Decision
Ms X and St James’ Hospital
From Office of the Information Commissioner (OIC)
Case number: OIC-163364-M5V8K9
Published on
From Office of the Information Commissioner (OIC)
Case number: OIC-163364-M5V8K9
Published on
Whether the Hospital was justified, under section 15(1)(a) of the FOI Act, in refusing access to further medical records sought by the applicant on the ground that no further records exist or can be found
29 April 2026
In a request dated 25 April 2025, the applicant sought access to her files and images when dealing with four named consultants during different treatments and time periods. The applicant specified the consultants, the relevant departments, and the approximate time periods. Two of the consultants were psychiatrists, one was from the Neurology Department, and the other from the Radiology Department. On 1 May 2025, the applicant edited her request by including records from one further consultant psychiatrist. The Hospital agreed to this addition on the same day.
In a decision dated 16 June 2025 (received by the applicant on 2 July 2025), the Hospital said that it decided to grant the request in full. According to its schedule of records, the Hospital released a medical record chart and a PDF extract from applicant’s electronic patient record (EPR) from four of the named consultants.
On 1 August 2025, the applicant requested an internal review of the Hospital’s decision. The applicant claimed that there should have been further records included in the release of records from the Hospital.
The Hospital did not issue an internal review decision and so, following engagement from this Office, the Hospital issued its effective position on 11 September 2025. In its effective position letter, the Hospital said that the applicant had since revised her original request to seek all medical records from 1 January 2019 to 1 September 2025, including all radiology imaging. The Hospital said that the applicant was particularly interested in a letter of support dated March 2025 from one of the named consultant psychiatrist’s services.
In its effective position letter, the Hospital said it would release all the requested medical records to the applicant, including the correspondence in a restricted access folder associated with the psychiatric service in question, which contains the letter of support. The Hospital said that the documents in this folder are not normally filed in the general medical records and so this is why these records were not contained in the original release of records. According to its updated schedule of records, the Hospital released a medical record chart, a PDF extract of the applicant’s EPR from 2019 to September 2025, and a letter of support referred to in the EPR.
On 8 October 2025, the applicant applied to this Office for a review of the Hospital’s decision. The applicant provided a lengthy submission along with her application to this Office. While I do not intend to repeat the whole submission, I can confirm I have had regard to it and I will briefly summarise the main points below.
In particular, the applicant stated that email correspondence from her to the Hospital staff and a hand delivered letter to a named consultant were not included in the release of records. The applicant also stated that a letter of support was missing from a named consultant from the Neurology department. She said that a doctor from the Hospital wrote to her GP on 16 April 2025 promising a letter of support to assist the applicant to change her place of accommodation. The applicant included in her submissions an excerpt from this letter from the Hospital which referred to the letter of support.
The applicant also said that another letter of support she received from the consultant psychiatrist, released with the Hospital’s effective position on 11 September 2025, was not the original signed version of the letter she wanted. The applicant said that the letter she received in the release of records was created on the same day of the release, 11 September 2025, rather than on the day it was dated, 14 March 2025. The applicant also referred to a letter of consent the applicant said that this consultant wanted her to sign before providing the letter of support. The applicant said that this was also missing. In addition, the applicant also questioned why records from the named psychiatric service folder were only identified when the Hospital issued its effective position. Finally, the applicant expressed concern at the doctors involved in the processing of her FOI request.
I have now completed my review in accordance with section 22(2) of the FOI Act. In carrying out my review, I have had regard to the submissions made by the applicant and the Hospital. I have decided to conclude this review by way of a formal, binding decision.
At the outset of this review, the Hospital’s position was that no further relevant records exist or could be found. This is, in essence, a refusal to grant access to the additional records the applicant is seeking under section 15(1)(a) of the FOI Act, which provides for the refusal of a request where the records sought do not exist or cannot be found.
Accordingly, this review is concerned solely with whether the Hospital was justified in its decision to refuse access to further relevant records under section 15(1)(a) of the Act.
It is important to note that the role of this Office is not to determine what records should exist, to adjudicate on how FOI bodies perform their functions generally, nor to act as an alternative dispute resolution mechanism with respect to actions taken by FOI bodies, or by any other parties. Our role is confined to reviewing the decision taken by the FOI body on the applicant’s request for records. We generally do not comment on which staff of the FOI body are involved in the search for records and decision on their release.
Section 15(1)(a) of the FOI Act provides for the refusal of a request where the records sought do not exist or cannot be found after all reasonable steps to ascertain their whereabouts have been taken. Our role in a case such as this is to review the decision of the FOI body and to decide whether that decision was justified. This means that I must have regard to the evidence available to the decision maker and the reasoning used by the decision maker in arriving at their decision and also must assess the adequacy of the searches conducted by the FOI body in looking for relevant records. The evidence in “search” cases generally consists of the steps actually taken to search for the records along with miscellaneous and other information about the record management practices of the FOI body, insofar as those practices relate to the records in question.
In its submissions to this Office, the Hospital stated that each patient is issued with a unique patient identifier known as a medical record number (MRN). It said that each time a patient attends the Hospital, they are registered under that unique MRN and all medical tests, clinical notes, patient consultations, GP referral letters, out-going correspondence, and incoming correspondence from clinical professionals relating to the patient are filed under this MRN.
When the applicant’s request was received, the Hospital said that the Patient Administration System (PAS) was searched, using the applicant’s first name, surname and date of birth to identify the unique MRN. The Hospital said that a copy of the EPR was downloaded and the relevant information from the physical chart was copied.
The Hospital said that, on initial receipt of the applicant’s request, its Access to Information Office failed to search the folder associated with the named psychiatric service in the first search for records. For context, the Hospital said that this folder is accessible to relevant personnel only in the Department of Psychiatry. The Hospital stated that, after the applicant claimed there were missing records; namely, a letter of support from the Department of Psychiatry relating to an accommodation issue, and requested all medical records from 2019 to September 2025; the search described above was carried out again but with a wider date range applied. It also said that the Access to Information Office contacted the named consultant psychiatrist in relation to the letter of support which was referenced in the EPR notes but was not filed there. The Hospital said that the letter of support was filed in the named psychiatric service folder and the consultant psychiatrist confirmed that this could be released to the applicant at the effective position stage on 11 September 2025.
The additional consultant psychiatrist, whom the applicant referred to in the addition to her request on 1 May 2025, was not mentioned either in the Hospital’s original decision or effective position. The Hospital said that the reason for this was that this consultant psychiatrist no longer works at the Hospital and was providing locum cover at the time. The Hospital said that the other named consultant psychiatrist is the head of the team of consultants and so communication was directed to her.
In relation to email correspondence between the applicant and the respective consultants, the Hospital said that all clinical records are filed under the MRN. The Hospital further said that e-mail correspondence between patients and medical consultants is not always filed in the medical record unless a consultant specifically directs that a copy of the correspondence is filed because it is clinically relevant. This is why email correspondence was not included in the search for requested medical records.
The Investigating Officer asked the Hospital if the letter of support from the named consultant in the Neurology Department, which was referred to in a letter written by a doctor on 16 April 2025, was identified and why it was not released to the applicant. The Hospital responded by saying that the Access to Information Office has contacted the consultant to ask about the existence of the letter of support. The Access to Information Office has not received a response from the Neurology Department to date, but the Access to Information Officer said that she has searched the medical records and the patient correspondence and had a phone conversation with the medical secretary in that department and cannot identify a letter of support at this time.
The Investigating Officer also asked the Hospital for clarification on when the letter of support from the consultant psychiatrist, released to the applicant on 11 September 2025, was first created and why it appeared to the applicant that the letter was created on the day of release rather than when it was dated, namely 14 March 2025. The Hospital responded by saying that this letter of support was downloaded from the named psychiatric service’s folder in September 2025. The Hospital said that Adobe took the date that the document was downloaded to be the date of creation. The Investigating Officer asked if a signed version of the letter exists. The Hospital said that the letter released to the applicant is a copy and is not signed. It added that the applicant should contact the clinical department for signed documentation, but no signed copy currently exists in the applicant’s records.
In terms of the letter of consent from the consultant psychiatrist which the applicant said was not included in the release, the Access to Information Office said that there is an unsigned consent form in the named psychiatric service’s folder. The Access to Information Officer also said that there are some further documents in the relevant folder which were not considered for release. She said that the consultant psychiatrist has been contacted in relation to the possibility of releasing these records to the applicant.
The Hospital effectively refused access to further relevant records under section 15(1)(a) of the Act on the basis that no further records exist or can be found. In its submissions to this Office, the Hospital has acknowledged that further records in the named psychiatric service folder have been identified and, as noted above, may need to be considered for release. Therefore, it is clear at this time that the Hospital has not undertaken all reasonable steps to locate all relevant records sought by the applicant.
Accordingly, I have no basis on which to find the Hospital’s effective refusal of access to further records was justified under section 15(1)(a) of the Act. It is not the role of this Office to effectively act as a first instance decision maker on access to these further records. In the circumstances, it seems to me that the most appropriate course of action for me to take is to annul the Hospital’s decision on the applicant’s request and to direct it to make a fresh decision on the matter in accordance with the provisions of the FOI Act. The applicant will have a right to an internal review and a review by this Office if necessary.
In terms of the correspondence between the applicant and the Hospital which were not included in the release of records, the applicant’s request appears to be confined to medical records. As the Hospital stated in its submissions, correspondence to the Hospital staff would not routinely be filed in the patient’s medical records and so this is why it was not included in the release of records. I find this to be a fair interpretation of the applicant’s request as correspondence is not necessarily a medical or clinical record. If the applicant is still seeking records of correspondence with the Hospital, it is open to her to make a fresh request for these records. Again, the applicant will have a right to an internal review and a review by this Office if necessary.
Having carried out a review under section 22(2) of the FOI Act, I hereby annul the Hospital’s decision. I find that the Hospital was not justified in refusing access under section 15(1)(a) of the FOI Act to further relevant records coming within the scope of the applicant’s request and I direct it to make a fresh decision on the applicant’s FOI request.
Section 24 of the FOI Act sets out detailed provisions for an appeal to the High Court by a party to a review, or any other person affected by the decision. In summary, such an appeal, normally on a point of law, must be initiated not later than four weeks after notice of the decision was given to the person bringing the appeal.
Mary Connery
Investigator