Author: Health Archives

Archives

The Neurosurgical Case Notes of Sir Geoffrey Jefferson

Posted on

By Karen Rushton, Wellcome Archivist/Curator, University Archive & Records Centre, The University of Manchester (Karen.rushton@manchester.ac.uk)

 

At the University of Manchester thanks to a generous Wellcome Trust grant we are currently working to catalogue the case files of 20th century neurosurgeon Sir Geoffrey Jefferson (1886-1961). Jefferson was the UK’s first Professor of Neurosurgery who spent most of his career at the Manchester Royal Infirmary (MRI).

 

The case files we hold cover Jefferson’s time working at the MRI between 1927-1940 on a wide range of neurological disorders including brain tumours, epilepsies, neuralgias, head injuries, and congenital spinal deformities. We also see references to lingering war injuries from WWI, occupational and traffic accidents, neurosyphilis, and the use of surgical and diagnostic techniques later considered to be controversial. The files themselves contain a number of record types including detailed case notes and accounts of surgery, correspondence, x-rays, and both clinical and pathological photographs.

Neurosurgery lecture, with Sir Geoffrey Jefferson on the back row second from the left & Norman Dott on the second row from the back on the left, n.d. ref: JEF/1/10/3

 

Going into the project the first major decision centred on what information we wished to record. The Lothian Health Services Archive in Edinburgh have recently completed a similar project centred on the case files of neurosurgeon Norman Dott (1897-1973) and so it was very helpful to be able to talk to staff there about their approach to the records. Most importantly we recognised that the Jefferson collection is one of a number of neurosurgery collections held across the country and it was important to recognise its part in a wider research web and so make our catalogue comparable to that of the Dott Collection.

 

When dealing with relatively modern patient records considerations surrounding data protection were paramount and procedures are in place to produce a public facing catalogue with all personal information removed and a complete catalogue for use in-house and to be accessed by approved researchers. MeSH has been employed throughout for indexing purposes and provides an invaluable tool for selecting files based on conditions and symptoms. It is here where expert advice from a neurologist based within the University has aided us in creating accurate indexing terms and updating old-fashioned terminology. However, the major barrier with MeSH has arisen regarding the potential indexing of surgical procedures. As a neurosurgeon rather than a neurologist the procedures that Jefferson performed were seen as being a very important factor in the descriptive content of the catalogue, but whether or not it was appropriate to index them or not was another matter. As a thesaurus of modern medical terminology MeSH essentially is not fit for this purpose. Whilst old-fashioned terms for conditions can be updated there is no appropriate terminology for now obsolete surgical procedures such as the frontal lobectomy.

 

Having worked on other medical case note projects in the past, namely the Stannington Project at Northumberland Archives dealing with children’s TB files, I was well prepared for the kinds of challenges we might encounter. Nonetheless there is an inevitable variation in the content of the records and in turn the approach to outreach activities and potential researchers. As all the Stannington files related exclusively to children many of the former patients were still alive meaning we were fortunate enough to be able to interact directly with subjects of the records. Equally the subject of TB feeds very well into existing narratives on public health and has many links to social history. Neurosurgery on the other hand is much less overtly approachable to those with a non-scientific or medical background and it is here where interpretative events and blogs have been essential in drawing out less obvious themes and material such as the possibility of the use of visual material in the files by artists working in the medical humanities.

 

Illustration of a brain aneurysm by Dorothy Davison, c.1940s, ref: uncatalogued

 

The cataloguing process is nearing completion but conservation and outreach work will be on-going as the project continues. As part of the Wellcome funding we will also be tackling several other medical collections including the work of 20th century medical illustrator Dorothy Davison, medical artwork from the teaching collections of 19th century obstetrician Thomas Radford, and papers relating to the pioneer of the artificial hip Sir John Charnley.

Guest Post

New NHS Code of Practice on Records Management

Posted on

Laura Hynds, records manager working within the NHS, January 2017

During 2015/2016 Daniel Scott-Davies and I, on behalf of the Archives and Records Association (ARA) were involved in the revision of the NHS Code of Practice on Records Management, last revised in 2009. The revised Code of Practice was written by the Information Governance Alliance (IGA) and can be found at the following link: https://www.gov.uk/government/publications/records-management-code-of-practice-for-health-and-social-care. The previous Code of Practice and associated retention schedule have now been withdrawn.

 

The NHS Code of Practice on Records Management is the key guidance document for those working at all levels in the health sector regarding records retention periods and records management. It is used as the basis for organisational policies on the subject and provides guidance to organisations on the transfer of Public Records to a Place of Deposit – these are records identified with continuing value which should be in the care of professional archivists.

 

Whilst the archives community has had significant involvement in the major revision of the 2006 Code, the first draft that was viewed by the ARA of the new code was far from best professional practice – in particular the retention schedule. Along with my colleagues, I had serious concerns about the number of categories with retention actions of ‘destroy’, the lack of consideration for records which should be reviewed for long term archival retention and inconsistencies with legislation. Following this initial review of the document, Daniel and I decided that the ARA needed to be more involved in the process.

 

It took a formal letter from the CEO of the ARA addressed to the chair of the IGA, copied to several senior stakeholders including Dame Caldicott and MPs, for our concerns to be taken seriously and for us to be added to the working group for the revised code. Once we were more formally involved, a good working relationship between the ARA and the IGA developed which will be useful to draw upon in the future. Working together, we negotiated many changes to the document which at times was challenging. Many of the changes that were made were linked to the input of archivists for the 2006 Code.

 

Whilst the published version of the code is not perfect, the document was at a stage where it could be endorsed by the ARA and is a much stronger document than it was back in the summer of 2015. The first part of the published code provides up to date guidance on a range of record keeping issues from records storage to digital continuity and there is a new, useful section on dealing with specific types of records. These range from prison health records to records created by social media and websites.

 

The area where the ARA has had the most input has been the records retention schedule. This now includes right at the start a message regarding recordkeeping and the Independent Inquiry into Child Abuse. Retention periods for clinical research trial records have changed in line with European Regulations. The disposal actions of several record categories have also been updated. If you work within the health sector or acquire records from the health sector into an archive, it is definitely worth reviewing your own policies in line with the new guidance – something we are doing at present.

 

The retention schedule is shorter than the previous one and we have concerns in particular over the length of the section on pharmacy records as this is an area that produces large amounts of significant records within many NHS organisations, particularly hospitals. The schedule at least now links to somewhere where additional guidance can be found. We also continue to be concerned over the guidance on maintaining electronic patient records held in systems. Both of these issues will hopefully be considered with the first annual review of the code in July 2017.

 

On the NHS Digital website, it is now possible to provide feedback on the Code of Practice prior to the annual review. The link to provide feedback can be found here: https://nhs-digital.citizenspace.com/information-governance-alliance/records-management-code-of-practice-2016-feedback/. One of our concerns with the initial revision of the code was the lack of representation from the Royal Colleges. Due to the regular review cycle the document will continue to be worked upon and developed so please feedback any concerns you may have from a recordkeeping point of view. Daniel and I are also happy to raise concerns and advocate for those within the profession regarding the code of practice as well as other issues regarding recordkeeping within the NHS.

News

Exhibition to commemorate the centenary of the Royal Masonic Hospital

Posted on

Thought that members of the Health Archives and Records Group might like to know about our current exhibition, Healing Through Kindness, which commemorates the centenary of the founding of the Royal Masonic Hospital. For further details see: http://freemasonry.london.museum/event/exhibition-healing-through-kindness/

The exhibition will be open Monday to Friday 10am until 5pm until 7 April 2017.

Opened as a hospital for war casualties in 1916, it was conceived originally as a hospital for freemasons in 1911. The First World War led to a change it plans and the freemasons offered to run the facility for the War Office if that government body found it suitable premises. The former Chelsea Hospital for Women was secured and the freemasons met all the running costs for the Freemasons’ War Hospital at 237 Fulham Road, Chelsea. It proved so successful that a second hospital was established at Fulham Palace in 1917 and a convalescent facility in Caversham, Berks as well.

After hostilities ceased the Hospital re-opened as the Freemasons Hospital and Nursing Home in 1920 and treated freemasons, their wives and children. This was before the formation of the National Health Service, when private nursing or hospital admittance was expensive for those on average incomes but public charitable hospitals offered limited, basic care.

Funds to maintain and finance the Hospital were raised by members and it proved so successful that a new, purpose-built Hospital with over 200 beds was opened in premises at Ravenscourt Park, Hammersmith in 1933. Opened by King George V and Queen Mary, the new building was known as The Royal Masonic Hospital.

The Wakefield Wing opened in 1958 with new operating theatres, wards and a nurse training school. Nurse training began in 1948 in the hospital basement until the purpose-built school and nurses home opened. Nurses who qualified at the Hospital wore a special silver belt buckle and were well-regarded within medical circles for their expertise and training. The Percy Still Wing, named after one of the founders of the Hospital, opened in 1976, providing state of the art operating theatres and a new pathology laboratory.

Freemasons contributed to care according to their means or was funded by the Hospital charitable funds. By the 1980s the Hospital accepted non-Masonic private patients as freemasons explored private medical treatment locally or chose NHS treatment. A series of Masonic reports recommended closure of the Hospital and support of local treatment for members requiring medical care. Despite these recommendations, the Hospital remained a popular cause among members and the Hospital continued to offer innovative services, such as Neurolinguistic Therapy and a private IVF Unit run by Robert Winston and Raul Magara during the 1980s-1990s. However, rising medical and service costs led to the closure of the Hospital in 1996.

The exhibition draws on the archives of the Royal Masonic Hospital which are now catalogued to item level, with details included in our on-line catalogue, reference: GBR 1991 RMH – see http://freemasonry.london.museum/catalogue16.php

Workshop

Open source archive software: a report on National Archive’s workshop on ATOM and Archivematica

Posted on

By Geoffrey Browell, Head of Archive Services, King’s College London 

 

I co-organised a workshop in early December at The National Archives (TNA) on ATOM and Archivematica software, along with TNA’s Higher Education Archive Programme  and Artefactual Systems, the Canadian development company which supports both these applications.

The workshop was attended by around 40 archivists and records managers from around the UK, including existing or prospective users of the systems and those simply interested in learning more.

ATOM’s development was supported by the ICA and it is used across the world to manage and publish descriptions of archives. Archivematica manages digital preservation workflows for digitised and born digital content.

Key questions/points that inspired the day included:

  • Examples of the real application of Archivematica – how difficult is it to customise and how easy is it to use?
  • Do regional consortia offer the best opportunity for the application of digital preservation?
  • How can data on other systems such as CALM be imported into ATOM?
  • How is training best delivered?
  • How will these open source systems be best supported given the limitations of institutional IT?

 

The day began with an introduction and overview of both systems from Artefactual’s Justin Simpson and Dan Gillean. Their slides are available here.

There were then a series of five/ten minute presentations from invited speakers. Gary Tuson, County Archivist at Norfolk Record Office (NRO), spoke eloquently about the Eastern Region Archivematica trial that saw a number of archives in that Region, led by NRO, use Archivematica for digital preservation. He offered real encouragement that a regional model might help, although it was only a small-scale trial. Archivematica, unlike ATOM, is not available with multi-tenanted functionality. This places some limitations on the creation of a genuinely collaborative initiative and more work needs to be done to assess the viability of consortia – perhaps involving trials in other regions such as London.

Lindsay Ould, Borough Archivist at Croydon, described her experience of migrating elderly CALM data into a new instance of ATOM. Their existing CALM system was used by Archives, Museums and Local Studies, meaning that the style and structure of data was very diverse and often unclean and out of date. More than 1000 collection and accession records were migrated to a new hosted version of ATOM. Lindsay described working with an external developer to cleanse the data and she pointed out that this took up a disproportionate amount of time. Lastly, she spoke about developing a simple search interface and future plans to also make museum descriptions visible.

David Cordery, of Max Communications, was next up and spoke about the challenges of migrating data into ATOM, similar to those which Lindsay had experienced. He stressed the usability and intuitive controls provided by ATOM, but also the ability for users to customise the front end delivery of archive data and that the system is especially useful when managing images. Max provides a service to extract, clean and re-publish data in new ATOM instances and offers ongoing support.

Jenny Mitcham of York spoke next on the use of Archivematica to manage research data – a proof of concept joint venture between the Universities of Hull and York, The National Archives and JISC. Research data management is a big challenge for universities, as it is a requirement of the Research Councils that such data, for example generated by scientific research, be preserved and managed for a time. Jenny highlighted the concept of ‘parsimonious preservation’ coined by Tim Gollins of The National Archives – essentially doing ‘just enough’ to capture the right information in digital preservation, and avoiding unnecessary processes. Jenny listed a number of pros and cons of using Archivematica, including its versatility, flexibility and ability to integrate with other systems, versus its fiddly processes, unsophisticated user interface and the need to train staff to use it. This impressive project is now hoping to move to a production phase and bring on board the Borthwick Institute and integrate Archivematica more fully with ATOM. Much more information can be found on the project website and digital archiving blog.

Ed Pinsent of the Digital Preservation Training Programme at ULCC, is working with Artefactual to develop more mature training in the use of the two systems. He revealed the results of a survey of the digital preservation community in 2015, which highlighted the need for practical (and less theoretical) hands-on training, especially using real tools. ULCC will be working closely with Artefactual on UK Archivematica training in 2017. Learn more about the work of ULCC’s DP training here.

The second half of the workshop focused on hands-on sessions using the two systems and work-sheets provided by Artefactual. This gave the opportunity for attendees, working in groups, to import, manage and manipulate test data and gain a better understanding of what the systems have to offer. Test instances were set up, enabling attendees and those not present to explore the systems from their workplaces.

More information about Archivematica can be found here; and on ATOM, a series of YouTube tutorials here.

Overall, this was a very useful workshop, not least in bringing together a diverse collection of archivists and records managers from higher education, local authorities and other sectors, and others such as representatives of Arkivum, the DP specialists. It is hoped that an ATOM user group will be founded as a consequence of the workshop, to complement a thriving Archivematica group.

I would like to thank The National Archives for hosting and helping to organise the day, and Artefactual for their assistance throughout the day and since.

The blog was originally posted on the King’s Collection blog: https://blogs.kcl.ac.uk/kingscollections/2016/12/20/open-source-archive-software/

Archives

Publication of the Survey of Hospital Records In Ireland

Posted on

The National Archives of Ireland have published their survey of hospital archives in Ireland. The survey funded by the Wellcome Trust was carried out between May 2014 and December 2015 with the objective of establishing the location, extent, content and condition of the archives of hospitals in the Republic of Ireland. Approximately 200 locations were identified as holding records and It was envisaged that the survey findings and recommendations would provide a basis for the development of policy on permanent preservation and access, and facilitate the formulation of a strategy to ensure the transfer of all records of permanent value to the custody of archival institutions.

For more information on the survey and to download a copy please visit the following link: http://www.nationalarchives.ie/2016/11/talk-on-survey-of-hospital-archives-22-november-at-1800/