THE IMPORTANCE OF CONFIDENTIALITY
The relationship between dentist and patient is based on the understanding that any information revealed by the patient to the dentist will not be divulged without the patient’s consent. Patients have the right to privacy and it is vital that they give the dentist full information on their state of health to ensure that treatment is carried out safely. The intensely personal nature of health information means that many patients would be reluctant to provide the dentist with information if they were not sure that it would not be passed on. If confidentiality is breached, we face investigation by the General Dental Council and may also face legal action by the patient for damages and, for dentists, prosecution for breach of the 1998 Data Protection Act.
GENERAL DENTAL COUNCIL
All staff must follow the General Dental Council’s rules for maintaining patient confidentiality.
WHAT CONSTITUTES INFORMATION?
In our context personal information held by the practice about a patient includes:
The patient’s name, current and previous addresses, bank account/credit card details, telephone number/e-mail address and other means of personal identification such as his or her physical description
Information that the individual is or has been a patient of the practice or attended, cancelled or failed to attend an appointment on a certain day
Information concerning the patient’s physical, mental or oral health or condition
Information about the treatment that is planned, is being or has been provided
Information about family members and personal circumstances supplied by the patient or others
The amount that was paid for treatment, the amount owing or the fact that the patient is a debtor to the practice.
PRINCIPLES OF CONFIDENTIALITY
Personal information about a patient is confidential in respect of that patient and to those providing the patient with health care. Should only be disclosed to those who would be unable to provide effective care and treatment without that information (the need-to-know concept) and such information should not be disclosed to third parties without the consent of the patient except in certain specific circumstances described in this policy.
DISCLOSURES TO THIRD PARTIES
There are certain restricted circumstances in which a dentist may decide to disclose information to a third party or may be required to disclose by law. Responsibility for disclosure rests with the patient’s dentist and under no circumstances can any other member of staff make a decision to disclose.
A brief summary of the circumstances is given below.
When disclosure is in the public interest
There are certain circumstances where the wider public interest outweighs the rights of the patient to confidentiality. This might include cases where disclosure would prevent a serious future risk to the public or assist in the prevention or prosecution of serious crime.
When disclosure can be made
There are circumstances when personal information can be disclosed:
Where expressly the patient has given consent to the disclosure
Where disclosure is necessary for the purpose of enabling someone else to provide health care to the patient and the patient has consented to this sharing of information
Where disclosure is required by statute or is ordered by a court of law
Where disclosure is necessary for a dentist to pursue a bona-fide legal claim against a patient, when disclosure to a solicitor, court or debt-collecting agency may be necessary.
Disclosure of information necessary in order to provide care and for the functioning of the NHS
Information may need to be disclosed to third party organizations to ensure the provision of care and the proper functioning of the NHS.
Referral of the patient to another dentist or health care provider such as a hospital.
DATA PROTECTION CODE OF PRACTICE
The Practice’s Data Protection Code of Practice outlines the required procedures to ensure that we comply with the 1998 Data Protection Act. It is a condition of engagement that everyone at the practice complies with this Code of Practice.
ACCESS TO RECORDS
Patients have the right of access to their health records held on paper or on computer. A request from a patient to see records or for a copy must be referred to the patient’s dentist. The patient should be given the opportunity of coming into the practice to discuss the records and will then be given a photocopy. Care should be taken to ensure that the individual seeking access is the patient in question and where necessary the practice will seek information from the patient to confirm identity. The copy of the record must be supplied within forty days of payment of the fee and receipt of identifying information if this is requested.
Access may be obtained by making a request in writing. We will provide a copy of the record within 40 days of the request and fee (where payable) and an explanation of your record should you require it.
The fact that patients have the right of access to their records makes it essential that information is properly recorded. Written records must be
Contemporaneous
Accurate and comprehensive
Signed by the dentist
Neat, legible and written in ink
Strictly necessary for the purpose
Not derogatory
Be such that disclosure to the patient would be unproblematic.
PRACTICAL RULES
Records must be kept secure and in a location where it is not possible for other patients or individuals to read them Identifiable information about patients should not be discussed with anyone outside of the practice including relatives or friends. A school should not be given information about whether a child attended for an appointment on a particular day. It should be suggested that the child is asked to obtain the dentist’s signature on his or her appointment card to signify attendance Demonstrations of the practice’s administrative/computer systems should not involve actual patient information When talking to a patient on the telephone or in person in a public area care should be taken that sensitive information is not overheard by other patients. Do not provide information about a patient’s appointment record to a patient’s employer. Messages about a patient’s care should not be left with third parties or left on answering machines. A message to call the practice is all that can be left. Disclosure of appointment books, record cards or other information should not be made to police officers or Inland Revenue officials unless upon the instructions of the dentist Patients should not be able to see information contained on computer screens. Discussions about patients should not take place in the practice’s public areas. All conversations being conducted within hearing of any patient should be strictly professional matters, never discussing a patient by name. Similarly, if any mistake, misunderstanding or confusion has arisen, every effort must be made to prevent other patients being aware of the problem by dealing with it quietly and unobtrusively, rather than drawing attention to the problem by discussing it openly. Whenever possible, such a conversation with a patient should be in a private part of the Practice where you will not be overheard. Conversations on non-professional matters should be reserved for the staff room. Patients are attending us as professionals and we must respect this at all times.
DISCIPLINARY ACTION
If, after investigation, a member of staff is found to have breached patient confidentiality or this policy, he or she shall be liable to summary dismissal in accordance with the practice’s disciplinary policy.
QUICK POINTS
All conversations being conducted within hearing of any patient should be on strictly professional matters, never discussing a patient by name. Similarly, if any mistake, misunderstanding or confusion has arisen, every effort must be made to prevent other patients being aware of the problem by dealing with it quietly and unobtrusively, rather than drawing attention to the problem by discussing it openly. Whenever possible, such a conversation with a patient should be in a private part of the Practice where you will not be overheard.
Patients are attending us as professionals and we must respect this at all times.
All matters relating to a patient’s treatment are held in medical confidence and therefore must never be discussed outside the Practice or with other patients.
Every effort must be made to hide a patient’s notes from prying eyes; strangers should not be allowed in the filing room or behind the reception desk.
Matters relating to any patient must never be discussed within earshot of another patient. Violation of this confidence may result in dismissal without notice.
Compliance with this policy is a condition of employment of all staff.
At this practice the need for the strict confidentiality of personal information about patients is taken very seriously. This document sets out our policy for maintaining confidentiality and all members of the practice team must comply with these safeguards as part of their contract of employment/contract for services with the practice.
