[Yakovlevs]

Esteemed forumites,

The NHS appears to have lost all medical records of a patient, following her heart surgery two years ago.

I am aware that there are a number of senior IT experts on the forum and wondered if any had ever contracted for the NHS and might therefore have some insight into how to set about tracking these missing records down. Presumably they must be in the system somewhere?

Most grateful for any thoughts on the matter.

[Flyin'Dutch']

Hospital record or GP record?

[Yakovlevs]

Sorry, should have been clearer. It was the hospital records following surgery at Southampton.

[Flyin'Dutch']

Hospital records are for a large part paper only - so if they are lost they may well be lost.

GP records are mainly electronic and as such not subject to loss; it may not help an awful lot but the GP would have had letters from the Hospital detailing diagnosis, plan, Operation done (if applicable) follow up and discharge.

Hope that is helpful.

[johnm]

With grateful thanks to Tony Blair, NHS IT managers of the 1990s and their disastrous and expensive NPfIT without which all patient records would have been electronic and shared between hospital and GP.

(sorry I just couldn't resist )

[PeteSpencer]

They're not lost, just temporarily uncertain of their position.
In my personal experience lost paper hospital NHS notes were always somewhere, but usually not tracked out to an individual: i.e. temporarily 'borrowed' then forgotten in a peripheral clinic in a cottage hospital miles from anywhere, swhere a follow up appointment took place,or in the boot of a Consultant's car.

Or the registrar has borrowed them for a case write-up.

They are somewhere: you/hospital records need to indulge in a little lateral thinking.

Your strongest ally is the Secretary of the Consultant who was treating the patient. Medical Secretaries can work miracles.

Good luck

Peter

[Dodo]

Back in 1974, before starting medical school, I had a vacation job working in the medical records department of a local hospital looking for misfiled records so that they could be correctly filed, and for records of patients who had not been seen for more than 10 years so that they could be archived. I wonder how much has changed.

[Pete L]

Was the patient at multiple hospitals or clinics? If so likely to be a transfer issue as above. The NHS used to use that for queue management when they knew they weren't going to meet a target. I think that practice has mostly been stopped.

What should also be on line is all of the recent correspondence, meant to be duplicated to the patient's GP. Any records of clinical procedures are likely to be in a computer system as well, as will prescriptions. Records meant to be kept for up to 12 years in most hospital systems. So even if lost, a fair amount of the history could be reconstructed.

[PaulB]

Sorry, should have been clearer. It was the hospital records following surgery at Southampton.

Depends what you want.... parts will certainly be electronic but parts may be paper.

Lab results, radiology (CT, MRI, X-ray, ultrasound etc) will almost certainly be electronic (including reporting for radiology). Prescribing will probably be electronic as will letters (of referral and to & from GPS)

Depending on the Trust, other bits may be electronic too....

There will also be a paper record that contains the bits thrust aren’t electronic, and as others have said, they will be somewhere but the their actual location and the location that the casenote tracking system says will be different, probably down to human error.

As someone suggested above, the consultant’s secretary should be the first port of call.

[Jim Jones]

the consultant’s secretary should be the first port of call.

Just for information, the pay scale for the above crucial staff member...

Band 3

Point 6 £16,968
Point 7 £17,524
Point 8 £18,157
Point 9 £18,333
Point 10 £18,839
Point 11 £19,409
Point 12 £19,852

[PeteSpencer]

My secretary and her colleagues were upgraded to PA pay scales in the late 90s in recognition of the massive extra work they undertook apart from just typing letters.

Her radar-like sixth sense found many a set of lost notes by painstaking checking of dates, personnel and appointments.

As I said above:

Your strongest ally is the Secretary of the Consultant who was treating the patient. Medical Secretaries can work miracles.

Peter

[Jim Jones]

Medical secretary jobs, for hospital consultants, are being advertised at those rates today.

[Genghis the Engineer]

I don't have a solution, but a comment.

A few years ago I went to my GPs for a travel vaccination, they offered me a printout of all my vaccinations, which I accepted with thanks and took home. It missed out about 40% of all the vaccinations I've had - all with the NHS.

So I went back to the GPs and said "can you do something similar with my medical records" - eventually they grudgingly said that they could do a printout of my NHS medical records - which I arranged, and took away.

Not just about 40% of my vaccination records were missing, but so were several operations, two emergency admissions, and a known allergy.


So I sorted myself out with a medical records book - several are on the market, mostly but not all aimed at the USian market and with the help of the NHS printouts, some old diaries, childhood vaccination records my parents had in a box, and so on I built my own, rather more comprehensive set of records. They live at home in a book, my family know where it is, I take a photocopy of the most critical bits with me when I travel abroad.

Maybe it's the anally retentive aeronautical engineer in me, but if my aeroplanes have logbooks, and the NHS is unable to keep comprehensive and accessible medical records for me - I'll just have my own logbook.

So now do most of my extended family, after my experiences. My brother in particular has lived in two countries and had major medical treatment in a third, and his kids have lived in two countries. Maintaining your own / family records in the modern and mobile age may be for the foreseeable future the only way to guarantee having such records. No medical professional inside or outside the NHS has objected to helping ensure it's filled out.

As I see it, the NHS is extremely good at reactive medicine, but we owe it to ourselves to ensure we have medical records where these are important - not trust to the 1940s "cradle to grave" ethos, however laudable that is in principle.

G

[Sooty25]

the consultant’s secretary should be the first port of call.

Just for information, the pay scale for the above crucial staff member...

Band 3

Point 6 £16,968
Point 7 £17,524
Point 8 £18,157
Point 9 £18,333
Point 10 £18,839
Point 11 £19,409
Point 12 £19,852

Part time post?

[PaulB]

Band 3

Point 6 £16,968
Point 7 £17,524
Point 8 £18,157
Point 9 £18,333
Point 10 £18,839
Point 11 £19,409
Point 12 £19,852

Part time post?

Many are part time and will be paid pro-rata - the above are full time rates.