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Confidentiality – how do you ensure everyone is protecting patient information?
The General Medical Council (GMC) has published revised, expanded and re-organised guidance on confidentiality for all doctors practising in the UK.
We continue to train our staff on confidentiality; we ask everyone to sign confidentiality agreements and check that they understand what the agreement means, but a simple question asked of a member of staff by a patient is relatively easy to answer in the wrong way which in turn can lead to breaking patient confidentiality.
Let’s take this scenario as an example, whereby a receptionist is asked a simple question from a patient on the telephone and the receptionist’s train of thought from the patient's question which triggers the answer.
The patient is sent a recall letter inviting them in for an annual review. As we know, we send out 3 invite letters to patients. The patient hadn’t responded to the first invite, therefore the administrative team sent the patient a second letter which includes the text stating that they haven’t responded to the first letter.
A receptionist takes a phone call which happens to be on a Monday morning when the phones are the busiest. The receptionist had taken numerous calls that morning from patients demanding an appointment that day and had also dealt with an urgent call from a patient. The patient says ‘Hello it’s Mr. Bloggs speaking, I have a letter from the practice which says it’s the second letter for an annual review, but I have not had the first letter from you.’ The receptionist, who doesn’t send out letters, but obviously wants to deal with the call, looks up Mr. Bloggs on the practice computer as there is only one patient with this name, and can see that he had a first letter a month ago and a subsequent second letter. The receptionist considers to themselves whether the practice may have an incorrect address for the patient, and asks the patient, ‘Is your address 100 Any Street?’ Of course, what the receptionist should have said was, ‘Can you confirm your address please?’
As soon as the receptionist had made the mistake, they realised their error, but by then it was too late and the patient was not happy; they yelled at the receptionist over the phone and behaved in a very rude manner, causing upset and distress to the receptionist. The patient’s basic point of the fact that anyone could ring and say it’s Mr. Bloggs speaking was correct, but his angry reaction and his follow-up of writing a letter of complaint to the practice was the end result.
This is just an example of how a member of staff can easily word a question incorrectly and how easy it is to make a genuine mistake, something that is especially true if confidentiality training isn’t regularly revised and updated among staff.
GMC Chief Executive Charlie Massey says:
This refreshed, revised and restructured guidance on confidentiality will help doctors better understand their responsibilities when handling patient information in their everyday practice.
The guidance – Confidentiality: good practice in handling patient information – comes into effect on Tuesday 25 April 2017.
- The public protection responsibilities of doctors, including when to make disclosures in the public interest.
- The importance of sharing information for direct care, recognising the multi-disciplinary and multi-agency context doctors work in.
- The circumstances in which doctors can rely on implied consent to share patient information for direct care.
- The significant role that those close to a patient can play in providing support and care, and the importance of acknowledging that role.