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Digitising the Stannington Sanatorium patient files

21/12/202010/03/2016 by Northumberland Archives

As the Stannington Sanatorium Digitisation Assistant I am responsible for digitising over 4,000 patient case files and their contents, redacting personal identifiable information from these and uploading digital copies of the core documents to our publicly accessible, searchable, online catalogue. Before I can do this, my colleague, the Project Assistant has already sorted the forms, charts and various other items contained in each file into core and non-core documents and repackaged them in acid free folders for long term preservation. You can read more about this here.

A file ready to be digitised — The documents of patient file HOSP-STAN 07/01/01/2261 prior to digitisation

Before being digitised the pages in each file are checked to make sure they are in the correct order and any dog eared corners or folds are straightened out. The pages in the folder are then photographed on both the front and reverse sides to make sure that all the information in each folder is captured. The number of images captured varies from file to file and can be from just a few up to around fifty. Most files have around 10 to 15 pages, but the largest digitised to date contains over 140 pages!

We digitise the files using a high specification digital SLR camera connected to a computer. This allows us to take high resolution photographs of each page and is much quicker than digitising each page separately on a flatbed scanner. Using a flatbed would be the normal approach however the time constraints on the project mean we are digitising over 1,500 pages every week so this approach isn’t feasible.

Camera stand and laptop — The camera stand and laptop used to digitise each file.

The images are then processed and saved to nationally recognised standards set by The National Archives. Each file is saved in Tiff and Jpeg formats. The Tiff format creates files of a large size, but ensures that all the original information from the photograph is retained. Because of this and the sensitive nature of information in the un-redacted files they are stored on DVD in the Northumberland Archives strong rooms for security and long term preservation. The smaller Jpeg format allows us to keep these digital files on our own servers and readily accessible to staff and researchers if required.
The core documents from each folder (cover, case notes, x-ray card and discharge report) then have any information which could identify patients or is considered sensitive removed. This process involves using photo editing software on a computer, and reading each page to check for information such as names, addresses and dates of birth, and redacting it. This is a time consuming process not made easier by having to read a lot of hand written doctors’ notes!

Core documents being redacted in Adobe Photoshop — Adobe Photoshop is used to redact sensitive information from the core documents.

The final stage of the process is to upload the images to the relevant records on our online catalogue. Once this has been done a selection of pages from each file are publicly viewable along with each file’s catalogue entry and the digitisation process is complete. Currently over 18,000 pages have been digitised from over 1,400 patient files. Over 6,000 core documents are already viewable online via our catalogue in addition to a large number of radiographs and early patient files which were digitised during the first phase of the project.
A typical set of core documents from the file of a patient suffering from tuberculosis admitted to Stannington Sanatorium in the early 1950s can be seen below.

The front cover of a file — HOSP-STAN 07/01/01/2261/01

Inside the cover of a patient file — HOSP-STAN 07/01/01/2261/02

HOSP-STAN 07/01/01/2261/07 - — HOSP-STAN 07/01/01/2261/03

Pages from a patient file incuding discharge report — HOSP-STAN 07/01/01/2261/07

Working as the Stannington Sanatorium Project Assistant

21/12/202017/02/2016 by Northumberland Archives

As the Stannington Sanatorium Project Assistant my responsibility is to ensure the good preservation and access to the Stannington Sanatorium records. Since early November I have been removing boxes of our patient files from the shelves and repackaging them. This follows a set process. First I begin by opening the file and separating out the core documents from the other contents of the file, and securing them to the inside of the file with an archival quality brass paper clip. The core documents include X-ray records, discharge reports, treatment notes and case notes. These contain a wealth of information about each patient’s treatment and health during their time at the Sanatorium. The non-core documents vary greatly in content, usually (but not always) including temperature charts, a history of illness and medical permissions form completed by parents, reports and letters of their transfer. There are often a number of other documents included, and

A repackaged file with supplies - unfolded card folder, archival tape, Brass paper clips and a bone folder for folding the flaps of the folders. — A repackaged file with supplies – unfolded card folder, archival tape, Brass paper clips and a bone folder for folding the flaps of the folders.

we will look more closely at the contents of the files in a future blog. I also ensure the file itself is in good order for its conservation, that there is no yellowing sticky tape, old paper clips or pins that may corrode.

It is then folded with an archival-grade four-flapped envelope, which we were able to purchase thanks to our Wellcome Trust grant. These are high-quality, acid-free card envelopes; an excellent way to protect the documents from damage and dust ingress. This is then given a printed label with the file’s reference number, and tied together in acid-free archival tape tied with a quick-release knot. Due to the thickness of the files after their repackaging additional boxes are required, and I estimate repackaging will at least double the number of boxes the collection occupies.

Files yet to be repackaged on their temporary shelving

This all has to be given extra space within the Northumberland Archives strongrooms. I have moved the boxes yet to be repackaged to a new temporary location, and am refilling the shelves as the boxes are completed, updating their location references as I go. I have just passed the halfway mark, but there is a lot still to be done!

Once completed however, the records don’t just sit unused. We often have Subject Access Enquiries, usually made by former Stannington patients wishing to see their records, and these are dealt with by our research team. We require authentication and permission to do this, which can take some time. The documents are not only useful for finding out more about individual lives, but for research into tuberculosis in children and the history of its treatment. A number of research institutions have looked at redacted images of the files and radiographs, to learn more about Tuberculosis.

Repackaged boxes of files at their new permanent location

This has to be done with the strictest patient confidentiality, and we will discuss more about the redaction process in future blogs. A former colleague at the Northumberland Archives, Becky Cessford, is looking at the uses of the Stannington Sanatorium collection in the wider fields of archaeology of human remains, history of medicine and archival outreach in her PhD. She will discuss her fascinating project in a blog post for us sometime soon. It is fantastic that the records are being used by former patients and researchers as such a valuable collection should be appreciated. The team last year started to raise the collection’s profile through these blogs, talks, an online exhibition and a touring exhibition, and I hope to be able to carry on some of this in phase two. You can see the online exhibition here, and the touring exhibition will soon be moving from libraries across Northumberland to HM Prison Acklington until late March.

Beyond the court rolls – other manorial documents

27/01/201606/01/2016 by Northumberland Archives

In our first post we looked at some of the court rolls, and in the second how the courts worked. We will now explore some of the other documents that we commonly use to determine whether a place is a manor, and what else we can find out from them. From the documents we can learn more about agriculture and diet of the period, crime and the way criminals were treated, urban growth and industrial development, and land, house or property ownership. There is excellent scope for local history studies from these documents and the detail they give of land boundaries and the individuals who held them. There is also huge potential for genealogists – though you may think they would only provide information about the landed classes, some court rolls and other documents list the names of those renting or holding land by service. Here we have divided up the documents we use thematically.

Geographical documents

Surveys – as you would expect, these are descriptions of the manor and its boundaries. This can be very useful when trying to identify what land was owned by whom. They often also detail the customs of the manor, which often differed from place to place.

ZCR/M/2: Survey of demesne of Manor of Craster, Northumberland

Terriers – a survey arranged topographically, showing you the manor field by field or where open fields existed, strip by strip.

Maps – from the sixteenth century this survey information is commonly laid out in the form of maps. These marked out the boundaries, adjoining manors or parishes, and topographical features. Unlike the terriers these would be done to scale, and became increasingly accurate as time went on.

Boundary roll – Description of the manorial boundary, though not a full perambulation.

NRO 00452/E/3/3/1/2: Blanchland Bounder Roll, Northumberland.

Perambulation – A long description of walk around the boundary, detailing local landmarks.

Land holding and ownership

Rentals – the names of all the tenants of the manor, however they held it, with a description of what they held and how much they paid, and what form their payment took. Payments could be in the form of money or produce. If they were expected to provide services it would say what these were. These weren’t as frequent as accounts or court rolls and sadly don’t always survive.

Custumals – The survey of rents, services owed by the tenants to the lord of the manor, the rights of the lord, the obligations he owed, and the customs of the manor. These would need to be examined occasionally, and everyone reminded of what these were to avoid confusion. Often the customs or rents changed, for example if services or produce were exchanged for payments of money.

Extents – An often earlier form of rental, a valuation and description of everything on the manor, such as the manor house, mills, demesne land (much like a ‘home farm’, the land near the manor house farmed for the lord), tenant’s rents and services.

Surrenders and admissions – The transferral of copyhold land from one owner to the next was done by one owner ‘surrendering’ his or her claim to the lord, who then ‘admitted’ the next tenant. This would be written down in the court roll, and the new tenant would be given a copy of what was written, hence this being called ‘copyhold’.

ZCO IX/5/1: Enclosure Act for Ovingham, Bywell St Peter and Bywell St Andrew.

Enclosure Awards – Enclosure was the practice of taking areas of unused land, strip fields or common and dividing them into privately owned fields. This would be done through private act of parliament up until about 1800, after which public acts were made possible, and from 1845 Commissioners were appointed to oversee the process of enclosure and issue enclosure awards. The awards detail how the land was divided and who the owners were.

Court papers

Presentments – lists of the matters to be dealt with by the court, such as disagreements between tenants or disobeying the manor customs, often drawn up beforehand by the jury. They might often be included in the court roll. ZBL 2/13/21 has some interesting examples including those brought before the court for offences such as ‘speaking scandalous words’ of someone or ‘wrongful mowing’ of someone else’s meadow.

ZBL 2/13/21: Presentments at Melkridge

Suit rolls or Call books – like an attendance register of everyone who owed suit to the court or attended the court. In some places these could be resident books, not only of the tenants but of everyone who lived in the manor. They might be kept within the court books.

Customs of the manor – a list of the individual customs of the manor, such as how many animals an individual could feed on the common

Stewards’ papers

Accounts – These would be kept by the steward or bailiff of the manor, usually annually at Michaelmas (the 29^th September), and marked the income and outgoings of the manor. For example ‘charges’ or income from the rents, money from sale of produce or fines; and ‘discharges’ or expenditure from purchasing livestock, repairs or labour.

Appointment of bailiff – a bailiff was a manager for the day-to-day running of the manor appointed by the lord. In some cases the role would be unpaid, with one of the tenants being elected annually to serve as ‘Reeve’ or ‘Greave’. This document would detail the bailiff’s appointment in the role.

Notice of court – letter to the lord notifying him of holding the court, or a notice often posted on the church door, giving the date, time and location of the court.

Correspondence – between the lord and the steward over various court matters.

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