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Castle Health Centre , Colliery Road , Chirk , Wrexham , LL14 5DH
Telephone: 01691 772 434
Fax: 01691 773 840

 


   Confidentiality

 

Introduction

Confidentiality has been a keystone of medical practice since the introduction of the Hippocratic Oath and is the fundamental basis of the patient-doctor relationship.

Confidentiality is not only recognised in the medical profession's ethical code but also enshrined in a variety of statutes including the Human Rights Act (1998) and the Data Protection Act (1998). Article 8 of the European Convention on Human Rights, for example, gives individuals the right to respect for privacy and this includes medical records.

Legal, social and technological changes have brought increasing pressure on doctors to disclose information, but their duties to respect their patients' confidentiality remain largely the same.

The issue of confidentiality has been highlighted in recent years by the development of information technology. The use and exchange of information electronically means that it is no longer as easy as it was to maintain confidentiality and in 1997 a commission led by Dame Fiona Caldicott reported in detail on access to clinical information within the NHS.

This is a brief guide to how the Practice guards the confidentiality of personal information and strives to meet the requirements of the Caldicott Commission.

If you have any comments or concerns about issues of confidentiality please write to the Practice Manager.


Confidentiality & The Law

There are a number of laws relating to patient confidentiality. The two central ones are:

  • The Access to Health Record Act (1990) which now only applies to the medical records of deceased patients.
     
  • The Data Protection Act (1998) which is now the central piece of legislation. It regulates the processing of information about individuals "including the obtaining, use or disclosure of information." it gives individuals the right to be told what information is held about them and to see it, under certain restrictions. Paper and electronic records are covered, without time limit.

The Disclosure of Information

Third Parties

A doctor may only disclose information to a third party with the express consent of the patient - preferably in writing. This consent must be `informed' i.e. the patient must understand:

  • to whom the information will be disclosed
  • precisely what will be disclosed
  • the purpose of the disclosure
  • the significant, foreseeable consequences
  • that in certain circumstances e.g. disclosure to an insurance company, relevant information cannot be withheld
  • If a patient withholds consent a doctor may only disclose information where it is justified in the public interest - to protect the patient or a third party from the risk of death or serious harm. If a patient cannot be persuaded then he/she should be advised that the information will be disclosed.

Children

  • Children over 16 have the same right to confidentiality as adults. If under 16 and mature enough to understand the proposed treatment the doctor must respect the child's wishes with regard to confidentiality. If the child is not competent, whoever has responsibility under the Children's Act (1989) must give the authority to disclose. In all cases the overriding consideration must be what is in the best interests of the child.
     
  • A child's natural parents have parental responsibility if they were married at the time of the child's birth. Information about a young child may be disclosed to either parent without the consent of the other. If separated or divorced this is still the case unless a court order has removed parental responsibility from one or the other.

Deceased Patients

  • The obligation to respect patient confidentiality extends beyond death. Disclosure requires the authority of an executor or next of kin.
     
  • Anyone who may have a claim arising out of a patient's death may be entitled to see the patient's records under the Access to Health Records Act (1990).

Chirk's Confidentiality Policy

  • confidentiality is a cornerstone of health care and central to the work of everyone in the Practice
     
  • all information about patients is confidential, from the most sensitive diagnosis to the fact of being registered with the Practice or of having visited the Practice
     
  • the duty of confidentiality owed to a person under 16 is as great as that owed to any other person
     
  • all patients can expect that their personal information will not be disclosed without their permission except in the most exceptional of circumstances, when somebody is at grave risk of serious harm
     
  • standards of confidentiality apply to all health professionals, including students or others observing practice, who must follow their professional codes of practice and the law in making every effort to protect confidentiality
     
  • standards of confidentiality apply to all staff, who are required to sign a confidentiality agreement and are bound by contracts of employment to maintain confidentiality
     
  • non-clinical members of staff will not take decisions about the disclosure of confidential information on their own
     
  • people who are not employed by the Practice but who are working in the surgery will also be asked to sign a confidentiality agreement
     
  • any decision to disclose information to protect health, safety or well being will be taken by the relevant health professional in consultation with another member of the Practice or with a professional regulatory or defence body
     
  • any decision to disclose information to protect health, safety or well being will be taken in consultation with the patient if possible
     
  • any decision to disclose information to protect health, safety or well being will be based on the degree of current or potential harm, not on the age of the patient
     
  • the partners, as employers, are responsible for ensuring that everybody employed by the Practice understands the need for, and maintains, confidentiality
     
  • the partners, as employers, have responsibility for ensuring that systems and mechanisms to protect confidentiality are in place
     
  • the partners, as employers, are responsible for the actions of all those working in the Practice
     
  • policy and training will be reviewed on an annual basis by the Practice Manager

The Enforcement of Confidentiality

  • The GMC and the UKCC are responsible for regulating doctors and nurses over confidentiality.
     
  • A breach of confidentiality might lead to a finding of serious professional misconduct and possible loss of registration.
     
  • Our doctors have a personal duty to ensure that their staff are fully aware of the need for confidentiality.
     
  • All staff have a confidentiality clause written into their contract of employment.
     
  • All staff may be dismissed for a breach of confidentiality.

 

 
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Forthcoming Events

 
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