On behalf of Network Locum (now Lantum), Dr Ishani Patel has written a series of Case Studies for fellow GPs.
Patient confidentiality
Case:
I received a letter from a solicitor asking for proof that the nephew of a registered patient was Mrs M’s main carer and as he was seeking the ‘right to remain’ in the UK, a letter confirming Mrs M’s medical conditions, her physical limitations and carer requirements would be useful for her nephew’s immigration case. The letter did not contain any evidence of patient consent to release information and the patient herself had not been seen by the practice for over four months. It appeared from the record that there was little continuity in her care over the past several years and no details in the patient healthcare record regarding the patient’s mobility or history of carer needs. The patient is blind in one eye from a retinal detachment several decades ago.
I wrote to Mrs M directly informing her that I had received this request and asked her to make a routine appointment in person, with her nephew if necessary to meet with me.
Two weeks later I was due to see Mrs M however her son, also a registered patient, attended the appointment alone. He asked me to provide proof of his mother’s various mobility and medical problems. I explained my duty of care and the legal aspects of protecting Mrs M's confidentiality - I was unable to divulge any verbal or written information without Mrs M’s consent. The patient herself was abroad due to a family bereavement. The consultation concluded having explained that I was unable to provide a report until I had consulted with Mrs M directly.
Talking points:
The GMC published Confidentiality in 2009 which sets out the principles of confidentiality and respect for patients' privacy that doctors are expected to understand and follow.
GPs have a duty to protect and observe patient confidentiality unless there is a concern of a patient vulnerability or risk to themselves or the public. There is specific guidance relating to children, vulnerable patients, and even employment and insurance reports.
Patients must be able to trust doctors with their lives and health. To justify that trust you must show respect for human life and you must:
Make the care of your patient your first concern
Protect and promote the health of patients and the public
Provide a good standard of practice and care
Keep your professional knowledge and skills up to date
Recognise and work within the limits of your competence
Work with colleagues in the ways that best serve patients’ interests
Treat patients as individuals and respect their dignity
Treat patients politely and considerately
Respect patients’ right to confidentiality
Work in partnership with patients
Listen to patients and respond to their concerns and preferences
Give patients' the information they want or need in a way they can understand
Respect patients’ right to reach decisions with you about their treatment and care
Support patients' in caring for themselves to improve and maintain their health
Be honest and open and act with integrity
Act without delay if you have good reason to believe that you or a colleague may be putting patients at risk
Never discriminate unfairly against patients or colleagues
Never abuse your patients’ trust in you or the public’s trust in the profession.
You are personally accountable for your professional practice and must always be prepared to justify your decisions and actions.
To access further information regarding confidentiality click here: http://www.gmc-uk.org/static/documents/content/Confidentiality_0910.pdf
