We review our ethical guidance approximately every five years to make sure it is clear, helpful and relevant for doctors. Here, our policy officer for Standards, Alison Whiting, updates you on changes to our Confidentiality guidance.  

Since late 2014 we’ve collected your views on our Confidentiality guidance for doctors. We’ve also sought your feedback on seven explanatory statements. These explain how the core ethical principles apply in specific situations doctors may encounter in practice and sometimes find hard to deal with, for example, reporting gunshot and knife wounds or reporting concerns to the DVLA or DVA.

What you need to know:

  • Over 1,200 doctors, organisations and patients told us what they thought about our current guidance on confidentiality.
  • People asked us to make the guidance clearer on sharing information, and make it easier to read, refer to and follow.
  • Keeping the core principles, we restructured the guidance based on feedback from across the UK.
  • The updated guidance came into effect on 25 April 2017.

Where did we start?

First, my team and I gathered information to help us find out which situations doctors and patients find challenging.

Doctors often contact us with queries about confidentiality-related matters. So, we started by looking at the content of these enquiries. We also analysed which confidentiality issues most commonly arise in fitness to practise cases.

We then ran surveys to collect feedback from doctors, patients and their representatives. Through these, we asked about the content, format and structure of the existing guidance.

We also held two events for patients (in partnership with Disability in Action in Belfast and Age UK in London) where we explored their views on how and why their personal medical information might be disclosed.

Alongside this, we met with organisations that have a particular interest in confidentiality, including the BMA, the Chair of the UK Caldicott Guardians and medical defence bodies.

What did doctors and patients tell us?

Doctors and patients told us that the principles set out in the existing Confidentiality guidance were still sound. But they did suggest that the revised guidance should:

  • be easier to for doctors to read, refer to and follow
  • place a stronger emphasis on the importance of sharing information for direct care
  • distinguish more clearly between direct care and other uses of patient data
  • provide more advice on decisions about sharing information with patients’ friends and relatives
  • more clearly address the considerations that apply to disclosures about adults at risk of harm
  • make the legal framework for disclosure more explicit, especially on data protection responsibilities.

How did this feedback help us?

We used the feedback to decide how we could revise the Confidentiality guidance and explanatory statements. One of the most significant changes we made was to restructure the guidance.

The purpose of this change was to make the guidance easier to navigate and apply in practice. So, we split it into three sections dealing with disclosures:

  1. to support the direct care of an individual patient
  2. for the protection of patients and others
  3. for all other purposes (including healthcare service planning, the administration of justice and financial audit).

Once we had a revised draft of the guidance, we ran a formal public consultation for twelve weeks from 25 November 2015 to 19 February 2016. Just over 190 organisations, doctors, other healthcare professionals and members of the public responded.

During this period, my team, our Regional Liaison Service and our devolved office staff also met face to face with over 1,000 individuals in all four UK countries.

What else did we change in the guidance?

The core principles of our guidance on confidentiality haven’t changed. But, we have taken the opportunity to make the parts of the guidance identified by doctors and patients more clear.

Doctors work in multi-disciplinary teams, so we have emphasised the importance of sharing information for direct care.

We’ve also outlined the circumstances in which doctors can rely on implied consent to share patient information for direct care.

We’ve made the public protection responsibilities of doctors clearer, including when to make disclosures in the public interest.

And, we’ve underlined the significant role those close to a patient can play in providing support and care – and the importance of acknowledging that role.

We know doctors face new ethical dilemmas every day. We hope our updated guidance will help you tackle issues about confidentiality with a renewed confidence.

Our revised guidance on confidentiality came into effect on 25 April 2017.

If you have any feedback on the updated document, please leave us a comment below or email standards@gmc-uk.org.