I don't remember a discussion - although I may just have missed or being old, my memory is terrible.

Two things spring to mind:

Why is a GP receptionist not caught by confidentiality? The NHS has a Confidentiality Code of Conduct to which anyone working in the NHS arena (paid by the NHS or not) must abide. I therefore do not think that it is true to say they are not caught within the relevant medical confidentiality rules. I would also be very surprised if their contract of employment did not make reference to confidentiality, They would also be caught by the Common Law Duty of Confidence as I would say that all three conditions for this to apply would be met in all such circumstances. In addition they would be required to complete, at least, the online training available to NHS organisations, and mandated by the DH.

Secondly, as someone who has NHS Clients and is also a user of their services I have never come across medical receptionists triaging patients, as they are not qualified to do so. When I call my doctor the receptionist always offers me the earliest available appointment. They then (after the appointment has been confirmed) ask if I can tell them the problem, they always state that there is no need to but it might help the doctor in advance of the consultation. 

If receptionists are doing this in places (and I am sure there will be exceptions), then this is bad practice and someone needs to complain to that GP practice or the local PCT (or CCG as it will be from next month).

If people so see a wider issue here, it might make a good subject for a study for someone's Masters or similar in order to get supporting evidence one way or the other.


Simon Howarth MSc. MBCS CITP
www.informationedge.co.uk



-----Original Message-----
From: This list is for those interested in Data Protection issues [mailto:[log in to unmask]] On Behalf Of Ian Welton
Sent: 19 March 2013 10:52
To: [log in to unmask]
Subject: [data-protection] Confidentiality

The ICO's recent prosecution:-

Medical receptionist prosecuted after
unlawfully accessing patient’s details
http://www.ico.gov.uk/news/latest_news/2013/medical-receptionist-prosecuted-after-unlawfully-accessing-patients-details-12032013.aspx

brought to mind a subject I was intending to document at a later stage (when more supportive documentation was available) but upon further reflection that delay appeared as cruel a reflection of the actions being considered as the acts themselves.

Part of the responsibilities
of Doctors - General Practitioners (GP's) - is to monitor the general health of the population and report to a central point health matters of local concern. In that way, by that mechanism, health problems could be identified and dealt with at an early stage and the general health of the population would be improved; Society would benefit.

Recently
(The last few years) guidance discussed within the DP health world regarding an old problem doctors receptionists historically had, in prioritising cases, was provided with an answer from the data protection world. Receptionists should give a 14 day waiting period for patients who did not state what was wrong with them, and hence the patient would be put in a situation where the only way to get an appointment in a reasonable time period was to disclose to the receptionist their health problem allowing the receptionist themselves to determine the seriousness of that complaint and correctly create an appointment. The DP discussion oddly centred upon receptionists not being caught within the relevant medical confidentiality rules.

This
has lead to a situation where, to my knowledge, people with what can be seen as minor symptoms when discussed over the phone by a patient with little medical knowledge are given later appointments than medically required, and people who do not wish to discuss what can be very serious medical ailments are given 14 day appointments.

An outcome for
things like stomach problems caused by something within the community is that they are never seen by the GP because by the time the appointment arrives they are either cured, or in hospital. (Considered in these circumstances something like the 1854 cholera epidemic in London could come to a GP’s attention only when he was advised by a central authority.)

Whilst the difficulties GP's receptionist face in making appointments are not to be underestimated, and at times may be particularly difficult, those difficulties used to be the exception rather than the rule. Today it appears they have been made into a rule, to the detriment of the health and wellbeing of society generally, apparently as a result of an age old but irregular difficulty being given an answer which could be used generically to stop a problem initially developing.

It may be that the modern call centre staffed by medically trained people who are subject to the medical codes of confidentiality will be seen as an answer to this, but that does not yet remove the dilemmas faced by GP's receptionists at the surgeries and certainly will not stop those initially minor problems in the community which can be the root to so many health problems in society.


The point again coming out of this to me is a reiteration of the fact that providing a definitive answer which allows a difficulty to be dispensed with by alleviating the need for thought or consideration within that area presents more difficulties than it solves.


Ian W

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