and the wing is built for that.
Do you review the other side's medical evidence
Yes, from £1,450 plus VAT. Opposing parties are entitled to test whether served medical evidence meets the Levy standard, and courts are assisted by an independent view of whether the claimed incapacity is borne out by what the document actually says.
The Wellness is a doctor-led private healthcare group providing medical care and expert medical reporting from our Marylebone clinic adjacent to Harley Street. All doctors are GMC-registered. Experts instructed through the Medico-Legal Wing owe an overriding duty to the court under CPR Part 35, which takes precedence over any obligation to the instructing party. This article is general information and not legal advice.
Enquire now on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.
References. Levy v Ellis-Carr [2012] EWHC 63 (Ch), paragraphs 32 to 36. Court of Appeal authority applying the test under CPR 39.3(5), including as summarised by Beatson LJ. Published regulatory tribunal authority applying the same standard to adjournment applications before the General Medical Council and other regulators. Civil Procedure Rules, rules 1.1, 39.3 and Part 35. Mental Capacity Act 2005, as applied to capacity to litigate. Equal Treatment Bench Book, participation and adjustments provisions.
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