Researching hospital-related records

The concept of the 'hospital'

Today, hospitals are known as institutions whose purpose is the provision of healthcare to patients. They incorporate a wide range of services geared towards the provision of emergency, preventative, diagnostic, rehabilitative, long-term, and mental health care.

Before this contemporary concept of the 'hospital', in different times, they have provided different services. Hospitals have served as places of rest and recovery, sites of disease isolation, care provision to people in poverty or the religious, and places of confinement or imprisonment. Their oversight at times has been provided by the Church, the Crown, philanthropic individuals and institutions, the armed forces, the state, and by private corporations.

The evolution of services reflects changing approaches to personalised medical care and wider public health over the centuries. However, due to the evolution of the term ‘hospital’ over time, it can be difficult to search for hospital-related records.

Other terms have been used to refer to hospital-pertinent services, and unless these are known, some records might remain invisible. However variable the term, it still maintains a common theme over time: being a place or institution, outside of the home, through which care is given in response to some aspect of an individual's health.

The National Archives collection reflects the changing status of the ‘hospital’ over time and contains a wealth of records through which researchers can explore this rich and diverse history. This blog offers some tips and pointers on how to search for such records, and an overview of the most relevant series.

Searching in Discovery

Identifying relevant records about hospitals in The National Archives catalogue search, Discovery, can be difficult due to the range and diversity of records available. A search in the catalogue for 'hospital' returns over 500,000 results across the entire collection. This includes over 300 series of records and more than 450,000 single-item level records that reference hospitals in their description.

These records primarily relate to interactions between instruments of state and hospital authorities. They have largely been created by entities such as the Royal administration, legislature, courts, police, military, medical councils, governmental departments and non-ministerial departments. They do not contain internal records produced by hospitals, such as personal medical records and administrative records, which are most often held within the hospitals themselves or in local archives.

Most of the hospital-related records at The National Archives were created from the 18th to 20th centuries. The rise in identifiable sources during this era can be attributed to the increase in the number of hospitals throughout this period, as well as the increased role of the state in healthcare provision. In addition, the term ‘hospital’ grows in use with the development of healthcare institutions from an uncommon and indistinct form into a fundamental and recognisable social necessity. The following chart illustrates this distribution of records that mention ‘hospital’ in their description over the centuries in The National Archives' collection.

Narrowing down 'hospital' records

To further identify hospital-related records that are most relevant to a particular research question, or narrow down the scope of the results to a specific time or theme, the results filter can be used. Or, if looking for more specific terminology, the advanced search option can be used to search within the results.

Someone hoping to find information on smallpox and hospital care in the 19th century, might initially search ‘hospital’ from 1800 to 1899. This search returns over 324,000 results. If the user then presses advanced search, they can then type 'smallpox' and any spelling variation (i.e. 'small-pox') into the ‘Find Any of these Words’ option.

This produces a much more targeted result set of under 200 records. Furthermore, this result set can then be filtered via the creator of such records via the ‘collection’ option on the left-hand side of the results. The Ministry of Health collections, for instance, hold some 75 records relating to hospitals and smallpox, which may provide insights into the strategic medical practices around smallpox. Whereas the Home Office collections, which hold nine records on the same subjects, may provide more governmental policy and oversight concerns over smallpox and hospitals.

Significant collection areas

Several collection areas at The National Archives contain a wealth of records relating to hospitals. Many hospital-related records are found within:

• The War Office
• The Ministry of Health
• The Admiralty
• The Chancery
• The General Nursing Council for England and Wales
• Welsh Office
• Prerogative Court of Canterbury
• Department of Health
• Colonial Office
• Commonwealth and Foreign and Commonwealth Offices and the Home Office collections

Substantial quantities of records are scattered across another 80 collection areas. These collections can be useful to different areas of study.

The medieval period

It's difficult to locate records from the medieval period (974–1485) due to the lack of hospitals as we know them today.

There are, however, records relating to the small-scale church-run hospitals primarily administered by monasteries. Collections such as the Chancery records contain transfers and grants of land associated with hospitals under the names of 'masters of hospitals'. These provide some insights into the existence and names of hospitals in medieval times. Records of the King’s Remembrancer also provide Ecclesiastical records that draw on church-run hospitals.

The early-modern era

There are more record collections to draw on in the early-modern era (1485–1714). The Records of the Exchequer has records of the surrenders of the hospitals during the dissolution of the monasteries in Henry VIII’s reign (1509–1547). Such collections, therefore, name and highlight the sorts of care-related institutions that existed prior to their surrender to the Crown. During the 16th and 17th centuries, record collections of the state and its forces become more useful for studying hospitals during this era. The Admiralty records, for example, contain information on their hospital ships and Naval hospitals.

With the expansion of the Empire through the early modern era, records from the Colonial Office and the War Office give some insights into hospitals abroad during this time. Additionally, the registers of the Privy Council incorporate some warrants and petitions about admissions into hospitals, providing some personal histories and interesting individual narratives.

18th century onwards

There is a significant jump in the volume of records from the 18th century onwards. Here, there are many collection areas that are particularly useful for hospital research.

The Ministry of Health and Predecessors collections include a wealth of insights into the provision of hospitals through poor law commissions and the establishment of the asylum system. The Charity Commission contains records relating to hospitals as philanthropic projects, whereas the Department of Education contains files on the administration of children hospitals. Again, the 18th and 19th-century records on hospitals are often found in collection departments such as the Colonial Office and the Admiralty. These bodies were providing an ever-increasing number of care services to the forces and those working in administrations throughout the Empire.

By the 20th century, the increasing role of the state as the provider of health care to the populace means that departments of state and associated health bodies are where most hospital-related records are found. The most useful collection departments are:

• The Ministry of Health
• Department of Health and Social Security, and its successor the Department of Health
• The Welsh Office
• General Nurses Council
• Medical Research Council
• War Office
• the English National Board for Nursing, Midwifery and Health

Departments such as the Home Office, Treasury, Cabinet Office and the Prime Minister Office also contain records relating to hospitals. This is due to the intersection of public policy and budgets with the provision of public health care through hospitals and a substantial volume of records regarding the establishment of the NHS.

From the later 20th century to the present, Discovery also contains several archived websites and datasets relating to hospitals, reflecting the changing media of hospital-related records.

A place to begin

There is a wealth of information found in The National Archives collection that shows the history of hospitals over the centuries. This blog can provide a useful place to start exploring their histories. Further information can also be found on The National Archives' collection guides and explore the collection pages.

About the author

Jessica Gregory is a PhD student exploring Britain’s 19th and 20th century censorship laws at the University of Kent in partnership with the National Archives. Her thesis explores advertisements that were considered indecent by authorities because of their allusions to sex-related products through the years 1889–1939.

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