What counts as confidential info, GMC principles on appropriate/inappropriate breach situations

Question 1

Give 4 examples of confidential info?

Answer 1

Medical records

Audio/visual recordings

Patient details

Fact that they are your patient

Question 2

If a clinician uses a patient case as an example, why could that be confidential info?

Answer 2

Details of patient’s specific diagnosis and treatment could make them identifiable to third-parties

Question 3

Give 4 examples of where professional duty of confidentiality arises from?

Answer 3

Regulatory bodies eg. General Medical Council

Common law

Statute (act of parliament)

Employment contract

Question 4

What is a statute?

Answer 4

Act of parliament

Question 5

Why do GMC principles state that patient confidentiality is essential for the clinician-patient relationship?

Answer 5

Maintains trust in clinician-patient relationship

Question 6

Give 2 reasons why trust in the clinician-patient relationship is important?

Answer 6

Patients are willing to seek medical attention

Patient give doctors relevant info to provide good care

Question 7

Why does GMC state that appropriate info sharing is important?

Answer 7

Efficient provision of safety and care of individual patients and the wider community

Question 8

Do GMC principles state that a clinician must always obtain patient consent to disclose confidential info?

Answer 8

Need patient consent, unless law allows/requires clinician to disclose info regardless of obtained consent

Question 9

In situations where confidential info is inappropriately disclosed, is confidentiality still maintained?

Answer 9

No, there is breached confidentiality

Question 10

How could an email containing confidential info cause a confidentiality breach?

Answer 10

Email is sent to wrong person who has similar address to correct patient

Question 11

Give 2 examples of how confidential info could be lost or stolen in a hospital, causing a confidentiality breach?

Answer 11

Unencrypted memory stick

Ward handover notes

Question 12

How could a confidentiality breach occur in public?

Answer 12

Casual conversation, notes containing identifiable info are left in public area

Question 13

How could a confidentiality breach occur online?

Answer 13

Peer groups on social media, clinicians post identifiable info

Question 14

How could patient enquiries lead to a confidentiality breach?

Answer 14

Their identity isn’t verified by security checks, so person might be mistaken as correct patient or given info without patient consent to share

Question 15

If there is serious/persistent failure to follow GMC confidentiality principles, what are the 3 consequences for the doctor?

Answer 15

Risk of losing registration

Dismissal

Criminal prosecution

Question 16

What 2 consequences does the employer face after a confidentiality breach?

Answer 16

Bad publicity

Financial penalty with civil claim

Question 17

What GMC document provides advice for social media use by clinicians?

Answer 17

Doctors’ Use of Social Media (2013)

Question 18

What GMC document provides guidance on maintaining child confidentiality?

Answer 18

0-18 ethics guide summary

Question 19

If the child is aged 16-17, are the competent to consent to medical treatment?

Answer 19

They are presumably competent to give consent

Question 20

Is a 16-17 yrs old child entitled to the same duty of confidentiality as an adult?

Answer 20

Yes

Question 21

Where has the guidance for confidentiality of a 16 or under child come from?

Answer 21

Sexual heath and contraception cases

Question 22

What does the guidance for children 16 or under confidentiality state?

Answer 22

They still are entitled to a duty of confidentiality

Question 23

What assessment is done to evaluate if a child aged 16 or under can give consent for medical treatment?

Answer 23

Gillick competence assessment

Question 24

What 3 qualities must a child aged 16 or under have to give consent for their treatment, according to Gillick competence assessment?

Answer 24

Enough intelligence, understanding, competence

Question 25

If a child aged 16 or under is Gillick competent, how do their rights compare to parental rights?

Answer 25

Child's right to confidentiality and confidential care is more important than any parental rights

Question 26

If a child aged 16 or under is not Gillick competent, do they still have right to confidentiality?

Answer 26

Child is primarily owed confidentiality but they can't give informed consent, so individual with parental responsibility is involved in decisions regarding child's care

Question 27

If a child aged 16 or under is not Gillick competent, who is involved in decisions about the child's medical treatment?

Answer 27

Child Individual with parental responsibility for child

Question 28

If an adult lacks capacity, are they still owed duty of confidentiality?

Answer 28

Yes

Question 29

If an adult lacks capacity, who else is involved in their decision-making, and 3 things what do they contribute?

Answer 29

Individuals involved in the patient's care contribute their own values, beliefs, wishes

Question 30

If an adult lacks capacity, what is the purpose of discussing and disclosing their confidential info?

Answer 30

Must be in the patient's best interests

Question 31

Do deceased patients still have consent?

Answer 31

Yes

Question 32

If a living patient asks to keep their info confidential after their death, must this be obeyed?

Answer 32

Yes, disclosing info after death would still be a breach of confidentiality

Question 33

Give 2 examples of when confidential info of a deceased patient can be disclosed?

Answer 33

Requested by law To assist coroner

Question 34

What are the 4 circumstances in which confidential info can be disclosed?

Answer 34

Patient's best interests Public interest Statute or judge-ordered Implied/express consent

Question 35

When patient consent is obtained to disclose confidential info, what 3 factors must the patient agree with?

Answer 35

What info is being disclosed Why the info is disclosed Consequences of disclosure

Question 36

If patients give implied consent to disclose confidential info, who does this entail?

Answer 36

Family and other healthcare members

Question 37

If a patient wishes to not disclose their confidential info to other healthcare members, what is the clinician's response?

Answer 37

Patient wish must be respected

Question 38

In the patient's best interests, give 2 examples of when confidentiality is breached?

Answer 38

Emergency situation Patient lacks capacity to consent

Question 39

When confidentiality is breached in the patient's best interests, what is this act called?

Answer 39

Act of necessity

Question 40

Give 4 examples of situations in which statute requires obligatory disclosure of confidential info?

Answer 40

Road traffic collisions Notifiable disease Human fertility Cancer registries

Question 41

When the GMC investigates a doctor's fitness to practise, must their confidential info be disclosed?

Answer 41

Yes

Question 42

In a NHS counter fraud investigation, why is there full disclosure of confidential info?

Answer 42

To identify fraud risks as accurately as possible

Question 43

Give 3 examples of situations in which a judge can order disclosure of confidential info in a court of law?

Answer 43

Criminal proceedings Child protection proceedings Coroners' court: examining violent and unnatural deaths

Question 44

If a court witness is judge-ordered to disclose confidential info, will they face consequences for this breach?

Answer 44

No, this breach is privileged as the judge has requested it

Question 45

In a trial, who determines the extent of confidential info that is disclosed?

Answer 45

Judge

Question 46

In what type of circumstance can healthcare professionals disclose confidential info for public interest?

Answer 46

Exceptional circumstances

Question 47

If there was a serious crime, why must healthcare professionals disclose confidential info?

Answer 47

Prevent crime and support crime investigation and detection

Question 48

If healthcare professionals knew that a person was abusive, must they disclose confidential info of that person in public interest?

Answer 48

Yes, to prevent serious harm or abuse to others

Question 49

If healthcare professionals have judged that achieved public good outweighs duty of confidentiality in an exceptional circumstance, what do they do?

Answer 49

Disclose the relevant confidential info in public interest

Question 50

When confidential info is disclosed in public interest, how much info should be disclosed?

Answer 50

Relevant info to case details only

Question 51

When decisions to disclose confidential info are made in public interest, are all the decisions equally important?

Answer 51

Yes, all decisions choosing disclosure must have their own merits

Question 52

Why must healthcare professionals record any decisions made to disclose confidential info in public interest?

Answer 52

To show the exceptional circumstances under which decisions were made

Question 53

Even if confidential info is disclosed in public interest, should consent still be gained?

Answer 53

Ideally yes

Question 54

Give 2 situations in which public interest disclosure can be shared with police?

Answer 54

Serious harm to individuals Serious harm to national security/public order

Question 55

According to the Police and Criminal Evidence Act 1984, can police request disclosed confidential info for any case?

Answer 55

No, it must be a serious arrestable offence

Question 56

According to the Police and Criminal Evidence Act 1984, what warrant is needed to obtain confidential info?

Answer 56

Special procedure warrant

Question 57

According to the Police and Criminal Evidence Act 1984, who can order to disclose confidential info of a victim or suspect?

Answer 57

Circuit judge