Confidentiality: disclosing information about serious communicable diseases



We give examples of when it might not be practicable to seek consent in paragraph 14 of Confidentiality: good practice in handling patient information. You can find all of our guidance online.


In this guidance, the term ‘serious communicable disease’ applies to any disease that can be transmitted from human to human and that can result in death or serious illness. It particularly applies to, but is not limited to, HIV, tuberculosis, and hepatitis B and C.


You can get advice from Public Health England, Public Health Wales, Communicable Disease Surveillance Centre in Northern Ireland and Health Protection Scotland.


Good medical practice (General Medical Council, 2013). You can find all of our guidance online.


See Health clearance for tuberculosis, hepatitis B, hepatitis C and HIV: New healthcare workers (Department of Health, 2007); Health Clearance for Tuberculosis, Hepatitis B, Hepatitis C and HIV for new Healthcare Workers with direct clinical contact with patients (Scottish Government, 2008); The Management of HIV infected Healthcare Workers who perform exposure prone procedures: updated guidance (Department of Health, 2014); and HIV Infected Health Care Workers: Guidance on Management and Patient Notification (Scottish Government, 2005). 


Universal precautions, otherwise known as standard infection control precautions, are the basic infection prevention and control measures necessary to reduce the risk of transmitting infectious agents. Guidance on infection control is provided by Health Protection Scotland, NHS Wales, DHSSPS Northern Ireland and the Department of Health in England.


Guidance for clinical health care workers: protection against infection with blood-borne viruses – Expert Advisory Group on AIDS and the Advisory Group on Hepatitis (Department of Health, 1998); HIV post-exposure prophylaxis: guidance from the UK Chief Medical Officers’ Expert Advisory Group on AIDS (Department of Health, 2008). 


The NHS (Venereal Diseases) Regulations 1974, The NHS Trusts (Venereal Diseases) Directions 1991 and The NHS Trusts and Primary Care Trusts (Sexually Transmitted Diseases) Directions 2000 state that various NHS bodies in England and Wales must ‘take all necessary steps to secure that any information capable of identifying an individual… with respect to persons examined or treated for any sexually transmitted disease shall not be disclosed except – (a) for the purpose of communicating that information to a medical practitioner, or to a person employed under the direction of a medical practitioner in connection with the treatment of persons suffering from such disease or the prevention of the spread thereof, and (b) for the purpose of such treatment and prevention’. There are different interpretations of the regulations and directions, and concerns about their compatibility with the European Convention on Human Rights. In particular, there have been concerns that a strict interpretation of the regulations would prevent the disclosure of relevant information, except to other doctors or those working under their supervision, even with the patient’s consent. There have also been concerns that the regulations would prevent disclosure of information to known sexual contacts in the public interest. Our view is that the regulations and directions do not preclude disclosure if it would otherwise be lawful at common law, for example with the patient’s consent or in the public interest without consent.


See also our case study about a parent who refuses to allow her daughter to be tested for HIV.