Sharing information with non-clinical staff involved in the direct care of a patient

Background

Mr Villiers had testicular cancer and had a testicle removed. He has regular reviews to check that the cancer hasn’t returned. 

When Mr Villiers starts a new job as head teacher in a village school, he comes to register at Dr Kelly’s GP practice. 

Scenario 

Mr Villiers is concerned because the practice manager and one of the receptionists have children who attend his school.  He is concerned about this as he doesn’t want them to know about his surgery – he is worried that other parents, or children may find out. He asks Dr Kelly for a guarantee that only the doctors will have access to his medical records.

Dr Kelly is sympathetic to Mr Villiers’ concerns.

What the doctor did

Dr Kelly explains to Mr Villiers the important role that administrative staff play in supporting patient care. For example, they scan incoming test results into the electronic record system for the GPs to review. He also explains that with only a small number of staff there may be periods of several days when only the practice manager and receptionist are on duty. It would be impractical, and possibly unsafe, to tell these particular members of staff not to deal with any correspondence relating to Mr Villiers’ care. 

Dr Kelly reassures Mr Villiers that his staff are aware of their of their contractual obligations and personal responsibilities to maintain confidentiality, and have recently had training on the subject. 

What the doctor had to consider

• Most patients understand and expect personal information about them to be shared with the doctors and other professionals who provide or arrange their direct care. This also includes the administrative staff who directly support that care e.g. by managing correspondence. 
• Doctors can rely on a patient’s implied consent to disclosures for direct care purposes as long as:
• Doctors 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 and consider whether compromise is can be reached. If not, and the doctor thinks it is essential to share information to provide the patient with safe care, they should explain that they can’t refer for or arrange treatment without it.
• Doctors with management responsibilities should make sure that any staff employment contracts they’re responsible for contain obligations to protect confidentiality.