Confidentiality Flashcards
What is confidentiality?
The protection of a patient’s personal information or personal informed decision from unauthorised parties. (DoH, 2003).
The statutorily protected right and duty of health professionals not to disclose information acquired during consultation with a patient. (Medical Dictionary for the Health Professions and Nursing, 2012).
what do NMC say about confidentiality
As a nurse or midwife, you owe a duty of confidentiality to all those who are receiving care. This includes making sure that they are informed about their care and that information about them is shared appropriately.
what do GMC say about confidentiality
Patients have a right to expect that information about them will be held in confidence by their doctors.
what does the NHS say about confidentiality
Maintaining the confidentiality of health records is the duty of all staff involved in the delivery of health care. Accurate and secure personal health information is an essential part of patient health.
What makes information confidential?
A duty of confidence arises when one person discloses information to another (e.g. patient to clinician) in circumstances where it is reasonable to expect that the information will be held in confidence. It;
– a. is a legal obligation derived from case law
– b. is a requirement established within professional
codes of conduct
– c. must be included within NHS employment
contracts as a specific requirement linked to disciplinary procedures.
(NHS Code of Practice (DoH, 2003).)
Confidential information includes…
Person-identifiableinformation;
• Name, address, post-code, DOB, NHS/CHI number
• Parts of information that can be pieced together to identify
an individual
• Healthinformationinanyform,including‘word
of mouth’.
• Information that is private and not routinely shared.
• Certain information about NHS services, finances and general business.
• Occupational health and employee records.
• Information about colleagues that would not routinely be shared.
describe Confidentiality as a legal duty of care
• Arises from;
– Common law: decisions of courts – Statute law: passed by Parliament
• Data Protection Act 1998: superseded Data Protection Act 1984 and Access the Health Records Act 1990.
• Health information attracts a legal duty of confidence which prohibits disclosure without consent – BUT;
• The duty to share information can be as important as the duty to protect patient confidentiality.
describe The statutory obligation for disclosure of confidential information
Article 8 of the Human Rights Act 1998: Everyone has the right to respect for his private and family life, his home and his correspondence.
NHS (Venereal disease) Regulations 1974: GUM clinics can only release confidential information to the patient’s GP only with explicit consent from the patient (it cannot be implied).
Human Fertilisation and Embryology Act 1990 (1992 amendment): Fertility clinics also require explicit consent before allowing disclosure of information to the patient’s GP.
Abortion Act 1991: Abortions must be notified to the Chief Medical Officer.
Misuse of Drugs Act (1971): Known or suspected drug addicts must be notified to the Home Office.
Public Health (Infectious Diseases) Regulations 1988: Certain infectious diseases must be notified to the local authorities.
Prevention of Terrorism Act 2000: Any person with information that might prevent an act of terrorism must report it to the police.
Gillick competence/Fraser guidelines 1985: Whether or not a child is capable of giving the necessary consent will depend on the child’s maturity and understanding and the nature of the consent required.
describe Disclosure and breaching confidentiality
Release of relevant information.
In law, 3 types of information/disclosure
• Free and open-high
• Judicious - medium
• Secrets-low
Disclosure is only lawful and ethical if the individual has given consent to the information being passed on. Such consent must be freely and fully given.
Consent to disclosure of confidential information may be:
• implied
• explicit
• required by law or
• capable of justification by reason of the public interest
(NMC, 2012)
describe Disclosure with implied consent
When it is assumed that the person in the care of a nurse understands that their information may be shared within the health care team.
Nurses should make people in their aware of this routine sharing of information and clearly record any objection.
describe Disclosure with explicit consent
– When a person in the care of a nurse agrees to disclosure, having been informed of the reason for that disclosure and with who the information will be shared.
– Can be written or spoken.
describe Disclosure without consent
Required by law: a number of Acts create a duty to disclose information; – Children’s Act – Road Traffic Act – Terrorism Act – Criminal Investigations Act – Public Health Regulations
When is disclosure allowed?
Staffarepermittedtodisclosepersonal information in the vital interest of the individual to prevent harm or if it is a matter of life or death.
• Staff are permitted to disclose personal information if it is in the public interest in order to prevent and support detection, investigation and punishment of serious crime and/or to prevent abuse or serious harm to others;
• Serious crime and/or national security
• Significant risk of harm to the general public
describe Health protection legislation
Registered medical practitioners (RMPs) have a statutory duty to notify the ‘proper officer’ at their local council or local health protection team (HPT) of suspected cases of notifiable diseases.
All laboratories performing a primary diagnostic role must notify Public Health on the confirmation of a notifiable organism (causative agent).
what is Guidance for disclosing information (FIONA-C)
– Formal justification of purpose.
– Information transferred only when absolutely necessary.
– Only the minimum required.
– Need to know access controls.
– All to understand their responsibilities.
– Comply with and understand the law.
