The Department of Health and Social Care has published an updated consensus statement for health professionals on information sharing when a person is at risk of suicide.
While not changing healthcare professionals’ current legal duties, the guidance aims to ‘promote greater sharing of information within the context of the relevant law’.
Produced in collaboration with a range of organisations including the RCGP, it also outlines the current legal position with regards to UK General Data Protection Regulations (GDPR).
The Zero Suicide Alliance has published an accompanying document to help clinicians put the guidance into practice providing examples of when it may or may not be appropriate to share information and wording to use when having discussions with patients.
In 2018, the NHS Resolution (NHSR) Learning from Suicide Related Claims report identified failure to share information as a recurrent theme in deaths by suicide, the Alliance points out and concerns remain that practitioners may not feel equipped or trained.
The DHSC updated guidance says ‘there are clearly times in dealing with a person at risk of suicide when practitioners will need to consider informing the family and friends about aspects of risk and may need to create a channel of communication for both giving and receiving information that will help keep the person safe’.
It stresses that data protection law does not prevent sharing personal data in an emergency situation, including to protect a person from serious harm, or to prevent the loss of human life and that in some situations ‘it might be more harmful not to share data than to share it’.
And says it is up to the practitioner to make a judgement about whether the benefits to an individual or society in disclosing information without consent outweigh both the individual’s and the public interest in keeping it confidential.
‘Determining where to draw the line is a matter for professional judgement in each individual case’, it advises.
Under UK GDPR there are allowances for disclosure of information that is of substantial public interest on a case-by-case basis but any information shared must be kept to a minimum and limited to only what’s necessary.
The consensus statement also notes: ‘It is also clear that the duty of confidentiality is not a justification for not listening to the views of family members and friends, who may offer insight into the individual’s state of mind or predisposing conditions which can aid care and treatment.’
Gaining consent should always be the first step in such discussions and it is vital to carefully document all such conversations, the statement says.
And it outlines the importance of appropriate information sharing between agencies.
The supporting document from the Zero Suicide Alliance gives the example of someone being discharged from an A&E department or secondary care facility and their GP not being informed or advised how best to manage risk.
‘Transitions between and within organisations are known to create or increase suicide risk if not managed effectively,’ the Alliance says.
‘The efficient, timely and comprehensive communication of risk within and between agencies is essential.’
DHSC guidance stresses that practitioners consider discussing cases with colleagues or seek advice from legal teams, a professional association or regulatory body if they are unsure whether information should be shared, ‘rather than simply withholding it’.
READERS' COMMENTS [3]
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How tickbox and burecratic. Has the UK ever asked itself this honest question: how often is it written “no suicidal ideation” or “no safeguarding concern”, merely to avoid litigation, burecracy, vilification, consequence and scapegoating? Go on, call it out. The NHS is a cunning jackal and jester in disguise at all levels, full of slogans like equality, transparency, duty of candour and care which it dismisses within its own hierarchical demeanor. It hasn’t learnt a thing and should look deeply into the mirror at its double standards. Professionals do not forget Dr Bawa-Garba’s case, nor their treatments from the pandemic.
I have written to the Zero Suicide Alliance: ‘May I please ask: What is your position with regard to the need to increase awareness of antidepressant (and other prescription drug induced) akathisia, disinhibition and emotional blunting; and its widely published association with suicide’? Response awaited.
I have not yet received a response from the Zero Suicide Alliance (ZSA). The following secondary question therefore awaits submission:
If a patient becomes suicidal on an antidepressant, does the ZSA recommend that the family be told that the treatment is suspected to be the problem?