Confidentiality, in a nutshell
Confidentiality forms a cornerstone of a Doctor-patient relationship and except for certain circumstances outlined in law; whatever is discussed in a consultation remains confidential. A medical secretary transcribes a clinical letter following consult, but they too are bound by the same requirements of confidentiality.
I send a copy of the clinical letter to a patient’s General Practioner and any other allied health professionals involved in their treatment, such as physiotherapists or referring clinicians. The General Medical Council (GMC) guidelines state that ‘appropriate information sharing is an essential part of the provision of safe and effective care. Patients may be put at risk if those who are providing their care do not have access to relevant, accurate and up to date information.’
The GMC outlines that I can rely on a patient’s ‘implied consent’ to share information with those who provide direct care. Implied consent, as per the GMC, means that ‘it would be reasonable to infer that the patient agrees to the use of information, even though this has not been directly expressed’.
I have yet to experience a situation where a patient does not wish me to share information with those involved in their treatment.
If information is shared that is not related to direct clinical care, such as audio and research, a patient’s consent is normally needed.
Personal information may be disclosed if a serious adverse incident has occurred that needs investigation. It is usually a statutory requirement of the Doctor to provide such information.
Public interest disclosures are another example of when information can be given without consent. This occurs when benefits to society arising from the disclosure outweigh the patient and public interest in keeping the information confidential. Examples include outbreaks of food poisoning.
I have to explain to my patients that the information obtained and given in the consultation will be shared in an appropriate manner with those people involved in their care. If you have any worries, please do not hesitate to discuss them with me.