Making and using visual and audio recordings of patients

Recordings made as part of a patients care, including investigation or treatment of a condition

Recordings for which separate consent is not required

10

Consent to make the recordings listed below will be implicit in the consent given to the investigation or treatment, and does not need to be obtained separately.

  • Images of internal organs or structures
  • Images of pathology slides
  • Laparoscopic and endoscopic images
  • Recordings of organ functions
  • Ultrasound images
  • X-rays
11

When seeking consent to treatment or any other procedure6  that involves making one of the recordings listed in paragraph 10, you should, where practicable, explain that such a recording will be made and could be used in anonymised form for secondary purposes, including in the public domain.

6

See part 2 of Consent: patients and doctors making decisions together for advice on making decisions about investigations and treatment, including sharing information with patients. 

12

You may disclose or use any of the recordings listed in paragraph 10 for secondary purposes without seeking consent provided that, before use, the recordings are anonymised; for example, by the removal or coding of any identifying marks such as writing in the margins of an X-ray (see paragraph 17). Further advice on anonymising information is available from the Information Commissioner’s Office.7 

17

You may disclose anonymised or coded recordings for use in research, teaching or training, or other healthcare-related purposes without consent. In deciding whether a recording is anonymised, you should bear in mind that apparently insignificant details may still be capable of identifying the patient. You should be particularly careful about the anonymity of such recordings before using or publishing them without consent in journals and other learning materials, whether they are printed or in an electronic format.

7

See the Information Commissioner's Office for organisations.

Recordings for which specific consent is required

Consent to make recordings as part of the patient's care

13

You must get the patient’s consent to make a recording that forms part of the investigation or treatment of a condition, or contributes to the patient’s care, except in the circumstances described in paragraph 10. You should explain to the patient why a recording would assist their care, what form the recording will take, and that it will be stored securely.

14

Wherever practicable, you should explain any possible secondary uses of the recording in an anonymous or coded form when seeking consent to make the recording. You should record the key elements of the discussion in the patient’s medical record.

Disclosure and use of recordings made as part of the patient's care

15

Recordings made as part of the patient’s care form part of the medical record, and should be treated in the same way as written material in terms of security and decisions about disclosures. You must therefore follow the GMC’s guidance in Confidentiality: good practice in handling patient information. You will usually need the patient’s consent before disclosing recordings from which the patient can be identified (see paragraph 17). But disclosures may also be made where they are required by law, directed by the judge or other presiding officer of a court, or can be justified in the public interest.

16

Disclosures in the public interest may be justified where the benefits to an individual or to society of the disclosure outweigh both the public and the patient’s interest in keeping the information confidential. You must weigh the harms that are likely to arise from nondisclosure of information against the possible harm, both to the patient and to the overall trust between doctors and patients, arising from the release of information. You must make a separate assessment in each case, taking into account the proposed content of the recording, the way in which it will be used, the patient’s rights to respect for their privacy and dignity, and whether making information publicly available is necessary to fulfil the objective.  For further information about disclosures in the public interest see our guidance Confidentiality: good practice in handling patient information.8 

8

Paragraphs 63-70 of Confidentiality: good practice in handling patient information, provide advice on disclosing information in the public interest.

17

You may disclose anonymised or coded recordings for use in research, teaching or training, or other healthcare-related purposes without consent. In deciding whether a recording is anonymised, you should bear in mind that apparently insignificant details may still be capable of identifying the patient. You should be particularly careful about the anonymity of such recordings before using or publishing them without consent in journals and other learning materials, whether they are printed or in an electronic format.

Adult patients who lack capacity - making recordings as part of care

18

If you judge that an adult patient lacks capacity9  to decide about an investigation or procedure which involves a recording, you must get consent from someone who has legal authority to make the decision on the patient’s behalf10  before making the recording.

9

Further guidance on assessing capacity is set out in Consent: patients and doctors making decisions together

10

Welfare attorneys and court-appointed guardians (Scotland); holders of lasting powers of attorney and court-appointed deputies (England and Wales).

19

Where no individual has legal authority to make the decision on a patient’s behalf, or where treatment must be provided immediately, recordings may still be made where they form an integral part of an investigation or treatment that you are providing in accordance with the relevant legislation or common law.11 

11

Making decisions about treatment and care of patients who lack capacity is governed in England and Wales by the Mental Capacity Act 2005 and in Scotland by the Adults with Incapacity (Scotland) Act 2000. In Northern Ireland, there is currently no relevant primary legislation, and decision making for patients without capacity is governed by the common law. At the time of publication, a legislative framework for new mental capacity and mental health legislation is being developed.

Adult patients who lack capacity - disclosure and use of recordings made as part of care

20

Where a recording has already been made as part of the patient’s care, but may also be of value for a secondary purpose, you should anonymise or code the recording wherever that is practicable and will serve the purpose. If the recording cannot be anonymised or coded, you should seek the agreement of anyone with legal power to make decisions on behalf of the patient. If there is no person appointed, the law permits you to decide whether the recording can be used. Whoever takes the decision it should be made in the public interest, in accordance with the relevant legislation or common law (see paragraph 16).12 

16

Disclosures in the public interest may be justified where the benefits to an individual or to society of the disclosure outweigh both the public and the patient’s interest in keeping the information confidential. You must weigh the harms that are likely to arise from nondisclosure of information against the possible harm, both to the patient and to the overall trust between doctors and patients, arising from the release of information. You must make a separate assessment in each case, taking into account the proposed content of the recording, the way in which it will be used, the patient’s rights to respect for their privacy and dignity, and whether making information publicly available is necessary to fulfil the objective.  For further information about disclosures in the public interest see our guidance Confidentiality: good practice in handling patient information.8 

12

Personal information can be disclosed if it will benefit or is in the best interests of the patient but this is unlikely to apply in the circumstances covered by this guidance. Paragraphs 13-17 of  Confidentiality: Disclosing information for education and training purposes provides advice on disclosing personal information for education and training purposes about patients who lack capacity. 

Children or young people - making recordings as part of care

21

Children or young people under 16 who have the capacity and understanding to give consent for a recording may do so, but you should encourage them to involve their parents in the decision making. Where a child or young person is not able to understand the nature, purpose and possible consequences of the recording, yo must get consent from a person with parental responsibility to make the recording.13  You should follow the advice in paragraphs 13 - 14 on seeking consent to make a recording, and in paragraphs 15 - 17 on disclosure and use of recordings made as part of care.

13

You must get the patient’s consent to make a recording that forms part of the investigation or treatment of a condition, or contributes to the patient’s care, except in the circumstances described in paragraph 10. You should explain to the patient why a recording would assist their care, what form the recording will take, and that it will be stored securely.

14

Wherever practicable, you should explain any possible secondary uses of the recording in an anonymous or coded form when seeking consent to make the recording. You should record the key elements of the discussion in the patient’s medical record.

15

Recordings made as part of the patient’s care form part of the medical record, and should be treated in the same way as written material in terms of security and decisions about disclosures. You must therefore follow the GMC’s guidance in Confidentiality: good practice in handling patient information. You will usually need the patient’s consent before disclosing recordings from which the patient can be identified (see paragraph 17). But disclosures may also be made where they are required by law, directed by the judge or other presiding officer of a court, or can be justified in the public interest.

16

Disclosures in the public interest may be justified where the benefits to an individual or to society of the disclosure outweigh both the public and the patient’s interest in keeping the information confidential. You must weigh the harms that are likely to arise from nondisclosure of information against the possible harm, both to the patient and to the overall trust between doctors and patients, arising from the release of information. You must make a separate assessment in each case, taking into account the proposed content of the recording, the way in which it will be used, the patient’s rights to respect for their privacy and dignity, and whether making information publicly available is necessary to fulfil the objective.  For further information about disclosures in the public interest see our guidance Confidentiality: good practice in handling patient information.8 

17

You may disclose anonymised or coded recordings for use in research, teaching or training, or other healthcare-related purposes without consent. In deciding whether a recording is anonymised, you should bear in mind that apparently insignificant details may still be capable of identifying the patient. You should be particularly careful about the anonymity of such recordings before using or publishing them without consent in journals and other learning materials, whether they are printed or in an electronic format.

13

Further information about assessing capacity and consent issues for children or young people is set out in our guidance 0-18 years: guidance for all doctors