About the Project
The Historic Hospital Admission Registers Project (HHARP) began as a partnership between Kingston University’s Centre for Local History Studies and various hospital archives in London and Glasgow. It began life in 2001 as a project to create a database of late 19th and early 20th century admissions to the Hospital for Sick Children at Great Ormond Street, whose extensive archive is still maintained and housed within the Great Ormond Street Hospital for Children NHS Trust (https://www.gosh.nhs.uk/about-us/our-history/archives). Subsequently, the project was expanded to include three other children’s hospitals: the Evelina Hospital (now part of Guy’s and St Thomas’s NHS Trust), whose records are held at the London Metropolitan Archives; the Alexandra Hospital for Children with Hip Disease (records held at the Barts Health NHS Trust Archives: https://www.bartshealth.nhs.uk/barts-health-archives) and the Royal Hospital for Sick Children, Glasgow, whose records were at the time of the project held by the hospital itself, but in more recent times have been moved and are now held as part of the NHS Greater Glasgow and Clyde Archives. Details of the holdings can be found here: https://archiveshub.jisc.ac.uk/data/gb812-rhsc
In September 2020, Kingston University withdrew from the HHARP project and HHARP is now run as an independent entity by two of the founding academics, Dr Andrea Tanner and Dr Sue Hawkins.
Funding for the development of HHARP (originally known as Small and Special) 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 Great Ormond Street database for admissions between 1852 and 1914 was launched to the public in 2007, the databases for the Evelina and the Alexandra Hospital for Children with Hip Disease were made available in early 2010, while that for Glasgow was added in September 2010. The GOSH database was extended again in 2015 with the addition of admissions from 1915-1921. The admissions between 1915 and 1921 are loaded in full, with the exception of patient names which are withheld until each record reaches its 100-year anniversary, at which time an algorithm releases the name information. All records will be complete on 31 December 2021.
Forty-three volumes of case notes relating to patients at Great Ormond Street Hospital have also been added to the website. The case notes have been imaged and part-transcribed and the images and transcriptions can be found via the Great Ormond Street database, linked to the relevant admission records. The first set of 14 volumes belonged to Dr Charles West, the hospital’s founder and were added in 2007. These volumes contain 1214 case notes covering the period 1857 to 1873. The second set of 29 volumes of case notes (4710 individual cases) belong to Dr Archibald Garrod. They were added in 2012 and cover the period 1899-1913.
The Admission Registers of all four hospitals (plus those for Great Ormond Street’s convalescent home, Cromwell House) cover a period ranging from February 1852 (when Great Ormond Street’s doors first opened) through to 31 December 1921. While the Great Ormond Street records are continuous for the whole period, the other hospital records cover shorter runs within these dates: Cromwell House, 1869 to 1910; the Evelina, 1874 to 1877 and 1889-1902; Alexandra Hospital for Hip Disease, 1867 to 1895; and Glasgow, 1883 to 1904. The Registers share a common core of information: child’s name, age (in years and months), sex, and (in most cases) the address. Note, for data protection reasons, records relating to admissions to Great Ormond Street less than one hundred years from the date of viewing have been anonymised. Anonymisation is removed as the record passes 100 years of age. By 31 December 2021 the complete record for all admissions will be visible.
Further columns provide diagnosis, dates of admission and discharge, and the outcome of treatment, described as ‘Cured’, ‘Relieved’, Not Relieved’ or ‘Died’. Additional information common to all records, includes the name of the admitting doctor, the child’s sponsor and the ward to which they were admitted.
Individual hospitals included variable information in their registers. Cromwell House records, for instance, provide information on the child’s history of infantile diseases and its vaccination status. In the Evelina records brief details of treatment received and post mortem results were sometimes available. The Alexandra Hip Hospital records are quite different, as all the children are suffering ostensibly from the same disease; thus the registers focus on the nature of the hip disease suffered, and include information about the condition of child’s limbs before, during and after their stay at the hospital, describing the deformities, presence of abscesses etc. They also frequently comment on the duration of illness before admission and likely cause of the problem. Unlike Great Ormond Street records, those at the Evelina and the Alexandra Hip Hospital have provision for recording details of the parents – although this information was not collected as frequently as we would have liked. The Glasgow records contain information on a patient’s parents, name and occupation and religion.
The same methodology was applied to each set of hospital records to enable meaningful comparisons between the institutions. Funding from the Wellcome Trust (and the Special Trustees at Great Ormond Street in the case of that hospital) enabled the original volumes of Registers (1852-1914) to be microfilmed 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 ready to send to volunteers, who input the data using a data entry programme. Later, as technology advanced, volunteers worked from digital images accessed online via a custom-built transcribing system.
The databases were built in MS Excel, using a template originally designed for the Great Ormond Street records by Peter Tilley (the project’s technical advisor), and later adapted by Juliet Warren to incorporate new data elements from subsequent hospitals. Initially, although most volunteers had experience of the Victorian hand, very few had medical knowledge or were familiar with the streets of Victorian London. Crib sheets of common disease terms, terms used in postmortem reports and 19th century therapeutics were provided, while photocopies from the index to a 1909 London Gazetteer were supplied to help with identifying streets or areas. The A to Z Trust also kindly supplied a copy of the very first London A to Z for reference. The same team of volunteers has worked on the project throughout, and as they gained experience their ability to transcribe the specialised content accurately grew, and as a result they became a very skilled group of workers.
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 mistakes had been made in the original registers. The standardisation of key data elements by the project team enabled such original errors to be corrected while maintaining the integrity of the source material. A rigorous system of proofreading ensured every entry was checked twice, to minimise the introduction of 21st-century typographical errors, and the process was completed by a series of computerised validations.
At the core of the HHARP website are the four databases of hospital admissions and the collection of case notes, which are accessed via the powerful search tool provided. But enhanced with a growing collection of articles and a gallery of images, HHARP is more than a set of databases, it provides a portal into the world of Victorian and Edwardian children’s hospitals and has been welcomed as such by family historians and academic researchers alike.
In the pages under ‘Historical Background’ can be found a range of articles on the development of each hospital, the doctors and nurses who worked there, and a host of images kindly provided to us by the supporting archives. The articles have been contributed by the team’s medical historians, Dr Andrea Tanner and Dr Sue Hawkins, hospital archivists and others involved in the Project. There is also a small collection (under ‘General’) of articles contributed by leading medical historians on health provision in the late 19th century.
While it is absolutely free to use, we ask HHARP users with more than a passing interest to register to access the more detailed information. The purpose of this is to protect the valuable databases contained within HHARP from unscrupulous users. Much effort, given voluntarily, enabled this resource to be built and we are eager to try to prevent this freely given labour from being exploited. Registered users are able to download a limited amount of material from the website, but restrictions are in place which apply to volume downloads in order to protect the database. Users who would like to acquire large volume downloads can request this and we can produce custom-designed volume downloads for bona fide researchers.
The constitution of the project team has inevitably shifted and changed since it was first formulated in 2001. The list below recognises the important contribution of all members, past and present. All have now moved on to other things and sadly some have since died. The exceptions are Dr Andrea Tanner and Dr Sue Hawkins, who continue to be the guardians of HHARP working an independent management team.
- Dr Andrea Tanner
- Dr Christopher French
- Dr John Stuart
- Dr Sue Hawkins
- Juliet Warren
- Annie Sullivan
- Dr Helen Goepel
- Kingston University Team of Volunteers
The Technical Team
The development of the resource owes a huge amount to our technical advisers:
- Peter Tilley – Database Design Consultant and technical advisor to the project, who sadly died in 2020.
- Oliver Cope – Website Application Development (www.ollycope.com).
- Alicja Skowronska – Clinical Coding Consultant.
- Nicholas Baldwin – Archivist, Great Ormond Street Hospital for Children.
- Katie Ormerod – then Deputy Archivist, St. Bartholomew's Hospital Archives & Museum.
- Alma Topen – then Archivist, Royal Hospital for Sick Children, Glasgow.
- Prof Dan Young – then Honorary Archivist of the Royal Hospital for Sick Children and Emeritus Professor of Surgical Paediatrics, University of Glasgow, who sadly died in 2013.
- Glasgow and West of Scotland Family History Society (http://www.gwsfhs.org.uk/).
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.
We are also indebted to Anne Morgan (Amendit Design Services) who designed both the original Small and Special site and its transformation into HHARP and who sadly passed away in late 2009.
Dr Elizabeth Lomax
The Project team was extremely grateful to Dr Elizabeth Lomax for allowing us to borrow Small and Special as the name for the original website; and hope she will forgive us for the move to a new name. Her book, Small and Special: the development of hospitals for children in Victorian Britain, remains an inspiration to our work on children’s hospitals.