Health & Social Care Services: Reporting and Record Keeping

This report provides an overview of effective reporting and record keeping in health and social care services. It details the statutory requirements governed by legislations like the Data Protection Act 1988, Health and Social Care Act 2012, GDPR 2018, and Freedom of Information Act 2005. The report also describes the regulatory and inspecting bodies' requirements, emphasizing the Caldicott principles and the role of a Caldicott Guardian. It illustrates the process of storing records, explains the reasons for sharing information both internally and externally, and clarifies the internal and external needs for recording information in healthcare settings. The importance of accurate and accessible patient records for better treatment and care is highlighted, concluding that proper record keeping is essential in hospitals and healthcare organizations.

Effective Reporting and Record
Keeping in Health and Social Care
Services.
(ASSIGNMENT 1)

TABLE OF CONTENT
• INTRODUCTION
• Describe the statutory requirements for reporting and record keeping in own care setting.
• Describe the regulatory and inspecting bodies requirements for record keeping and reporting in a care
setting.
• Illustrate the process of storing of records within own care settings.
• Explain the reasons for sharing information within own care settings as well as with the external bodies.
• Appropriately explain both the internal and external needs for recording the information in the own care
settings.
• CONCLUSION

INTRODUCTION
• The health plays a very important role in the life of every
individual.
• There is great need of health care record keeping in the hospitals.
• This is because it will adequately provide a complete brief about
the history of the patient.
• This record helps in the better treatment of the patient in the
hospital

Describe the statutory requirements for reporting and
record keeping in own care setting.
• The statutory legislation of recording keeping on health care is
governed by various legislations.
• These includes the Data Protection Act 1988, Health and Social
Care Act 2012, General Data Protection Regulation 2018
(GDPR) and the Freedom of Information Act 2005.
• The GDPR 2018 provides the individuals rights on how the data
in the hospital is kept.

Describe the regulatory and inspecting bodies requirements for
record keeping and reporting in a care setting.
• The Caldicott principles has to be followed by every hospital with
reference to the recording of the data.
• These includes that a model of quality standards for the
administration of confidentiality and access to private information of
the patient to the third party.
• Moreover, a Caldicott Guardian is a senior person is appointed who
is responsible for protecting the privacy of individuals health and
care data and its creation by the administration of the hospital.

Illustrate the process of storing of records within own
care settings.
• Create or receive
• Use or modify
• Maintain or protect
• Destroy or dispose
• Preserve or Archive

Explain the reasons for sharing information within own
care settings as well as with the external bodies.
• Sharing of information among the healthcare practitioners and
health care organizations is quite essential for getting the accurate
care towards the right person when they require it.
• Having fear about sharing the information must not stand in a
manner of the need to safeguard as well as encourage the welfare
of children, young people and adults at the developing the risk of
neglect and abuse as well (Using Technology in Health and Social
Care, 2021).

Appropriately explain both the internal and external needs for
recording the information in the own care settings.
• Records of the Patient computerization has enormously at a standard
level as well as are more likely to continue, specifically as the
technology enhances as well as are more become more affordable
and as per the enhanced demands for well-being care information.
• If the records of the patients within future are automated version of
various recent records, therefore, an opportunity to enhance the
fundamental resources for well-being care will have been lost.

CONCLUSION
• This presentation concludes about the need of health care record
keeping in the hospitals.
• This also summarises that the record helps in the better treatment
of the patient in the hospital.
• This presentation would conclude about the statutory requirements
that are necessary for the record keeping of a patient.
• This would also explain about the regulatory bodies that are
involved in the reporting of the heath care setting.

REFERENCES
• Records Management Process, 2021 [Online]
Available through:
https://www.hyland.com/en/resources/termino
logy/records-management/process
• Using Technology in Health and Social Care,
2021 [Online] Available through:
https://www.highspeedtraining.co.uk/hub/tech
nology-in-health-and-social-care/