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Q&As: Patients' records

Confidential information

Q. Our Practitioner and Patient Services Agency (PPSA) has asked us to return to the sender any hospital letters and other correspondence sent in error when the patient has never, or is no longer, registered with the practice. We normally send any information on to the new GP if we know who the patient is registered with. Is there any point in returning the letters to the originator, who clearly will not have this information?

A. You should always return such correspondence promptly to the originator who will be able to check the correct contact details with the PPSA through the National Strategic Tracing Service. This is a database of current contact details for all GP registered patients. If every GP co-operates in this way it is much less likely that vital information will fail to reach its correct destination.

There is more danger that confidential information will be lost or go astray if the practice redirects mail incorrectly to the intended recipient, which could constitute a breach of patient confidentiality. It would also fail to alert the originator that it is necessary to correct the patient's contact details, which could have serious implications.

The power

of attorney

Q. If an Enduring Power of attorney (EPA) has not been lodged with the Court of Protection, is the EPA valid? One of our patients, who is currently mentally competent, has completed an EPA form in favour of her husband and two children. However, the EPA has not been lodged with the Court of Protection. One of her sons has now asked for a copy of all of her medical records based upon his Power of Attorney. Is this permitted?

A. EPAs relate to the management of a patient's financial affairs and not to their medical care. The patient may be unable to manage her financial affairs, even though she is legally not mentally incapacitated, and the EPA can be used to manage these on her behalf. The bank must comply with the patient's particular stipulations, for example that more than one attorney must be involved or that an accountant or solicitor must oversee the financial management of the patient's affairs.

Once the patient has become mentally incompetent to manage their affairs, the EPA must be registered with the Court of Protection. If your patient is becoming incapacitated then the attorney should apply to register the EPA sooner rather than later.

The Court of Protection becomes involved only at this stage. Until the EPA is registered the attorney should normally consult with your patient regarding management of their financial affairs.

An EPA may be terminated by the patient at any time, provided the patient remains mentally competent to do this.

In relation to medical records, if the patient is still mentally competent then good practice as well as legal and ethical requirements dictate that you seek her consent to the disclosure of any of her confidential medical records to a third party.

In view of your patient's current mental state I believe that you are correct in checking with her that she consents to your disclosure of her medical records to her son.

Wessex LMCs

Neither Pulse nor Wessex LMCs can accept any legal liability in respect of the answers given – you should seek independent legal advice before acting on the information concerned

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