INCORPORATING THE MICROGRAPHICS MARKET PLACE AND THE MICROGRAPHICS NEWSLETTER OCTOBER 2002
ISSN 1476-3842
ISSUE No. 10
IHRIM National Annual Conference Extract from Dr Brian Gibbons’ keynote speech Dr Brian Gibbons, Deputy Minister fo r Health in i the Welsh National Assembly opened the conference by welcoming everyone to St David's Hotel and Spa, Cardiff, he said "Having the conference in Cardiff Dr Marianne Evans, President o f IHRIM is part of a two way welcomes Dr Brian Gibbons to the IHRIM National Conference in Cardiff. process where we in Wales learn from the best practice of other parts of the UK and abroad and hopefully you will learn from us as well". The Deputy Minister went on to say "Many people will be aware of the links between Wales and the National Health Service, not least because the founder of the NHS was Nye Bevan. But in the context of today's conference on health records we should not forget the other great Welsh health service pioneer - David Lloyd George whose pre First World War Health Insurance Scheme created the initial momentum towards a public service, health care system in the UK". Dr Gibbons made reference to a novel based on early 20th century health service in the Welsh Valleys called 'The Surgery at Aberfrwdd'. It is based on the memoirs of an English doctor who came to work in Wales almost 100 years ago. Part of the new Health Insurance Scheme was the requirement to keep some form of medical record - a revolutionary idea that did not meet with much acclaim. The hero of the novel stated that in the early years they did not rigidly observe the terms of service...and ignored as an absurdity the rule that a separate card must be filled up for every new patient, stating full name, sex, address and occupation with details of the illness and treatment. So the enormous parcel of blank record cards remained undisgorged amongst empty hampers and bottles in the store room. All was well until, no doubt in an early example of Clinical Governance at work, the Cardiff HQ asked to inspect the cards that had been filled up. In desperation the doctors were forced to spend their evening hours conjuring up details to enter on the records until, at last, they were able to send a~respectable batch to HQ for inspection. For a month nothing was heard but then the message came asking for the next installment as the HQ easily expected at least ten times the number of cards submitted and asked for more care in record keeping because even in a leap year, the month of February did not extend to February 30th!I! The Deputy Minister explained that the Welsh Assembly has a commitment to the modernisation of the NHS in Wales and
that they had already published "Improving Health in Wales" which is their plan for the renewal of health services. The plan makes clear the fundamental role that Information Management and Technology has in achieving its goals, while recognising that progress is not possible w ithout the dedication and commitment consistently demonstrated by the NHS staff. Dr Gibbons said "We recognise that there are too many examples where the recording, collection, extraction and use of accurate and complete information falls well below publicly and professionally accepted standards. Shortcomings have been identified in all of the recently published major reports of care failures: Bristol Royal Infirmary, Alder Hey, the Shipman case and various publications from the Audit Commission. Michael Buckley, the NHS Ombudsman was quoted in 2001 as saying "Poor communication and inefficient record keeping are at the root of many of the problems we come across in our investigations'. The findings of these reports and the public outcry which accompanied them has focussed attention on the vital importance of information and electronic support systems to care professionals, service users and service user's representatives alike". Dr Gibbons went on to explain that he had been in the front line of delivering clinical care and knows that, without an accurate and complete care record, the best outcome for individual service users cannot be successfully achieved or subsequently audited. If we do not have the record or if we do not believe its contents, the whole basis of clinical care is thrown into doubt. He said that the cumulative knowledge contained in medical records gives us the vital information on what causes damage or promotes the health or the population as a whole, and it is this cumulative information which is at the heart of clinical audit and clinical governance, which is central to the quality of service that patients can expect when they call on the NHS. The Deputy Minister said "The full utilisation of the potential of medical records will only be achieved if we are able to fully exploit that electronic data recording and recall provides. It is easy to say but we are aware that it will not be easy to achieve. In the first instance it will rely on clinicians and support staff to input data as part of their routine practice. But this is but one step in the care process. We will create an information culture and we will need your skills and dedication together w ith a technological infrastructure to achieve this". Dr Gibbons finished his speech by wishing the delegates well over the three days and hoped that everyone would leave the conference invigorated and confident in that we are a profession to be proud of, now and in the future. IHRIM - Institute of Health Record Information & Management