Confidentiality

About the guidance

Confidentiality (2009) sets out the principles of confidentiality and respect for patients' privacy that doctors are expected to understand and follow.

Use the tabs below to

  • read the guidance;
  • see how these principles apply in situations doctors often encounter or find hard to deal with; and
  • access a range of learning materials, including
    • case studies
    • a PowerPoint presentation for teaching others, and
    • a literature review.

Confidentiality

You can use this online version or the headings on the left to find the guidance you need quickly and easily.

You can navigate through the guidance page by page using the links at the foot of each page or browse for something more specific through the contents page, or open a pdf version of Confidentiality.

Explanatory guidance

Explanatory guidance explaining how these principles apply in situations doctors often encounter or find hard to deal with is available below:

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Case studies

Case studies

These case studies highlight and explore some of the principles covered in Confidentiality and its explanatory guidance. We hope that they will help doctors and others to understand how the principles in the guidance apply in practice. They are intended to illustrate the principles in the guidance, and are not a substitute for the guidance, or for specific advice from experienced colleagues, a Caldicott Guardian or equivalent, or a professional or regulatory body.

  • Elder abuse - what should Dr Rix do when his elderly patient tells him, in the strictest confidence, that her daughter and carer has hit her?
  • Serious communicable diseases - what should Dr Biggs do when his patient says he does not want his GP, and later his surgeon, to be told of his HIV diagnosis?
  • Vulnerable adults - what should Dr Praed do when he learns that a young patient with learning disabilities is falling into bad company and neglecting his diabetes?
  • Alcoholic colleague - Dr Okonkwo is a GP whose patient is a physician with an alcohol problem. Should Dr Okonkwo raise a concern about her patient's fitness to practise?
  • Sex offender - Dr Hosta is a psychiatrist treating a sex offender who she thinks might not register with the police. Should Dr Hosta report her concerns to the police or prison service?
  • Deceased patient - Dr Kaur receives a letter from solicitors acting for a deceased patient's widower, asking for copies her medical records; but they contain details of a termination from before their marriage as well as information about her mental health provided by the patient's daughter. Should she disclose?
  • Reporting crime - Dr O'Hara  is a doctor in a drug addiction clinic. Her mobile phone is stolen and she has good reason to believe it was one of six patients. Should she report the theft to the police, even if it involves identifying the patients, without being sure which of them stole the phone?
Please Note

The case studies are fictional and for illustration purposes only.

They provide examples of how the principles in the guidance might be applied in the kind of situations doctors encounter. Decisions about disclosing confidential information without consent are among the most difficult doctors have regularly to make, relying on a careful balancing of the factors specific to the case at hand.

These learning materials do no represent GMC guidance or policy in themselves, nor are they intended to replace Confidentiality, the explanatory guidance on confidentiality or any other GMC guidance.

GMP in action 

GMP in action is an interactive web section which brings the GMC's ethical guidance to life.

You get to choose what the doctor should do in a series of case studies highlighting how the principles in our guidance might work in practice.

The following case studies explore issues covered in Confidentiality.  Please note that when you access the interactive case studies, you must first click on the receptionist.   

 
Adrian. Adrian goes to a sexual health clinic where Dr Peters realises that Adrian's partner has not told Adrian that she is HIV positive. Should Dr Peters disclose this information to Adrian? Decide what Dr Peters should do.
Mr Jessop. Mr Jessop shares concerns about his wife's fitness to drive with their GP, Dr Williams. Should Dr Williams inform the DVLA? And should she tell Mrs Jessop the source of her concerns? Decide what Dr Williams should do.
Dr MacDonald. A young man is brought to A&E with what looks like a stab wound. Should Dr MacDonald tell the police? What should she say when there is criticism of the case in the local press? Decide what Dr MacDonald should do.
Marlena Cieslak. Marlena Cieslak attends A&E with injuries resulting from domestic violence, but does not want the police involved. Decide what Dr Gallagher should do.
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Presentation

Presentation

This PowerPoint presentation provides some historical, ethical and legal context to the guidance, including an explanation of why confidentiality is seen as such a fundamental professional value.

It highlights what's new in the guidance and some of the confidentiality questions most frequently asked by doctors and patients.

Please feel free to use it in your own teaching and training.

Please note - To view the additional notes in the presentation, you will need to save it to your computer and open the presentation from there.

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Background

Development of the guidance

You can read more about the development of Confidentiality (165kb, pdf), which explains the process we undertook during the review, and the results of an audit (119kb, pdf) undertaken of the process for analysing the responses we received during two phases of consultation. 

Literature review

What concerns do patients and the public have about privacy in healthcare? How far do doctors understand their legal and ethical duties to seek consent, respect objections and when to share information about patients? A literature review of Public and Professional Attitudes to Privacy of Healthcare Data (316kb, pdf) was one part of the scoping work for the review which led to this guidance.

Podcast

Listen to a podcast on reporting gunshot and knife wounds:

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