Incomplete and inaccessible clinical records
Cwm Taf Morgannwg University Health Board received 2 coroners' reports about this hazard between 26 Jan 2022 and 25 Jun 2024.
They came from 1 coroner. A similar concern was raised again 1 time after the first warning.
No published response from Cwm Taf Morgannwg University Health Board was found for the earlier reports.
The story, report by report
Spacing grows with the time between reports.
“The Clinical records in the Ty Llidiard Unit were not all entered contemporaneously in a single clinical record”
Original on judiciary.uk ↗ No published response from Cwm Taf Morgannwg University Health Board was found for this report.
- 2 years 5 months laterClosely relatedConfidence 0.90 · high
“Mental health practitioners are not easily able to access all of a patient's relevant clinical records pending the introduction of a”
Original on judiciary.uk ↗ Repeated from the earlier report:clinicalrecords
Cwm Taf Morgannwg University Health Board responded.Response (PDF) ↗Response (PDF) ↗
- All reports to Cwm Taf Morgannwg University Health Board
Each row is one judged link between an earlier and a later report. Open a row to read both quotes, found word for word in the originals.
2022 → 2024Isobel Stapleton2 years 5 months after Manon Jones · same coronerClosely relatedConfidence 0.90 · high
Closely relatedConfidence 0.90 · highBoth reports highlight that clinicians cannot readily obtain a complete, up‑to‑date set of a patient’s clinical records. The earlier issue concerned missing contemporaneous entries in a single record; the later issue notes practitioners lack easy access to all relevant records pending a unified system.
Manon Jones · 26 Jan 2022
“The Clinical records in the Ty Llidiard Unit were not all entered contemporaneously in a single clinical record”
Original on judiciary.uk ↗ Isobel Stapleton · 25 Jun 2024
“Mental health practitioners are not easily able to access all of a patient's relevant clinical records pending the introduction of a”
Original on judiciary.uk ↗
No published response from Cwm Taf Morgannwg University Health Board was found for this report.
No specific action could be extracted with a verified quote.
No specific action could be extracted with a verified quote.
- Each report's concerns were extracted by Nemotron 3 Nano on Nebius Token Factory, each with a quote copied from the report.
- Concerns from reports to Cwm Taf Morgannwg University Health Board at least six months apart were compared by meaning (Qwen3 embeddings) and wording (TF-IDF).
- The closest pairs were judged by Nemotron 3 Super with reasoning on. Only identical or closely related, with confidence of at least 0.70, are shown.
- Every quote was checked by code as an exact substring of the original text. Names of staff and family are redacted, and the deceased are named by report title only.
| Link | Meaning | Wording | Judge | Coroner |
|---|---|---|---|---|
| 2022 → 2024 | 0.69 | 0.17 | Closely related · 0.90 | same |
Judge model: nvidia/nemotron-3-super-120b-a12b. How Nemotron did the work · Full methodology.
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This shows that a similar concern was raised again after an earlier report. It does not say why, and it is not a finding about any organisation or person. To report an error, see the corrections route.