Lloyd George envelope

David Lloyd George introduced a card to record medical information for low-income male workers who paid into National Health Insurance, a scheme introduced following the National Insurance Act 1911, when he was Chancellor of the Exchequer. Its creation has been seen as the beginning of the development of a nationally compatible records system. Between 1911 and the formation of the NHS in 1948, the record-keeping cards were in general use by health boards. Their size was based on their storage in the large number of available ammunition boxes during the First World War. ==Design and usage==

Lloyd George envelopes are beige-coloured card wallets and measure with red or blue markings for male or female patients, respectively. Owned by the Secretary of State for Health, the Lloyd George record stayed with the individual's GP, wherever they moved to in the UK, and hence contain a person's lifelong health record. Continuation cards can be inserted inside. These have the date of printing in the bottom right-hand corner. The Lloyd George record has been seen by some to have a certain sense of privacy, with notes tucked away in the wallet, unlike being visible on a computer screen. Their small size was seen by some as "easy to handle". They provided an easy to visualise summary, prevented unnecessary lengthy note making and could be carried in the doctor's coat pocket when out on a home visit. ==Limitations==

Recorded detail varied between physicians, and ranged from documenting every illness to omitting major surgical procedures. Hospital letters typically arrived in an A4 form and needed to be folded to fit into a Lloyd George envelope, whereas new sheets were easily added into the larger folders. Medical record-keeping varied among practices, from solely using Lloyd George records, to adapting them, to using a combination of Lloyd George and A4, to, in a few cases, moving to computer records. Effective use of Lloyd George records was seen as requiring an almost obsessional attention to detail. ==Discontinuation==

In the latter part of the twentieth century, as record keeping became more detailed and hospital interventions resulted in more documentations, the Lloyd George envelopes became increasingly bulky. The envelopes were phased out in the late twentieth century and mostly replaced with A4 folders, and eventually digitised with the adoption of computerised medical records. Since then, no further Lloyd George envelopes are produced. File:Lloyd George envelopes in box.jpg|Lloyd George envelopes stacked in box: compact, with insertion cards and folded hospital letters File:Lloyd George envelopes with inserts- joined.jpg|Lloyd George envelopes held by rubber band File:Lloyd George envelope with inserts and extension.jpg|Lloyd George envelopes held by Sellotape ==References==