About the project

The Great Ormond Street Historical Patient Database Project, launched in 2001, is the result of a partnership between Kingston University’s Centre for Local History Studies and the Museum and Archives Department of Great Ormond Street Hospital for Children NHS Trust. Funding for the project came principally from the Research Resources in Medical History Programme of the Wellcome Trust, with additional financial support from the Friends of Great Ormond Street Hospital, the Nuffield Foundation and the History Research Unit at Kingston University.

The Records

The Admission Registers of the Hospital for Sick Children at Great Ormond Street, from its opening in February 1852 until December 31st 1914, form the core of the project, and will be complemented at a later date by Registers of Cromwell House, the hospital’s convalescent home, from 1869 until December 1910. The Hospital Registers are of uniform format. Each entry gives the child’s name, age (in years and months), sex, and address. Further columns give diagnosis, which can include as many as four separate conditions, date of admission into the hospital and date of attack. The date of discharge is recorded, along with the result of treatment, which is given as ‘Recovered’, ‘Relieved’, ‘Not Relieved’ or ‘Died’. A column for remarks gives such details as operations performed, drugs issued, brief post-mortem results or an explanation for a premature discharge of the child from the hospital. The final column gives the name of the hospital governor or medical officer who sponsored the patient. In later versions, the Registers also included the name of the admitting doctor and the ward the child was initially admitted to.

Methodology

Funding from the Special Trustees at Great Ormond Street and the Wellcome Trust enabled the Registers to be microfilmed at the National Archives, and digital photocopies made. The photocopies were divided into batches of approximately twenty pages, or four hundred entries, and each batch was tagged and numbered.

The database was built in Microsoft Access, using a template designed by Peter Tilley, the project’s technical advisor. Batches were issued to volunteers, who input the data using a data entry programme. Although most had experience of the Victorian hand, very few had medical knowledge, and even fewer were familiar with the streets of Victorian London. The fields that caused most problems for transcribers were the addresses and diagnoses, and crib sheets of common terms were provided. In addition, photocopies from the index to a 1909 London Gazetteer were supplied to help with identifying streets or areas, and The A to Z Trust kindly supplied a copy of the very first London A to Z for reference.

In order to maintain the integrity of the Registers, entries were typed into the database exactly as they appeared, even where it was suspected that a mistake had been made by the clerks.

A rigorous system of proofreading ensured every entry was checked twice, to minimise the introduction of typographical errors, and the process was completed by a series of computerised validations.

Addresses

In order to help users locate addresses, additional fields were added to the database to provide standardised spellings of street names, and to incorporate Registration Districts and Registration sub-districts. This complicated and painstaking work was undertaken at Kingston by Juliet Warren. Currently, it has been restricted to London addresses, but may be widened to include all addresses at a later date.

The Diseases

Children’s diseases in the nineteenth century were imperfectly understood, and nosology has changed greatly since then. Diseases range from the expected typhoid fever and (w)hooping cough to talipes (club foot) and taenia (tapeworm). Many children were admitted with diseases of poverty, such as tubercular joints and lungs, rickets and rheumatism. Abscesses, caused by infections, under-nourishment and tubercular conditions, were common, and eczema was remarkably prevalent. Chorea, or St. Vitus’ Dance, is now familiar to all involved in the project, as is the distressing strumous ophthalmia, an eye condition rampant in children’s homes and orphanages. As with the addresses, the volunteers entered the disease or condition exactly as it was written in the Register. This resulted in many different spellings of even common diseases such as diarrhoea and scarlet fever. A new field was added to the database containing a standardised spelling of the diagnosis and two levels of classification were applied. The first, developed specifically for the project by Dr Andrea Tanner and Dr Sue Hawkins, groups diseases by body site, and the second applies the modern World Health Organisation’s International Classification of Diseases (ICD10) to the condition, work which was undertaken by Alicja Skowronska, a senior medical coder at Great Ormond Street Hospital for Children.

The Case Notes

Fourteen volumes of case notes for Dr Charles West survive, and they have been made available via the database. Each page was scanned, loaded in the website and linked to the relevant patient’s entry in the main database.

Small and Special Website

The Small and Special website has been developed, with funds provided by The Friends of the Children of Great Ormond Street, to make the database available to as wide an audience as possible, regardless of location or field of interest. Access is unrestricted and is completely free to use. Some restrictions have been applied to the volume of data which can be viewed at any one time, to protect the database from unscrupulous users.

Small and Special also contains a library of articles on subjects connected to the Hospital and the period, including a history of the Hospital for Sick Children at Great Ormond Street, pen-portraits of some of the medical officers, nurses and patients, and articles on the buildings which made up the Victorian and Edwardian institution. Most of the articles have been written by historian, Dr Andrea Tanner, the architect of the Project. The remainder have been contributed by archivist Nicholas Baldwin, and others involved in the Project. The articles are complemented by a collection of images of the Hospital from the period.

Project Team

Dr Andrea Tanner – Project Director
Dr Christopher French – Director of the Centre for Local History Studies, Kingston University
Juliet Warren – Researcher and Database Manager, Kingston University
Annie Sullivan – Project Development Consultant and Volunteer Manager, Kingston University
Dr Sue Hawkins – Project Manager and Researcher, Kingston University
Nicholas Baldwin – Archivist, Great Ormond Street Hospital for Children

Technical Consultants

Peter Tilley – Database Design Consultant and technical advisor to the project
Oliver Cope – thelettero – Python Web Site Development
Anne Morgan – Amendit Design Services – Web Design
Paula Stephenson –  Web Manager, Great Ormond Street Hospital for Children and UCL Institute of Child Health
Alicja Skowronska – Clinical Coding Consultant

The Project team would like to acknowledge the enormous contribution made by the large number of dedicated volunteers and Kingston University students, without whose work on transcribing the registers, checking and correcting the database, this project would have been impossible.

Dr Elizabeth Lomax

The Project team is extremely grateful to Dr Elizabeth Lomax for allowing us to use Small and Special as the name for the website. It is derived from the title of her book, Small and Special: the development of hospitals for children in Victorian Britain.

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