What the Pre-Action Protocol for Clinical Disputes requires of your medical records

For clinical negligence fee-earners and paralegals · ~6 min read · quotes from the official Protocol, current as of March 2024

The bundle requirement, in the Protocol's own words

Paragraph 3.5 of the Protocol is unambiguous:

"At the earliest opportunity, legible copies of the claimant's medical and other records should be placed in an indexed and paginated bundle by the claimant. This bundle should be kept up to date."

Pre-Action Protocol for the Resolution of Clinical Disputes, para 3.5

Three things follow from that single sentence: it has to happen early (not once proceedings are issued), it has to be indexed and paginated — not just collected — and it has to be kept up to date as further records arrive, which on a live clinical negligence matter can mean re-indexing more than once.

The 40-day clock on the other side's records

Once a compliant request for records is made, paragraph 3.4.1 gives the healthcare provider 40 days to respond, at a cost no greater than that permitted under the Access to Health Records Act 1990 / Data Protection Act 1998. If that deadline passes with no records and no explanation, paragraph 3.7 lets the claimant apply to court under CPR rule 31.16 for an order for pre-action disclosure — and the court can impose costs sanctions for the delay.

Where a chronology is explicitly required

The Protocol calls for a chronology at more than one stage, not just as a courtesy to the reader:

• The Letter of Claim (Annex C2) — under "Dates of allegedly negligent treatment", the template calls for the claimant's solicitor to "include chronology based on medical records."
• The Letter of Response (Annex C3) — the defendant is expected to comment on the chronology enclosed with the Letter of Claim, or "enclose a revised chronology of events" if they disagree with it.
• The Stocktake stage (para 6.1.2) — if the dispute isn't resolved and proceedings become necessary, the parties "should continue to co-operate and should seek to prepare a chronology of events which identifies the facts or issues that are agreed and those that remain in dispute."

In other words: a chronology isn't produced once at the end. It is created early, exchanged, potentially disputed and revised by the other side, and refined again before proceedings — on both a live document cadence, not a one-off deliverable.

What this means in practice

• Start indexing and paginating as records arrive, not once the file is "complete" — the Protocol says "at the earliest opportunity."
• Expect to update the bundle and chronology more than once — new records, a Letter of Response disputing your chronology, and the Stocktake stage can each trigger a revision.
• Every entry in the chronology should be traceable to the record it came from — if the defendant disputes it, you need to be able to point to the source page, not just the assertion. See what makes a chronology good, not just present.
• Don't let the 40-day and 4-month clocks catch you preparing the bundle from scratch — if records or a chronology take days to assemble by hand each time they need updating, that's time coming out of a Protocol timetable that's already fixed.

Quotations are from the Pre-Action Protocol for the Resolution of Clinical Disputes as published on justice.gov.uk (updated 22 March 2024); check the current text directly for any matter where precise compliance matters. General information for legal professionals, not legal advice.