As doctors, you often see patients at times of distress and difficulty. It is likely that you may come into contact with someone who is at-risk or suffering from abuse or neglect.
Take prompt action if you think that patient safety, dignity or comfort is or may be seriously compromised.
Whether or not you have vulnerable adults as patients, consider their needs and welfare and offer them help if you think their rights have been abused or denied.
Treat patients as individuals and respect their dignity and privacy.
Support patients in caring for themselves to empower them to improve and maintain their health.
Treat information about patients as confidential.
Be satisfied that you are handling personal information lawfully.
Disclose the minimum information necessary for the purpose.
Give patients information about all the options available to them in a way they can understand.
Listen to patients, take account of their views, and respond honestly to their questions.
Keep up to date with, and follow, the law, our guidance and other regulations relevant to your work.
Principles of adult safeguarding
- Adults have the right to live in safety, free from abuse and neglect
- People are supported to make decisions in their own interests
- Any intervention should be the least restrictive of the adult adult’s freedom
- The adult should participate as fully as possible in any decision that is made. Professionals should work collaboratively to provide appropriate protection, help and support.
What is abuse and neglect?
There are many forms of abuse that doctors and health care professionals need to be aware of. These include:
- Physical abuse
- Domestic violence/abuse
- Sexual abuse
- Psychological or emotional abuse
- Financial or material abuse
- Modern Slavery
- Organisational/ institutional abuse
- Neglect/acts of omission
- Self neglect
If you are familiar with the types of abuse and the clinical indications of abuse it will help you to identify which patients are at risk of harm. Many forms of abuse are criminal offences.
“…adults sometimes have complex interpersonal relationships and may be ambivalent, unclear or unrealistic about their personal circumstances.
…People have complex lives and being safe is only one of the things they want for themselves. Professionals should work with the adult to establish what being safe means to them and how that can be best achieved.”
Care Act 2014 Statutory Guidance
Disclosing information about adults at risk of harm
Safeguarding law and practice differs across the UK. You must be familiar with the procedures where you work.
In England, certain persons or bodies must give information to a Safeguarding Adults Board, at its request, to enable or assist the board to perform its functions. The explanatory notes to the Care Act 2014 make clear that individual doctors can be asked for information under this provision. You can find further information about Safeguarding Adults Boards in the Care and Support Statutory Guidance.
There are legal requirements in Wales for certain persons and bodies (including Health Boards and NHS Trusts) to provide information in response to requests from Safeguarding Boards and local authorities. Further information on Safeguarding Boards can be found in Social Services and Well being (Wales) Act 2014 Code of Practice: Working Together to Safeguard People Volume I Introduction and Overview.
Similar requirements exist in Scotland for public bodies (including Health Boards) to provide information to councils, where they know/believe an adult is at risk of harm action is required to protect them, and to Adult Protection Committees. Further guidance can be found in the Adult Support and Protection Code of Practice.
In Northern Ireland, arrangements exist for information to be shared in respect of vulnerable adults with the Northern Ireland Adult Safeguarding Partnership (NIASP). More information on NIASP is contained in 'Adult Safeguarding Prevention and Protection in Partnership'.
It will usually be appropriate tell patients about any disclosures you make, even if they are required by law.
Good medical practice
Confidentiality: good practice in handling patient information
Consent: patients and doctors making decisions together
The Royal College of General Practitioners have produced an Adult Safeguarding Toolkit that sets out duties and responsibilities around safeguarding in
The BMA’s Adult Safeguarding Toolkit is about doctors doctors’ responsibilities to safeguard adults who may be at risk of abuse or neglect.