Patients who underwent surgery by disgraced brain surgeon Sam Eljamel are expected to highlight the problem of inaccurate or missing medical records as a central issue during the ongoing public inquiry into his practice. The reliability of Scotland's NHS medical record systems has come under intense scrutiny from regulators and patient advocates, who argue that gaps and inconsistencies undermine both patient safety investigations and legal proceedings.
Concerns about the accuracy and completeness of NHS medical records in Scotland have been raised repeatedly by the public services watchdog and other critics. Victims of Eljamel have reported "significant gaps" in their records and stated that the documented information frequently fails to match their actual experience of care. The Scottish government acknowledged the seriousness of these concerns and indicated it was working with health boards to strengthen the reliability of patient records.
Scotland holds millions of patient records containing details of health, care and treatment. These records become critically important when adverse events occur, as they form the foundation for investigations and legal action. Yet the NHS in Scotland operates without a unified central system for storing these records, and multiple concerns about their precision have surfaced in recent years.
How are medical records being used in current inquiries?
The long-running Scottish Hospitals Inquiry, which is examining patient safety failures at Glasgow's Queen Elizabeth University Hospital campus, has already heard testimony about missing records and poor documentation practices. Similarly, the newly commenced public inquiry into Eljamel's conduct at Ninewells Hospital in Dundee will place significant emphasis on the accuracy of medical records.
Alan Ogilvie, who was operated on by Eljamel in 1995 and now serves as spokesman for the Patients Action Group that campaigned for the inquiry, described how many affected individuals have discovered their official records do not reflect their actual experience.
"We see significant gaps where complications occurred, and narratives that seem massaged to suit the clinician's reputation rather than the patient's history,"Ogilvie said.
"When the 'official' computer record says one thing, but our own letters and memories prove another, you have to ask: Is the system there to record the truth, or to protect the institution?"
Ogilvie raised a fundamental question about the purpose of medical record systems:
"If we cannot trust the records from the past, how can we trust the lessons they claim to be learning for the future?"
What specific problems have the watchdog identified?
The Scottish Public Services Ombudsman (SPSO) has repeatedly highlighted deficiencies in medical record-keeping. In September, the SPSO upheld a complaint concerning nursing care at NHS Lothian following a patient's death from a serious blood infection, identifying incomplete cannula records and ordering the health board to issue an apology and conduct a review of record-keeping procedures. Earlier, the watchdog criticised NHS Lothian for failing to conduct a Significant Adverse Event Review into the death of a patient who died from a blood infection at the Royal Infirmary of Edinburgh. The SPSO found "concerning" gaps or incomplete nursing records, including four instances where clinical notes indicated a doctor had requested a microbiology report but no such report appeared in the patient's records.
What does the fatal accident inquiry into Michael Wilson's death reveal?
A fatal accident inquiry (FAI) into the death of two-month-old Michael Wilson at the Royal Aberdeen Children's Hospital has exposed critical failures in information sharing between NHS boards. The inquiry heard from a doctor who stated he would have advised against operating on Michael had he known, from the child's medical records, about an inherited heart condition. This condition had been the suspected cause of death of Michael's older brother in Glasgow two years earlier, but the information was not accessible across board boundaries.
At an earlier hearing, Sheriff Christine McCrossan remarked on the fundamental nature of the problem:
"It's almost verging into a public inquiry situation - something as fundamental as the medical records situation in the country. These boards are independent and they set up computer systems that don't seem to talk to each other."
What concerns have politicians raised?
Labour MSP Daniel Johnson emphasised that while medical records are an invaluable resource for clinicians, their reliability becomes paramount when other public agencies, including the Crown Office, depend on them.
"Important questions need to be answered about how the Crown Office, the Central Legal Office and other publicly funded bodies assess the reliability of patient medical records and the user protocols which support their use,"Johnson said.
What has the Scottish government said?
A Scottish government spokesperson stated that accurate, complete and accessible patient records are essential to safe care, continuity of treatment and effective investigation of adverse events. The spokesperson noted that NHS boards are responsible for the electronic patient record systems they operate and for ensuring that clinical information is accurate, secure, accessible and appropriately governed. The government indicated it uses a range of assurance mechanisms to support reliability, including national standards and data quality controls.
"We take the concerns raised from recent inquiries seriously and continue to engage with boards to consider findings and any recommendations for improving the reliability of patient records to support safe and effective care,"the spokesperson added.
What has emerged about record destruction in the Eljamel case?
NHS Tayside's medical director told the inquiry that all complaints about Eljamel made before 2012 may have been destroyed. The health board said it still holds notes for approximately 3,800 patients and records relating to roughly 4,000 procedures. More significantly, the inquiry heard that 40 theatre logbooks covering 1995–2013 were destroyed in July 2025 despite a "do not destroy" notice. An independent review found that inadequate systems and processes were responsible, though it concluded there was no malicious intent behind the destruction.
What is the current status of the inquiry?
The first phase of public evidence hearings concluded on 7 October, with the inquiry expected to resume in November. The second evidential phase, during which former patients will give evidence, is scheduled for December. The inquiry's first phase examined Eljamel's career, his supervision in 2013, and NHS Tayside's document-management and retention systems, with its remit including whether information about his practice was concealed and whether systems adequately protected patients.
Key Facts
- Scotland's NHS operates without a unified central system for storing patient records, with individual health boards maintaining separate electronic systems that do not reliably communicate with one another
- The Scottish Public Services Ombudsman has repeatedly identified gaps and incomplete records in NHS patient files, most recently in cases involving blood infections and inadequate nursing documentation
- Theatre logbooks covering 18 years of Eljamel's practice were destroyed in July 2025 despite a retention notice, though an independent review found no evidence of deliberate misconduct
- A fatal accident inquiry into a two-month-old's death revealed that critical information about an inherited heart condition was not shared between NHS boards, potentially affecting clinical decision-making
- The Eljamel public inquiry is expected to resume in November, with the patient evidence phase scheduled for December
