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.
