Published: 06/12/2001, Volume III, No. 5784 Page 4

The Commission for Health Improvement is to be asked to investigate poor medical-record keeping in trusts, after a report from the National Confidential Enquiry into Perioperative Deaths found that it was 'falling below acceptable standards'.

The annual report from NCEPOD says medical records departments have been a 'Cinderella service' for many years, and clinicians need to 'ensure that trust management are aware of the difficulties they face with regard to the loss of case notes for all patients, whether alive or dead'.

Co-operation with NCEPOD, which comes under the auspices of the National Institute for Clinical Excellence, is now mandatory.

Its reports will have the same status as NICE guidance from next April, and its remit is to be extended to take account of near misses and primary care.

NCEPOD chief executive Christobel Hargraves said: 'We are concerned about information not being sent to us, because we are a mandatory system. We know there are some high-profile cases that have not been reported at all, and we are concerned that people are not learning the lessons across the country. '

She said NCEPOD would be asking CHI to investigate recordkeeping systems at those trusts not providing data, or where medical records were not adequately maintained.

The report also says that cancer patients, particularly those presenting as an emergency, are receiving poor treatment.

It says there is varying expertise, poor compliance with recommendations and failure to collect data and run adequate multidisciplinary teams.

And it points out that many patients admitted as an emergency are not referred to specialised cancer surgeons, and it calls for clinical networks and local guidelines to ensure that all patients with cancer receive an early and appropriate referral to specialists.

Changing the way we operate , NCEPOD, www. ncepod. org. uk