ABSTRACT

This introduction presents an overview of the key concepts discussed in the subsequent chapters of this book. The book explores the law, accountability and then the records in context. It covers the courts' view of records. In its 2008 annual report, the National Health Service Litigation Authority (NHSLA) estimated that as at 31 March 2008, its total liabilities of outstanding claims for clinical negligence was £11.9 billion. If a health professional fails to maintain a reasonable standard of record keeping their accountability will impact in four distinct areas: their patient; their professional body; their employer; and society. Health professionals are often concerned about whether their records will stand up to legal scrutiny. Good records promote high standards of clinical care, continuity of care and better communication between members of the healthcare team. Poor record keeping compromises patient care and often reflects a wider underlying problem with the individual's practice.