Pagination of medical records

  • Published: February 06, 2020
  • Author: Sarah Wallace, Managing Director, Clinco

~ by Sarah Wallace

We’ve been hard at work in the Clinco offices, processing cases and moving matters forward for our client firms.  We’ve been seeing a number of very complex high value cases which have made full use of our expertise.  These cases are likely to run for many years.  In most of them the patient has evolving needs under active ongoing clinical management, across many different specialties.

Updating the records and chronology is almost always needed in these long running, complex matters.  Usually there will be substantial updating records from a range of healthcare providers.  It’s easy over time for the fee earner to lose control of the updating process and for the records to get out of hand.  Duplication or overlap can start to proliferate.  The bundle can become disorganised, and hard to navigate.  The knock on effect is that it’s more difficult to spot gaps in disclosure and track developments in the condition and treatment of the patient.

We’re often asked to rectify a bundle where a fee earner has taken over conduct of a matter in which this sort of thing has happened.  We have seen some poorly prepared records which have been subject to various attempts to update them.  We can always make it right, by doing whatever is needed to resolve the issues and get the case back into a good state.

We advocate, however, getting a good grip on the records right from the outset; and then maintaining control throughout the life of the case by updating methodically across the board at intervals of around 12-18 months depending on where the case is in terms of the expert evidence and the timetable.   If you use our service from the beginning we will update efficiently – as the groundwork will have been properly and consistently carried out, so we can swiftly eliminate overlap and duplication.  We have cases we have updated eight times already and the bundle remains in excellent shape.

We tend to update by extending the index and pagination, rather than insert pages.  This prevents the rather unsatisfactory ‘point additions’ – 100.1. 100.2 etc, which only get worse as the years go by and the suffixes get longer.  A straightforward extension of page numbering is clear and keeps the index easy to read.  It is also more compatible with digital versions of the records in pdf format.   If your preference is for a simple prefix per provider – eg A100 –  to keep updates from that provider directly following on rather than later in the bundle, then that is easy to do and gives a good clear result.

It is important for updating to be done correctly and in an organised way.  We keep an electronic version of everything we collate so when the time comes to update, we only need the new records – not the whole set back again – to eliminate overlap and complete the update.  Our overall aims at Clinco are to bring clarity and help fee earners to progress their cases – updating the records is a significant part of our work on your behalf.


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