AIBU to feel appalled by staff accessing murdered children’s records?

[girlfriend44]

https://www.bbc.co.uk/news/articles/cgrpdkevvnko

Poor parents of Grace and Barnaby Webber. not only were their children murdered they then found this out about people looking up the records who shouldn't have.

Hope all those people are totally embarrassed. Glad they got caught out.

The computer systems won't prevent staff from making an error - and bear in mind these systems are expensive to set up, so aren't replaced very often, so they won't be up to date tech.
However IT wouldn't just be able to see what file you've looked at, but how long you were on it and what pages. Most systems will have some sort of 'front screen' with basic demographic details etc on it. There's a big difference between clicking into that, realising you've made a mistake and closing it, compared to going through the file and accessing records case notes, documents/images etc.

If you look something up in error, you notice you’ve done it - wrong address or date of birth or whatever and you leave the record immediately so the system would show you moving on almost immediately. Any system I’ve worked with can see that you’ve logged in and also the parts of the file you accessed.

I too would leave a record saying “accessed in error” so there was an audit trail. If I’m reviewing files for self evaluation I’ll note that too. These aren’t uncommon practices and I’m guessing the subsequent investigation revealed no legitimate cause to access.

I didn't say they don't deserve to be sacked, but that certainly wasn't my experience of training. In fact, when I first started plenty of people would give me access to files as a student to read something because it was 'interesting' or a good example of work. Technically it was allowed as being a student on a team I could technically get involved in any of the cases, but it was a bit tenuous, especially when it was when my mentor didn't have time for me and just needed to find something for me to do!

This occurred to me too. There's an earlier post about social workers being sacked for accessing the file of a child killed by the parents, and i actually thought it would be natural professional curiosity to find out how/why it happened, what might have been missed, were there any clues,etc, so that you could learn from it.

If i had a weird/rare medical outcome it wouldn't bother me at all if other GPs in the practice had a look at my file for professional curiosity, isn't that how you learn and develop your knowledge/skills. Real life is always going to be a better teacher than a text book.

That makes sense, thanks.

I don’t understand it either. My work deals with confidential and sensitive cases. The details go into a central database that I have access to but I have never found the need or desire to access records of people I don’t directly work with. None of my colleagues do either.

I have an ex colleague who went to prison for 2 criminal offences - one was an offence against children and the other was misconduct in public office as he had been accessing children's records where he had no reason to. The misconduct offence had a longer tariff. I also have another colleague who lost her job for looking up records of people she knew personally.

@Muffsies although it would take time, any time something serious happens like that in social work there would be an internal review at least, and from that something published for staff - themes, patterns, learning etc. The difference obviously is that when it's done it's anonymised. The most serious and thorough examples are child safeguarding practice reviews (previously serious case reviews) They are as you say an incredibly important way of learning.

This has just reminded me though that when I worked for a local authority and there was a high profile case, the record was instantly locked, and anyone except the allocated workers had to request permission in writing to access. I'm surprised there isn't an equivalent here.

Same here. I used to work in payroll, which gave me access to everone's personal employment history file. I would never access a file unless i had to, and i didn't read the other documents on people's files. It just honestly didn't interest me, i was too busy, and i had no wish to invade someone's privacy like that.

Yanbu but also surely the trust could do things like password protect the data etc.

It's utterly shocking though.

Exactly. We regularly lock down files to all but a few authorised people. You would think it was standard practice

My friend’s daughter trained to be a nurse about ten years ago and she said that whenever the ward was quiet the students were always told to get all the patient notes out (including the ones they weren’t directly involved in) and read through them.

They were always told that reading medical notes and learning about the patient’s initial signs and symptoms, the tests they had and why, the processes involved with diagnosis , the reasons behinds treatments and the ways in which patient monitoring is carried out etc etc was one of the best ways to learn, especially following the patient journey by reading their clinic letters etc and discussing it between themselves and senior staff.

I imagine in some cases the patient’s records also contained medical information that wasn’t actually relevant to that patient’s current admission either but previous health issues they’d had.

I would guess that the patients weren’t told that their records were being passed around the student nurses for them to read.

Would students being given random patient records to read be classed as them inappropriately accessing people’s medical records even though it was done for learning opportunities?? I imagine so, after all they aren’t providing direct care for them and they have no need to know about those patients. I’m sure it happens in the majority of teaching hospitals though (and in GP surgeries and other settings).

Is this any different to what these professionals did when they were looking at the records of the children who were murdered? Couldn’t they most say that as the circumstances around the deaths were so rare they thought reading the records may provide learning opportunities for them? (identify gaps in their knowledge for example, or deepen their understanding on how such injuries and cases are managed?)

It is such a grey area.

The databases themselves are password protected (multiple layers usually), it would be impossible and unrealistic to password protect individual files within that. Not least because it would be impossible for staff to keep track of that many passwords, in health it could be hundreds of files a week someone needs to access.

I realise that. But we are talking about people who had died. There's no justification for not locking their data down

Despicable behaviour.
However, I and everyone else I know who has requested a copy of their nhs medical records has discovered them to be either incomplete or wrong or both. So based on this I’m taking comfort in the fact that if anyone is accessing records illegally they’ll be viewing inaccurate rubbish.

Its awful, my husband works in clinical pathways, he spends day in day out reading medical histories, it's drilled into staff that there is a record logged of who and when patient records are accessed, he's not even allowed to look at his own or close family in clinical setting (as in if they come up on his list coincidentally).

Its really shitty behaviour in my view, and they should be sacked.

However, that still needs to follow a fair process, which includes people being asked to explain why they accessed that record, so if it was accidental/mistyped id number/clicked wrong record, then they should have an opportunity to explain.

Surely, in this day and age, there are ways for patient notes to be anonymised if the case would be interesting for students/training, whatever. There should be no need for this excuse now, although fully appreciate this would likely have been common practice in the past.

I think there’s a difference in being directed to read, by a practice educator or supervisor/qualified worker as part of your practice training and just having a look for whatever reason. Any cases I looked at as a student social worker came with a task eg to do a piece of analysis or reflective writing or to bring to supervision for discussion. We weren’t allowed to just go a trawl files for something interesting - one student was withdrawn from training for looking at a neighbours file without reason or permission.

When something does happen in practice, there are a whole set of reviews to support learning in a structured way. There’s really no excuse for looking at records that you don’t have a permitted reason to look at.

Oh I misunderstood. But yes, in most places I've worked there is a system to have certain records with extra security and I'm surprised this didn't happen here.
For example, in social work it's typical that if a child is adopted, the records are restricted and from that point on, only the allocated workers and manager can access the file, and the manager has to grant permission for anyone else.
In the same vein, if something serious happens/is suspected, especially if it might reach the press, a manager will usually request that file has the same lockdown, just to avoid anything like this happening.

We had an admin lady look up her son’s ex girlfriend to check if she had had a miscarriage or lied. She then told the young woman she’d seen her notes so she reported her and she was sacked. It’s so disappointing when people you work with turn out to be different to who you think they are. I just would never do that.

Where is their lack of common decency and sympathy for the poor victims of this horrible crime? How utterly abhorrent of these scummy bastards. Im glad they got sacked. Its a pity they cant get a criminal record too.

Actually the systems are set up so that once something is finalised it can't be changed, it's a security measure so that records can't be amended/obfuscated at a later date.
That definitely becomes a culture/grey area when say, a newly qualified worker asks 'i need to write a care plan/assessment etc, has anyone got a good example I can look at...' (not saying that in itself is a crime, but re the boundary blurring that can lead to a poor culture developing unless there's good leadership)

When there are learning reviews an entirely new anonymised report will be written but obviously that's time consuming.

That's how it should be, if you had a good practice educator. As a student I certainly got left with a cabinet of paper files and no direction other than to do some 'self directed learning' (hospital placement) by a prac ed who was quite open about the fact that she only wanted students so they could do her typing!

Just sacked though.
IMO this should be a criminal case, with a fine or suspended sentence.

I've worked in the NHS for 35 years and it doesn't surprise me that this happened. The quality of training and the level of professionalism has really deteriorated.

I don’t think it has deteriorated but electronic records are easier to track.