I think we have discussed release of patient notes at Police request here before. Some years ago BAEM reached an agreement with ACPO on which notes may be released to the Police without patient consent and laid down strict criteria, which were essentially that a serious arrestable crime (eg murder, attempted murder) had been committed. The definition was swept away in the most recent PACES legislation, but I thought the offences still were the same.
The matter came up at our routine Police liaison meeting today, and to say that things have changed a bit is somewhat litotic. I welcome correction, but as I understand it, the Police now have only to apply to the local Security Management Service of the Trust while investigating any crime, and providing it is not a fishing trip the notes can be released - without as far as I could ascertain any reference to medical staff. It suggests that our notes, once made are no longer our property to guard, which contradicts the GMC guidance on notes:
20. You must not disclose personal information to a third party such as a solicitor2, police officer or officer of a court without the patient’s express consent, except in the circumstances described in the paragraphs which follow.
Disclosures in the public interest
22. Personal information may be disclosed in the public interest, without the patient’s consent, and in exceptional cases where patients have withheld consent, where the benefits to an individual or to society of the disclosure outweigh the public and the patient’s interest in keeping the information confidential. In all cases where you consider disclosing information without consent from the patient, you must weigh the possible harm (both to the patient, and the overall trust between doctors and patients) against the benefits which are likely to arise from the release of information.
23. Before considering whether a disclosure of personal information ‘in the public interest’ would be justified, you must be satisfied that identifiable data are necessary for the purpose, or that it is not practicable to anonymise the data. In such cases you should still try to seek patients’ consent, unless it is not practicable to do so, for example because:
* the patients are not competent to give consent (see paragraphs 28 and 29); or
* the records are of such age and/or number that reasonable efforts to trace patients are unlikely to be successful; or
* the patient has been, or may be violent; or obtaining consent would undermine the purpose of the disclosure (eg disclosures in relation to crime); or
* action must be taken quickly (for example in the detection or control of outbreaks of some communicable diseases) and there is insufficient time to contact patients.
24. In cases where there is a serious risk to the patient or others, disclosures may be justified even where patients have been asked to agree to a disclosure, but have withheld consent (for further advice see paragraph 27).
25. You should inform patients that a disclosure will be made, wherever it is practicable to do so. You must document in the patient’s record any steps you have taken to seek or obtain consent and your reasons for disclosing information without consent.
26. Ultimately, the ‘public interest’ can be determined only by the courts; but the GMC may also require you to justify your actions if a complaint is made about the disclosure of identifiable information without a patient’s consent. The potential benefits and harms of disclosures made without consent are also considered by the Patient Information Advisory Group in considering applications for Regulations under the Health and Social Care Act 2001. Disclosures of data covered by a Regulation4 are not in breach of the common law duty of confidentiality.
Am I missing something here, or are doctors and the GMC's safeguards being bypassed?
Best Wishes,
Rowley.