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Practice dilemma: Is patient consent on insurance request valid?

You receive a PMA report request from an insurance company relating to a patient who has a history of depression and recently attempted suicide. You notice the insurance company provided a recent signed form of authority and, in accordance with the Access to Medical Reports Act (1988) [1], the patient has indicated they do not wish to see the report before it is submitted. You are unsure as to whether or not the patient appreciates that you are under an obligation to disclose this information. Should you contact your patient about it before submitting the report?

You receive a PMA report request from an insurance company relating to a patient who has a history of depression and recently attempted suicide. You notice the insurance company provided a recent signed form of authority and, in accordance with the Access to Medical Reports Act (1988) [1], the patient has indicated they do not wish to see the report before it is submitted. You are unsure as to whether or not the patient appreciates that you are under an obligation to disclose this information. Should you contact your patient about it before submitting the report?

The new GMC guidance on confidentiality [2] says that when providing information in this context, there is an obligation to ‘be satisfied that the patient has sufficient information about the scope, purpose and likely consequences of the disclosure and the fact that information cannot be concealed or withheld' (paragraph 34[a]).

As you are unsure as to whether or not the patient's consent is valid you should contact the patient in order to clarify the position. This will allow the patient to confirm that they were aware that this information would have to be disclosed, but also gives them the option, should they wish, to see the report before it is submitted. You should make a careful note of the conversation and your actions in the patient's records.

If the patient does change their mind and wishes to see the report, you should complete the report in draft form and send a copy to them. Once the patient confirms that they are happy with the contents of the report, you should again document this in the records, and arrange for the report to be sent to the insurance company.

Dr Richard Stacey is a medicolegal adviser at the Medical Protection Society

Insurance files

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