Confidentiality: Short scenarios

These short scenarios highlight and explore some of the principles covered in Confidentiality and its explanatory guidance. We hope that they will help doctors and others to understand how the principles in the guidance apply in practice. They are intended to illustrate the principles in the guidance, and are not a substitute for the guidance, or for specific advice from experienced colleagues, a Caldicott Guardian or equivalent, or a professional or regulatory body.

  • A colleague’s fitness to practise: Dr Okonkwo is a GP whose patient is a physician with an alcohol problem. Should Dr Okonkwo raise a concern about her patient's fitness to practise?
  • Releasing records after death: Dr Kaur receives a letter from solicitors acting for a deceased patient's widower, asking for copies her medical records. Should she disclose?
  • Reporting crime: Dr O'Hara is a doctor in a drug addiction clinic. Her mobile phone is stolen and she has good reason to believe it was one of six patients. Should she report the theft to the police?
  • Concerns about a sex offender: Dr Hosta is treating a sex offender who is about to be released from prison. She thinks might not register with the police. Should Dr Hosta report her concerns?
  • Disclosing information for financial audit purposes: Dr Mitra is a consultant surgeon in a private hospital. He has been asked to provide patient records to an insurer. Should he do so?
  • Sharing information with a patient’s relatives: A 19 year old man is unconscious in ITU. His mother doesn’t want his father (her ex-husband) told anything about his care. Should Dr Wachuku agree to this?
  • Disclosing information for financial purposes: Dr Greenfield wants to write off some private fees as bad debt. Should she disclose to HMRC information that could identify the patients concerned?
  • Local clinical audit: Dr Khalid wants to employ a nurse to carry out a clinical audit of diabetes patients at his GP practice. Can he rely on patients’ implied consent for this use of their records?
  • Research: Dr Kadiri is planning a research project. Can he use identifiable patient information?
  • Sharing information with the direct care team: Dr Kelly is a GP. A new patient at the practice doesn’t want administrative staff to have access to his records. What should Dr Kelly tell him?