Forum Home → Discussion → Decision making and appeals → Thread
submissions and medical records
this should be read by all:
http://administrativeappeals.decisions.tribunals.gov.uk//Aspx/view.aspx?id=5020
As Ut Judge Wikely says, it’s a salutary tale - GP sent rep the full records, and included documents that should not have been included (court order, child protection) which were irrelevant to the issues. Rep didn’t read them as they arrived VERY late and just sent them in. oops. whilst GP clearly at fault, rep also at fault
also had they been read only those relevant need have been sent and then the tribunal would not have overlooked the relevant specialist referral (FTT had said there wasn’t one, when in fact there had been one ...)
I do so agree with Claire, but I feel really sorry for the rep in this case. Most of us have probably had narrow escapes from this type of scenario.
On one occasion the client’s medical record contained a consultant’s report on another person. On another occasion the record contained minutes of an interdisciplinary meeting to discuss care of the client’s child. I removed the offending documents from the records and sent them off to Tribunals Service with an explanation. I then sent the originals back to the GP with a covering letter.
And haven’t we all come across an entry in the record which states “Mrs X says she can walk 250 metres before the onset of pain”, when she’s told us she can’t walk 50 m? Or a radiologist’s report which comments that the patient has very mild wear-and-tear which should not give rise to symptoms, when the client says they are in agony?
that is true.
i’ve sent stuff back to GP’s myself (wrong patient’s info, such as that).
to my mind, the GP should be filleting such stuff out. and I have come across GP practices that actually do go to the trouble of redacting stuff (relating to third parties) but to the point that it becomes silly (eg. where it’s clear patient’s partner has been on the phone about whatever it is so the words “patient’s partner” or similar are blacked out ....
It’s an interesting one on many levels.
I have little sympathy for tribunals which adjourn for medical records. It can often be translated as “one or more of the members thinks the claimant is an utter fraud or all claimants are fraudsters so let’s get the claimant out of here and in front of someone else.” but equally often it’s simply “we won’t make a decision without medical evidence” without a second thought as to what that so-called medical evidence might tell them that they don’t already know. It’s an ongoing frustration given that there is a lack of understanding by all concerned as to just how little “medical” evidence is needed for a successful claim. I am beyond boredom and anger, for example, at hearing welfare rights advisers telling claimants that they cannot support them unless they have at least something from their GP. This is portrayed as a need for a “supportive” GP but of course it’s usually no such thing and is much more a way of cherry picking.
It is also perhaps symptomatic of the profiteering around the DPA that a GP delegates the reproduction of medical records; amongst the most personal data any organisation might hold on an individual, to an administrator/office manager who may in turn delegate to a junior to photocopy and charge for and not a one of them will consider DPA or other implications. It’s a growing issue. I recently had to suggest that having a flu jab in a Council Chamber 2 people at a time with no screen between them and a discussion of my medical history in front of another nurse and patient was wholly inappropriate. There’s little evidence the point was considered relevant let alone taken on board!
It’s an interesting one on many levels.
I have little sympathy for tribunals which adjourn for medical records. It can often be translated as “one or more of the members thinks the claimant is an utter fraud or all claimants are fraudsters so let’s get the claimant out of here and in front of someone else.” but equally often it’s simply “we won’t make a decision without medical evidence” without a second thought as to what that so-called medical evidence might tell them that they don’t already know. It’s an ongoing frustration given that there is a lack of understanding by all concerned as to just how little “medical” evidence is needed for a successful claim. I am beyond boredom and anger, for example, at hearing welfare rights advisers telling claimants that they cannot support them unless they have at least something from their GP. This is portrayed as a need for a “supportive” GP but of course it’s usually no such thing and is much more a way of cherry picking.
It is also perhaps symptomatic of the profiteering around the DPA that a GP delegates the reproduction of medical records; amongst the most personal data any organisation might hold on an individual, to an administrator/office manager who may in turn delegate to a junior to photocopy and charge for and not a one of them will consider DPA or other implications. It’s a growing issue. I recently had to suggest that having a flu jab in a Council Chamber 2 people at a time with no screen between them and a discussion of my medical history in front of another nurse and patient was wholly inappropriate. There’s little evidence the point was considered relevant let alone taken on board!
One sympathises.
There’s no dignity in the NHS, just a thin curtain.
One sympathises.
There’s no dignity in the NHS, just a thin curtain.
I had considerable sympathy for the bloke in front of me who had to strip off from the waist upwards as they couldn’t find a vein. That it became a gossipy talking point amongst a bored queue was wholly unacceptable. I can accept thin curtains in an NHS hospital in limited circumstances but less so on a planned vaccination programme. Presumably no-one gave them a years notice so as to be able to book the appropriate rooms we’ve had in previous years!
One sympathises.
There’s no dignity in the NHS, just a thin curtain.
I had considerable sympathy for the bloke in front of me who had to strip off from the waist upwards as they couldn’t find a vein. That it became a gossipy talking point amongst a bored queue was wholly unacceptable. I can accept thin curtains in an NHS hospital in limited circumstances but less so on a planned vaccination programme. Presumably no-one gave them a years notice so as to be able to book the appropriate rooms we’ve had in previous years!
I can promise you it’s the same when they want to shove a camera in you.
[ Edited: 19 Dec 2016 at 11:36 am by John Birks ]I can promise you it’s the same when they want a shove a camera in you.
Having had cameras in both ends I can attest to the truth of that. That said, my experience was very much that students were present and I would always authorise and welcome that. Apparently, under the influence of sedation, I actually didn’t!!!
That’s my story and I’m sticking to it!
Anyways, having successfully derailed the thread… :)
Was there a point to the thread? Oh yes.
Out of a sense of duty and respect, going back to the OP.
I’m surprised at the rep submitting ALL of that ‘information’ to a tribunal.
It’s just unhelpful - surely a brief scan would be sufficient to release the impertinent records?
There’s always the option of taking them all with you (obvs in the case at hand some info should have been returned to the GP or destroyed as irrelevant) and providing that info if required to disclose.
It struck me as odd for a WRA to request medical records at all but who knows the exact circumstances of the case.
Personally I cannot see the circumstances in which such a thing would be needed but there’s always an exception. That said, I could never see a scenario in which I would submit any evidence without having read it properly or at all. I don’t think being busy or over-worked, however much we all are, buys you any sympathy on that front.
I dunno Mike.
Whilst I agree in general, the lack of resources and proper funding for WRA services (referred to in the UT decision itself) inevitably has a knock-on effect on how well advisers are trained and on how well and regularly their work is supervised. To give just one example - it came out quite recently on these forums that one of our regular contributors is expected to give complex welfare rights advice - including on far from straightforward right to reside issues (if there are straighforward RtR cases) without the employer seeing the need for them to be provided with even a CPAG welfare rights handbook (refusing to do so, in fact).
I think sometimes we forget how lucky we are to have started off our careers in the days were services were adequately funded and where there was, at least in the majority of cases, a proper training and career development structure. I started off in 1998 in the independent advice sector - back then it was quite uncommon to have a centre manager/director who lacked any experience of advice giving themselves. Nowadays, amongst those whose primary concern is over their job title (I know of some centres whose directors’ first step in post is to insist the management committe make them ‘Chief Executive’ - get over yourself) and having something that looks good on their CV, it’s increasingly a rarity. And not having a proper understanding of what advice giving is and what it entails can all too easily result in not having ann understanding of the value of training or proper supervision.
None of this is to disagree with the thrust of what you’ve said - it is entirely unacceptable. But I can understand how it could happen, all too easily.
I too can understand how it can happen (and, like yourself, have been around a long time). I’ve also seen funding and physical resources slashed; managers who know little of advice work (fortunately not as yet where I work) and so on, but the other side of that coin is individual responsibility. The adviser concerned didn’t appear to raise any issues in this instance around lack of resources, inexperience and so on. As there are less of us about so does the responsibility on those of us left rise correspondingly to never fall before a standard which may do more general reputational damage.