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Currently, when a child is born you are handed a lovely red book ‘The  child health record’. It is given to the parents on or just after the birth of their child, and is used by parents to record standard health details such as height and weight as well as developmental milestones such as first words and first time walking. As the record has matured, additional information has been added in the form of inserts to aid parents with certain medical conditions.

As a parent I diligently tracked all of this information, knowing if my baby was in the correct limits for age and weight , vaccinations were up to date etc. I was in control, but I was also responsible. I also had all this relevant information in a small book that I could show any health or social care professional the health history of my child.

Giving back control, giving back responsibility.

When we reach 18, who is there to tell us we are a little overweight, our blood pressure is changing. It is not until we hit a crisis point that we seek help ( i.e. a back injury causing a GP visit) Only then are we told that we are obese and our blood pressure is too high. If only we had tracked this from a young age we would know that we were increasing our risk of injury and disease.

Clinicians letting go

In addition to this how many times have you taken someone’s blood pressure or a falls risk assessment and simply told them its a bit high today. Without writing it down , how many of us could recall what are blood pressure was taken a month ago? There is no single place or national record easily accessed by patients and clinicians to record vital health signs.

The Expert patient

You don’t need an existing medical condition to become and expert in your own health. Blood pressure, heart rate, weight, falls risk and current medication are all vital signs and assessments that patients can monitor themselves as well as clinicians. Seeing the effect of a new blood pressure medication could help medicines concordance or realising that your weight has slowly been increasing over the past 12 months could just be enough to make you think about some small changes.

Paper based or electronic?

There is no doubt that the digital age is well and truly here, however despite years of effort we still do not have a nationally available patient record. In addition to this there is more than one study to suggest that older people, no matter what their educational background find it harder to engage with technology. There are many health apps out there to track your fitness and wellbeing but many if these require a lot of detailed information on a regular basis, plus are not easily accessible to healthcare professionals.

Initially a paper based healthcare passport with electronic as future scope. Significant investment would be required for an electronic version both in terms of set up and ongoing data management.

Funding

After initial design and printing costs for prototypes I would see these small compact booklets as ideal business sponsored items which are normally offered to GP’s/ hospitals on the purchase of equipment and/or drugs. This should however be a national standard document ( the same principle as NEWS), same colour and size for all. This allows for easy recognition by both patients and clinical staff a like.

I have shared the idea at the Wessex Falls lead Forum with some great positive feedback so far. I have never attempted something like this and I am currently a team of one! I could let the idea pass me by, on the other hand I could share it and together we could kick start a new revolution. 

How you can contribute

  • Creating a national document
  • Publishing a national document
  • Marketing to relevant businesses
  • Buy in from primary care providers and CCG's nationally
  • Government support
  • Pilot scheme
  • Upscaling

Comments

  1. We are developing a patient passport for children cared for in the community with complex needs, based on a pre-existing model at Bristol Children's hospital. Like your plan, its first iteration will be hard copy with an electronic aspiration upstream. I would be happy to share experience about the logisitical challenges we have encountered.

  2. Guest

    Certainly there is a lot of scope for involving patients in their own monitoring. I previously worked on a unit where some patients would write their own evaluation of care in their nursing care plan. In my current department some patients or relatives help maintain fluid intake monitoring. Some patients are taken off the ward to have drinks in the hospital cafes or canteens.

    1. Thank you for your comment, there are various iterations along the same theme which are currently in use. However there is very little that is national and applicable to the whole adult patient population. The idea is to give people ownership and monitoring of their own health before they fall ill or require input from a healthcare professional.

  3. You may be interested in the Medication Passport, developed by CLAHRC NWL: http://clahrc-northwestlondon.nihr.ac.uk/resources/mmp

    1. Extending a project such as this would be an ideal, there is no point in reinventing the wheel!

      Thank you for the link , the project is quite extensive and upscaling has already been achieved to an extent. In addition to this they also have developed a paper document and a digital platform.

       

  4. Charlotte, I think that this is a very good idea. I would be happy to help with the design of the document and I have a beta website where I would be happy to publish the draft document for comment or it could be published for comment via my Q SIG. Regards Tom

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