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Doctor-patient confidentiality: A best practice guide

Doctor-patient confidentiality: A best practice guide

GPs have an unusual relationship with their patients. Together, you might well share moments that are deeply emotional and come to learn details that they’ve shared with no-one else, not even their closest.

That’s part of the job – but it also presents a challenge to GPs. There’s a need for doctors to be able to protect patients – but there are other situations where sharing information might be necessary.

The General Medical Council has drawn up useful guidance for such scenarios. In this post, we take a look at some of the GMC’s advice to give you an understand

GP confidentiality: What the GMC says

There are six key areas highlighted by the GMC when it comes to doctor/patient confidentiality and data.

Education and training

Patients’ data should anonymised for this purpose. If it’s not possible to do so, medical professionals should ask for the patient’s consent. When obtaining this consent, you should be clear about what the information is set to be used for and who will be using it. Patients have to have the opportunity to say no – and shouldn’t feel obliged to take part.

Employer requests

GPs might be asked for information by someone’s employer. Similarly, data on the health of an individual might be requested by an insurance company or sports team. You should only comply with such requests if:

  • you’re happy that the patient knows what is being requested and how it’ll be used
  • you have seen written consent from the patient
  • you only provide factual information that is relevant to the matter
  • you offer to show the patient your report or send them a copy

Spread of serious disease

There are some circumstances in which the ‘public interest’ means that health information must be disclosed. The GMC outlines that this could be the case when it comes to ‘serious communicable diseases’. It states:  “If you consider that failure to disclose the information would leave individuals or society exposed to a risk so serious that it outweighs the patient’s and the public interest in maintaining confidentiality, you should disclose relevant information promptly to an appropriate person or authority.”

Driving

The above scenario demonstrates that doctors have a duty to protect and promote the health of the public as well as their patients. This can also collide with doctor/patient confidentiality when it comes to driving. A driver has a legal responsibility to tell the DVLA if they have a condition or treatment that means they are unfit to drive. Doctors should tell them if they have such conditions and make clear that driving is something that isn’t safe in these circumstances (and, legally, should be reported). However, if they continue to drive when unfit a GP may feel it’s in the public interest to reveal this to the DVLA. Even then, GPs should alert patients that they feel this is necessary and let them know when they have contacted the DVLA.

Gunshot and knife wounds

It’s clearly in the public interest for the police to investigate serious crimes such as those involving gunshot or knife wounds – but doctors need to be careful not to deter patients from coming forward when they need medical assistance too. Again, this is a balancing act. If you feel that your patient and/or others are at a serious risk, you should disclose this to the authorities in a sensitive and appropriate manner.

Media criticism

Some patients choose to publicly criticise their GPs in the media. This can be stressful and frustrating – especially if you feel the details they have given to the press are inaccurate or misleading. However, it’s important to note that this alone doesn’t relieve you of your duty to maintain confidentiality. A public row can undermine a GP’s standing in the eyes of other patients and prolong the issue. GPs are advised to avoid commenting – or sticking to general remarks about their practice.

 

Any GP who is concerned about confidentiality – whether that’s maintaining this or balancing it against the public interest – should seek support. Contact us if you have a query on confidentiality or any other matter relating to your work as a GP.

GPs call for longer consultation time

GPs call for longer consultation time

The importance of looking after our GPs has never been more vital as more surgeries close, along with a sustained fall in UK GP numbers. What this means, is that highly skilled professionals in our industry are under pressure to see and treat more patients in an already long working day.

Law firm Slater and Gordon took a survey of 200 family doctors and discovered that 80% of these GPs felt they didn’t have sufficient time to properly diagnose patients. 35% of those who took part in the survey admitted they had missed symptoms, while 37% believed they may have prescribed the incorrect course of treatment.

Clinical negligence expert Parm Sahota, from Slater and Gordon, told the Telegraph: “Working in this area of law I already knew GPs were stretched, but the timeframes they are expected to practice within are suffocating.”

Royal College of GPs: ’10-minute appointment not fit for purpose’

Chair of the Royal College of GPs, Professor Helen Stokes-Lampard has responded to this research. Here’s her full statement:

“It has been clear for some time that the standard 10-minute appointment is no longer fit for purpose. As GPs, we want to be able to deliver truly holistic care to our patients after considering all the physical, psychological and social factors potentially impacting on their health.

“But when you consider that very few patients now come to us with just one health-related condition, and that we are increasingly up against the clock in consultations, this is simply not possible and in some cases it could be unsafe.

“We know that GPs and our teams are working under intense resource and workforce pressures and as a result, hard-working, experienced family doctors are burning out, and leaving the profession earlier than they would have done. These must be addressed, not just to keep general practice – and the wider NHS – sustainable, but for our patients’ safety.

“We have called for 15-minute appointments as a standard, with longer for those patients with complex health needs who need it. But with GP workload soaring, falling numbers of family doctors, and patients waiting longer for appointments, we need more resources and an expanded workforce to make these longer consultations feasible – otherwise it will only add to pressures and serve to undermine patients’ ability to access the care that they need.”

Measures regarding longer appointment times are absolutely required to help GPs and it’s important to make it clear that the knowledge and skill of GPs is appreciated by patients across the UK. In response to this research, an NHS spokesperson told the Telegraph:

“The recent GP Patient Survey showed that more than nine in 10 patients trusted their GP, and more than eight in 10 people described their experience at their GP practice as good or better.”

Action needed to help GPs

It’s clearly important to look after our GPs in order for them to look after the health of the community. The call for longer appointment times as standard have been around for some time, but the action required to address this is becoming increasingly urgent. With the previously mentioned surgery closures and fall in GP numbers in the UK, there’s increasing pressure on family doctors across the country.

MDS CEO Rohan Simon said: “As an MDO set up by GPs for GPs, we’re acutely aware that some members of our profession feel under pressure. We’re keen to make sure that GPs get help in these instances and are able to access the correct support if they do make an error.

“If any GP does have a concern, we’d encourage them to contact us. As a nation, we need to look after our GPs so that we keep our skilled professionals in their roles and that they have the help they need to do their jobs to the best standard.”

There’s help at hand if you feel under pressure in your GP role. If you feel you need support, don’t hesitate to get in touch with us by calling 020 8938 3631, or alternatively contact us online here.