These are the words of Juliet Butler who is a Trainee Advanced Clinical Practitioner at Kingston and Richmond NHS Foundation Trust. Here Juliet explains how the London Care Record supports her to provide the best possible care for patients as quickly as possible when working in the Emergency Department (ED) and on the hospital wards (24 June 2025).

What is your role/where do you work?

I am a physiotherapist by background. I am currently working as a Trainee Advanced Clinical Practitioner at Kingston and Richmond NHS Foundation Trust.

I am on six monthly rotations learning lots and enjoying the variety. At the moment I am working on a respiratory ward Mondays to Thursdays and some Fridays I join the Frailty Team in Frailty Same Day Emergency Care (SDEC) in ED.

When did you first start using the London Care Record?

I was aware of the London Care Record but I have to confess I did not start using it until I started working with the Frailty Team around two years ago.

With frailty our patients are often brought in by ambulance. Often the patients themselves are not able to provide information about themselves and  sometimes you cannot get hold of the next of kin. So you are faced with having to gather this information as quickly as possible from scratch. That is when the penny dropped for me about how vital the London Care Record can be. I now use it all the time both on the wards and when working with the Frailty Team in admissions avoidance

How does the London Care Record help you in this work?

In so many ways! But an example would be an elderly patient coming in to the Frailty SDEC who has fallen. I can view the ambulance report on the London Care Record and check some key information such as why the patient had fallen (for example was it due to trip hazards in their home or did they maybe black out?) and the action taken by the ambulance team. For example did they do an ECG, did they have to break the front door down?

I can also check the London Care Record to see what medications the patient has been prescribed. This is so important as often the patient cannot remember or can get flustered or confused. Having this information means I can talk to the patient and next of kin and check whether they are actually taking the medications as prescribed. This is really important information that I can then include in the discharge summary which will be useful for the GP and other health and care staff providing them with care.

The London Care Record also gives me wider information. For example, if I think the patient’s fall might have been cardiac related I can look at previous medical conditions and the investigations they have had for example whether they have had an echocardiogram. If they are already seeing a cardiologist, I can also check their previous clinical correspondence and future appointments.

Without the London Care Record I wouldn’t know nearly as much about a patient unless they are really on top of their health, which can be challenging in the field of frailty as patients often have a lot going on. That is why I use the London Care Record every day.

It’s really important to remain aware that, for varied reasons, not all patients will have information on the London Care Record so we need to continue to actively obtain this information if appropriate. But when all parts of the system are able to work together to give the full picture, it can be really useful.

Any other examples?

I’m currently working on a respiratory ward, and recently we had a patient whose X ray revealed thoracic fractures. A scan was recommended to determine further management. To clarify whether the fractures were new or old, I used the London Care Record. It helped identify that one of the fractures was new, so a follow-up scan was arranged. If the record had shown it was an old fracture, we might have avoided an unnecessary and costly scan. The London Care Record really helps guide patient care and also supports the efficient use of services like radiology.

What advice would you give health and care staff not currently using the London Care Record?

Quite simply the London Care Record is my ‘go to tool’ for gathering information about a patient so I can provide them with the best possible care as quickly as possible. I simply don’t think I could do my job as effectively and safely without it. My advice to any health and care professional is to give it a go. It is really easy to access and use. Before long it will be a must have tool for you like it is for me!!

You can find out more about the London Care Record here.