MEDICAL RECORDS

A brief guide to medical records from the Great War

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     I realise that this page doesn’t really fit in with the nursing theme of the rest of the site, but because of the association of nurses, hospitals and soldiers, I often get asked for information on finding soldiers’ medical records, and also for help in finding the records of hospitals that were active during the Great War. I usually feel a great temptation to say ‘Just forget it and move on to something else’ but as that could be seen as a tiny bit unhelpful, this is a brief outline of what records survive, what might survive, and what is a bit of a ‘no hope’ errand.

     The majority of British soldiers’ service records were destroyed in the German bombing of London in September 1940, and those that survived, or have subsequently been reconstructed, are often badly damaged and incomplete. However, those surviving records (30-40%) still provide the best chance of discovering where a man was wounded or taken ill, where he was treated, and the sequence of events at the time. These records are have now been digitised and put online by Ancestry, and are available free of charge as an online service at TNA and other large libraries and archives throughout the United Kingdom.  Alternatively they can be accessed via a paid subscription to the provider.

With no service record, the likelihood of finding the information rapidly decreases or more likely disappears altogether. In addition to their service records, all men and women who were patients at any time, and for any reason, had a range of military medical records completed during their stay. After the war most of these medical and hospital records were destroyed, and just a representative selection remain at The National Archives in class MH106 – no more than 2% of the total.
     There are admission and discharge registers for six general hospitals, one stationary hospital, six casualty clearing stations, five field ambulances, one ambulance train, one hospital ship and ten medical establishments in the United Kingdom. The records are not complete for most of the above and may only cover a very short time span – the basic details of can be found below. In addition, there are individual medical records for the officers and men of five units:

Leicestershire Regiment
Grenadier Guards
Royal Flying Corps
Royal Field Artillery
Corps of Hussars

     This group of records is large – many thousands for each unit – and if your relative was from one of the above, and was sick or wounded at any time during the Great War, there seems to be a good chance that he might have one or more medical record cards. They are held in rough order of service number, but are not indexed, and a thorough search of a single unit might take a day or two at least. Personally, if my grandfather or uncle had been in one of the above units I would consider it time well spent, and when it comes to searching for medical records there are not many things that I could say that about! If you want to get a rough idea of what’s available, go to the search page at The National Archives web site, enter the name of the unit in the search box and ‘MH106’ in the series code box. When you get your results, use the ‘Browse’ button on the right hand side of the page near the top to check what’s available for that unit. None of these records are available online, and you will need to visit yourself to take things further, unless you have a bottomless pocket to pay a researcher.

The National Archives

Admission and Discharge Registers
     The following units are those for which admission and discharge registers survive at The National Archives in MH106. In total there are 2078 of these registers, and the number includes some operation books, and miscellaneous registers. They cover units in most theatres – the Western Front, Egypt, Salonika, Serbia, and North Russia in 1919. Some are complete, while some are for specific dates only, and as the units moved around some have records for more than one location. One of the most complete, No.3 Casualty Clearing Station, has a total of 153 registers covering the period from 23 September 1914 to 6 December 1918. 
     Most units held separate registers for different nationalities, and in most cases British troops will not be combined with those, say, from Canada or India. Details of officers and women are usually held in different registers from other ranks. The registers for hospitals in the United Kingdom are kept in both date order, and also separately for each theatre of war in which a man had served prior to admission. The units are as follows:

14 Field Ambulance
51 Field Ambulance
66 Field Ambulance
139 Field Ambulance
149 Field Ambulance

3 Casualty Clearing Station
11 Casualty Clearing Station
31 Casualty Clearing Station
34 Combined Casualty Clearing Station
39 Casualty Clearing Station
82 Casualty Clearing Station

Bakharitza Detention Hospital
2 General Hospital
18 General Hospital
19 General Hospital
28 General Hospital
85 General Hospital
4 Stationary Hospital

County of Middlesex War Hospital, Napsbury
Queen Alexandra Military Hospital, Millbank, London
Mrs. Mitchison’s Hospital for Officers
Catterick Military Hospital
Craiglockhart Hospital, Edinburgh
Eccles Auxiliary Hospital
Bowhill Auxiliary Hospital, Selkirk (Officers)
Lennel Auxiliary Hospital (Officers)
Coldstream Mains (Officers)
Craiglea Annexe, Edinburgh (Officers)

H.M. Hospital Ship ‘Assaye’
31 Ambulance Train

     Trying to negotiate the The National Archives Catalogue to find the unit you want to is a bit of a maze.  Most units have records for certain dates only, and there are some interesting miscellaneous files detailing operations and laboratory records, but finding them can be confusing.  To help a bit, I've gone through the Catalogue and listed the piece numbers for each individual unit named above - it can be found on the following page:

The National Archives MH106 piece numbers for medical units listed above

War Diaries
     If you know from a service record the name of a hospital to which a man was admitted, then it’s just possible, but very unlikely, that he will be named in the war diary of that medical unit [The National Archives Class WO95, overseas units only]. A few officers may be named, particularly if they have an aristocratic background, and quite frequently a list of deaths is given for any particular day, but other than that the diary of a hospital or casualty clearing station is a record of the day-to-day running of the unit, with no information on the care of the patients. It may be of more use in showing the location of the unit at any specified time.

Hospital Records
     Thousands of separate medical units sprang up in the United Kingdom during the Great War, run by either the War Office, the Joint War Committee (British Red Cross Society and St. John’s Ambulance Brigade) or privately. In addition, facilities were also set aside in existing civil hospitals and asylums for the care of military patients. If a man was a patient in one of the latter institutions – a hospital that was working as a civil hospital prior to the war, and carried on in the same manner after the war, then there may be some records still held, particularly admission and discharge registers. There is a database of these records jointly held by The Wellcome Library and The National Archives, which can be searched online by either hospital or by town, and the links lead on to the current location and scope of any surviving records. The Hospital Records Database can be found here:

Hospital Records Database

     There are no surviving records of the large military hospitals which existed in the United Kingdom during the Great War other than those few listed above, and no records for the Territorial Force General Hospitals which were active throughout the United Kingdom. There may be a few records of smaller units and private institutions held in local archives, but there is no national register of these, and you would need to search individual local catalogues. Many Red Cross and small hospitals were run by private individuals who cared for their own records and took them home or disposed of them after the war. Some of these could still be in existence in private hands or mouldering in attics and sheds; most were simply thrown away.

Personal medical records
     Before the formation of the National Health Service in 1948, local doctors in the community worked in private practice and maintained their own records. For the majority of their work, they had no obligation to keep written records, nor to pass on their records to a higher authority. With the formation of the NHS, a few letters and notes did find their way into new medical records, but as these records have never been retained for more than a few years after death, there will either be no records, or no access to those records even if they still survive [i.e. if a veteran has died within the last couple of years, even if his records are still available, access would be denied except under very exceptional circumstances].

     This is only a very brief look at the records, and I would say that if you're searching for a man who was in the Leicestershire Regiment, wounded on the Western Front, taken to No.3 Casualty Clearing Station, and eventually ended up in hospital at Napsbury, then you're on to a good thing. For all others, think carefully about whether it's worth spending time on a search that is 99% sure to end in failure.  I have, however, met those who are in the remaining 1%, so all may not be lost!

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WHICH HOSPITAL?


I often get asked how and why an individual man ended up in hospital many miles from home rather than a local unit, and here are a few reasons and pointers

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     It's highly unlikely that any decisions were made overseas about a patient's destination once back in the United Kingdom except perhaps for a few senior officers, nurses and other women who had special accommodation set aside in London.

      The port of departure, and thus arrival in the UK, would depend on the position of the overseas Base Hospital, which in itself may have been a random choice initially. As the war progressed, specialist units were set up to treat various classes of illness and wounds, and that would have been a deciding factor in the fate of some men on arrival. There was also an enormous concentration of beds in London, Manchester and Birmingham and the chances of being treated in one of those areas was high. There was always a likelihood that men from London or Manchester would end up near home, just by chance.

      Although I have read accounts of men being purposely sent away from home to prevent hospitals being over-run with visitors, it seems that this was never the intention. By September 1914 there were three main aims when men arrived back wounded in the UK – to give priority to those most seriously injured, to clear beds in the largest hospitals as quickly as possible to make room for new arrivals and to ensure that the men were transferred between medical facilities as few times as possible.

      For men disembarking at Southampton, the most serious cases were transferred to the Royal Victoria Hospital, Netley and the Southampton War Hospital, the latter soon earning the reputation of being one of the busiest and 'heaviest' hospitals in the country. From Dover, the sickest men were found accommodation in London. Men needing specialist treatment were separated out and given some priority to admit them to a unit which suited their needs. Lightly wounded men and the walking wounded were often the ones chosen to do the longest journeys and therefore more likely to end up in cities such as Plymouth or Aberdeen.

      Apart from the worst cases the men would be found a place on the next available train, whatever its destination – there seemed to be little question of a Highlander turning down the 16.00 to Waterloo because he’d rather wait for the 19.30 to Glasgow. Because men were often wounded in large actions, it follows that men of the same regiment would frequently be wounded, treated and evacuated together, and find their way back to England if not ‘en masse’ then certainly in tens, dozens and scores. So it was not surprising that, for instance, fifty Scots ended up in No. 2 Eastern General Hospital at Brighton, and fifty Royal Sussex men in Manchester – often it was just the luck of the draw.

      As the war progressed, the pressure on beds became more severe and it was even more difficult to find accommodation than previously. However, as there were more trains there may have been several waiting at Southampton and Dover at any one time and always the chance of different outcomes, but it’s said that even the men themselves were often reluctant to make a decision about destination. Where was nearer, where was more exciting, where were their friends going; where would the soldier from Cornwall choose when he was in the West Yorkshire Regiment and most of his friends were going north? The vast majority of officer beds in the UK were in London, so an officer was very likely to be accommodated there, at least initially, wherever his home was. As the war progressed there were other important decisions to be made about special categories of patient.

      Before the ‘average’ man could be moved, account had to be taken of mental patients, neurological patients, those with venereal disease, enteric fever and dysentery, serious orthopaedic cases, cardiac and rheumatic conditions, eye and facial injuries - an ever lengthening list. Canadians, Australians, New Zealanders and South Africans also had to be filtered off to their own hospitals and the movement of patients soon became a very intricate and complicated process which didn't always allow a free choice of destination. Where this was impossible, facilities were put in place for seriously ill men, who were going to be in hospital for a long time to be moved nearer home when their condition was stable. If a man was expected to be in hospital for more than three months, there was a high chance that arrangements would be made for him to be transferred to a hospital in his home area – these transfers were often long-distance, and carried out by fitting extra patients into existing ambulance train journeys.

      Throughout the war the pressure on beds was always enormous and all Home Commands were instructed to expand their hospitals to the fullest limit. Of course this ‘fullest limit’ was never enough, and the number of beds was still increasing in October 1918. The expansion of the auxiliary hospitals and convalescent homes meant that most soldiers would eventually be transferred out of the main hospital, and this was most likely to be to a facility affiliated to that hospital, and therefore in the same locality. Initially he bed state nationally was being updated weekly and later on twice weekly, but as the situation became critical it was done on a daily basis. At time of the Armistice available beds nationwide stood at approx 364,133 and included 18,378 for officers. Between autumn of 1917 and beginning of 1918 the usual daily occupancy was 317,000.

     I’m sure there must have been many a bright young ‘walking wounded’ who, seeing more than one train drawn up in front of him, found some way of making a choice but it was really a question throughout of squeezing casualties in anywhere that had enough room to take them – choice would have put an impossible burden on a massively overstretched system.


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