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You will be connecting to our educational partner, which controls its own content, practices, and other policies.

  • Overview
  • Activity
  • Post-Test
  • Evaluation
  • Claim Credit
Good record-keeping

Good record-keeping



Time to Complete

0.5 hours


April 25, 2017


August 7, 2018

Programme Description

In this free article, MDU medico-legal adviser Dr Sally Old looks at the essentials of good record-keeping in primary care. Key learning points for GPs include what should be included in records, and common pitfalls to avoid. This article is provided by the MDU.

This article forms part of the MDU's Safe, ethical practice learning plan worth 4.5 CPD credits.

Educational Objectives

After reading this activity, healthcare professionals should be better able to:
  • Recall General Medical Council guidance on principles of record-keeping
  • List what should be included in patient notes
  • Reflect on how notes should be made so as to support patient care
  • Know how to avoid common pitfalls that may lead to complaints or claims
  • Know what to do if they make an error in notes
  • Author

    Activity and test author
    Dr Sally Old
    Medico-legal adviser
    Medical Defence Union


    This article is provided by the MDU


    This is a learning activity provided by MIMS Learning, featuring learning material and a test. Completing the test enables you to claim 0.5 learning credits (0.5 hours learning). This credit award is recommended by MIMS Learning based on completing the activity and reflecting on what you have learned. If you spend less time on the activity we recommend claiming fewer credits.

    Please proceed with the activity until you have successfully answered all the test questions and completed your evaluation. You will then receive your MIMS Learning CPD certificate, which will be added to your CPD organiser for access at any time and may be exported to the Clarity & RCGP Appraisal Toolkit for GPs. This activity is offered at no cost.


    Hardware and Software Requirements
    • A computer with an internet connection
    • Internet Browser: Internet Explorer 7.x or higher, Firefox 4.x or higher, Safari 2.x or higher, or any other W3C standards compliant browser
    • Additional Software: Adobe Flash Player and/or an HTML 5 capable browser maybe required for video or audio playback. PowerPoint or Adobe Acrobat Reader may occasionally be required
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