Working with doctors Working for patients

Sharing information for direct care

26. Appropriate information sharing is an essential part of the provision of safe and effective care. Patients may be put at risk if those who provide their care do not have access to relevant, accurate and up-to-date information about them.9 Multidisciplinary and multi-agency teamwork is also placing increasing emphasis on integrated care and partnership working, and information sharing is central to this, but information must be shared within the framework provided by law and ethics.

Implied consent and sharing information for direct care

27. Most patients understand and expect that relevant information must be shared within the direct care team to provide their care.10 You should share relevant information with those who provide or support direct care to a patient, unless the patient has objected (see paragraphs 30 and 31).11

28. The usual basis for sharing information for direct care is the patient’s consent, whether that is explicit or implied (see paragraph 13 for definitions). You may rely on implied consent to access relevant information about the patient or to share it with those who provide (or support the provision of) direct care to the patient if all of the following are met.

a. You are accessing the information to provide or support the individual patient’s direct care, or are satisfied that the person you are sharing the information with is accessing or receiving it for this purpose.

b. Information is readily available to patients, explaining how their information will be used and that they have the right to object. This can be provided in leaflets and posters, on websites, and face to face. It should be tailored to patients’ identified communication requirements as far as practicable.

c. You have no reason to believe the patient has objected.

d. You are satisfied that anyone you disclose personal information to understands that you are giving it to them in confidence, which they must respect.

29. If you suspect a patient would be surprised to learn about how you are accessing or disclosing their personal information, you should ask for explicit consent unless it is not practicable to do so (see paragraph 14). For example, a patient may not expect you to have access to information from another healthcare provider or agency on a shared record.

Patient objections to sharing information for direct care

30. If a patient objects to particular personal information being shared for their direct care, you should not disclose the information unless it would be justified in the public interest,12 or is of overall benefit to a patient who lacks the capacity to make the decision. You can find further guidance on disclosures of information about adults who lack capacity to consent in paragraphs 41–49.

31. You should explain to the patient the potential consequences of a decision not to allow personal information to be shared with others who are providing their care. You should also consider with the patient whether any compromise can be reached. If, after discussion, a patient who has capacity to make the decision still objects to the disclosure of personal information that you are convinced is essential to provide safe care, you should explain that you cannot refer them or otherwise arrange for their treatment without also disclosing that information.

If a patient cannot be informed

32. Circumstances may arise in which a patient cannot be informed about the disclosure of personal information, for example in a medical emergency. In such cases, you should pass relevant information promptly to those providing the patient’s care.

33. If the patient regains the capacity to understand, you should inform them how their personal information was disclosed if it was in a way they would not reasonably expect.