Concerns Rise Over Reliability of NHS Medical Records in Scotland

Concerns have been raised regarding the accuracy and reliability of the National Health Service (NHS) medical record systems in Scotland, with public services watchdogs and critics pointing to significant issues that could affect safety investigations and legal proceedings.

Patients operated on by disgraced brain surgeon Sam Eljamel have reported "significant gaps" in their medical records, stating that the information often fails to accurately reflect their care. These discrepancies will be a prominent issue in the ongoing public inquiry into Eljamel's actions at Dundee's Ninewells Hospital.

Alan Ogilvie, a patient operated on by Eljamel in 1995 and spokesperson for the Patients Action Group, described the official medical records as often not matching patients' lived experiences. "We see significant gaps where complications occurred, and narratives that seem massaged to suit the clinician's reputation rather than the patient's history," Ogilvie stated. He questioned the purpose of the system, asking, "Is the system there to record the truth, or to protect the institution? If we cannot trust the records from the past, how can we trust the lessons they claim to be learning for the future?"

The Scottish Public Services Ombudsman (SPSO) has repeatedly flagged issues with the accuracy of medical records. In a recent case, the SPSO criticized NHS Lothian for failing to conduct a Significant Adverse Event Review into a patient's death from a blood infection at the Royal Infirmary of Edinburgh. The watchdog found "concerning" gaps or incomplete nursing records, including instances where clinical notes indicated requests for microbiology reports that were not present in the patient's records.

Interconnected Systems and Data Gaps

The functioning of patient record systems and their ability to share information between NHS boards is also under scrutiny. An ongoing fatal accident inquiry into the death of two-month-old Michael Wilson at the Royal Aberdeen Children's Hospital has heard testimony about the potential impact of incomplete medical data. A doctor stated that knowledge of an inherited heart condition, previously suspected in Michael's brother's death, could have altered the decision to operate on Michael.

Sheriff Christine McCrossan commented on the fundamental nature of the medical records situation in Scotland, noting that different health boards operate computer systems that "don't seem to talk to each other." This lack of interoperability raises concerns about the seamless flow of critical patient information.

Labour MSP Daniel Johnson emphasized the importance of medical records for healthcare professionals but stressed the need for absolute clarity on their reliability when used by other public agencies, such as the Crown Office. He called for answers regarding how publicly funded bodies assess the trustworthiness of patient medical records and the protocols governing their use.

A spokesperson for the Scottish government acknowledged that accurate, complete, and accessible patient records are crucial for safe care, treatment continuity, and effective adverse event investigations. The government stated that NHS boards are responsible for their electronic patient record systems and ensuring the accuracy, security, and accessibility of clinical information. They also noted the use of national standards and data quality controls to support the reliability of these systems.

"We take the concerns raised from recent inquiries seriously and continue to engage with boards to consider findings and any recommendations for improving the reliability of patient records to support safe and effective care," the spokesperson added.