Confidentiality

What is confidentiality?

The duty of confidentiality requires Doctors, and other healthcare professionals, to keep their patients’ information private within the healthcare team, apart from in some very specific circumstances.

When can you breach confidentiality?

1. Implied consent has been given by the patient.

2. Information required by court / judge.

3. In the public interest and to protect patients or others.

4. Where patient may lack capacity and sharing the information is of overall benefit to the patient.

How is confidentiality breached if implied consent has been given by the patient?

E.g. a patient diagnosed with an illness asks the doctor to inform their family of the treatment options and prognosis.

How is confidentiality breached if information is ordered by a court / judge?

E.g. if police need access to medical records in the course of an investigation ( insurance fraud, etc.). This requires a court order.

How is confidentiality breached in the public interest or to protect patients or others?

• Where the interest to society / others of disclosing the information without the patient’s consent outweighs the benefit to the patient of keeping information confidential.

• Notification to authorities of notifiable diseases e.g. tuberculosis, measles, mumps etc. Note HIV and AIDS are not notifiable.

• Suspected cases of child abuse or of neglect, physical or emotional abuse, where the patient cannot give consent to disclosure.

• Informing the DVLA if a patient’s condition may affect their driving.

How is confidentiality breached where a patient may lack capacity?

E.g. a person with a severe mental illness plans to self-harm, the doctor may contact a mental health team to protect the patient.

If confidentiality has to be broken, how should it be done?

1. Informing the patient first (helps to maintain the doctor patient relationship).

2. Sharing the minimum information necessary.

Why is confidentiality important?

• Confidentiality is key in building trust in the doctor-patient relationship.

• Patients are likely to under-report their symptoms, or even avoid seeking medical help if they think that their confidential information will be disclosed without consent.