Libby,

Sadly you are right. It is common knowledge (it is even referred to in the circular) that the Audit Commission and others regularly criticised the poor standard of record-keeping, especially of patient-related medical/clinical records. They highlighted lots of issues, and wrong-doers including doctors and consultants. In my experience administrative records (Finance, HR, Purchasing, Estates, etc) are generally fairly well kept, whilst they are 'active'; but retention schedules are not always applied correctly; and their archival storage often leaves a lot to be desired...horror stories of cellars, attics, and even mortuaries being (mis-)used for storage.

In the mid-late 1990s the Secretary of State for Health used to be regularly asked for updates on progress towards improvements. Parliamentary Questions  were often tabled, sometimes about individual patients. More recent events (also involving record-keeping failures by Social Services) have been reported in the Press. So, whilst there are undoubtedly good examples, there are still too many bad ones. Of course, the consequences for the patient could be dire, so the imperative to put things right should be more highly prioritised.

These were all drivers for the production of the circular. Of course, there had been earlier circulars eg: The oft quoted HC(89)20 was issued in 1989 and replaced earlier ones dating back to the 1960s, so generations of NHS Managers and staff have no excuses! As in any organisation, central policies are not always adhered to locally...and, as you said, no matter how good the guidelines are, they must be implemented, compliance monitored, and remedial action taken. But that takes resources and commitment. Local managers sometimes have to be convinced of the need, and of the business (or personal career) benefits. That is why today's RMs need to have inter-personal, communication, presentational, project-management, and other skills in addition to their professional knowledge and expertise.

Things are improving: To their credit, the DH and NHS Executive have been pro-active in publicising the circular, and in co-producing training courses and other events; and the Departmental Records Officer's team have (for many years) been offering excellent practical advice on a regular basis. And the NHS Executive has (re-)launched its electronic patient record strategy (possibly some wrong-doers had been waiting for electronic records to replace paper ones, and to remove their problem?). And many hospitals really do 'manage' their records properly.

But there is undoubtedly still lots of scope for improvement, especially in under-resourced areas. In theory the NHS is no different than any other 'business' - but, in practice, its unique culture and mix of professions, and the fact that it doesn't (really) have to turn a profit mean that it therefore lacks incentives to prioritise RM make it different. But the big issues and solutions are all the same. 

Perhaps a group of us should set up as RM consultants specialising in working with the NHS? I don't think we would ever be short of work!

Best regards, and good luck! Mike (Marsh).

-----Original Message-----
From: Libby Adams [mailto:[log in to unmask]]
Sent: mercredi, 19. février 2003 15:37
To: [log in to unmask]
Subject: Re: NHS Records management policy/strategy


I would like to add a personal note here, to say that although the 'For The
Record' circular is excellent and although it may have been sent to NHS
Trusts, it doesn't necessarily mean that it's been implemented. In my
(limited) experience, records management in the NHS often extends at the
most to medical records, while there is little or no management of the
administrative records. This is changing in some Trusts, but not in others
and highlights that along with a policy there is often a need for training
and enforcement to ensure that it is actually implemented and that
professionals are employed to lead on it.

Just a few thoughts of my own...

Libby Adams
Archivist, University College London Hospitals NHS Trust



> ----------
> From:         Marsh, Mike[SMTP:[log in to unmask]]
> Reply To:     The UK Records Management mailing list
> Sent:         19 February 2003 12:06
> To:   [log in to unmask]
> Subject:      Re: NHS Records management policy/strategy
> 
> Hi Tony,
> 
> When I was with the Department of Health I co-authored a revised circular
> (HSC 1999-053)which was issued to all NHS Trusts. See the DoH / NHS
> Executive website at www.doh.gov.uk/nhsexec/manrec.htm - or look under
> COIN (Circulars on the Internet), under Records Management. Or speak to
> Steve Wells (DH DRO, based in Skipton House, London) or his DH DRO team in
> Premier Buildings, in Nelson (Lancashire). Also contact Lorraine Nicholson
> at Manchester University, or any member of IHRIM (Institute of Health
> Records & Information Management). They regularly run seminars for NHS
> staff, about NHS & Health RM Strategies. The RMs (Medical Records/Library)
> at most large NHS Trusts are members of IHRIM. If you get stuck, give me a
> call and I will provide introductions.
> 
> Regards, Mike (Marsh).
> 
> -----Original Message-----
> From: Tony May [mailto:[log in to unmask]]
> Sent: mercredi, 19. février 2003 12:52
> To: [log in to unmask]
> Subject: NHS Records management policy/strategy
> 
> 
> Hi
> Does anyone have or know of anyone in the NHS who has developed either a
> RM
> policy or strategy. If so can you pass their details onto me or if you
> have
> one or both of these yourself could you pass them on to me direct.
> Thanks
> Tony May
> Documents Manager
> Hertfordshire County Council
> Phone: 01992 556 729
> Comnet 26729
> 
> 
> 
> 
> 
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