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Practice dilemma: Text message complaint

One of your patients complains after a text message to remind her about an appointment was read by her teenage son. What should you do? Our legal expert gives advice.

Confidentiality is central to the doctor patient relationship. The Data Protection Act 1998 outlines that personal data should not be processed without the knowledge and consent of the relevant individual. The GMC guidance, ‘Confidentiality' (2009) expands on the ethical duties of doctors to inform patients about how their data will be used.

You should get a patient's consent to communicate by text. This gives you an opportunity to check they have the correct mobile number and to explain what types of information will be communicated and what security arrangements are in place.

The time and date of each message sent, as well as the content and any reply received, should also be carefully documented in the patient's medical record.

The practice should apologise to the patient for any upset that had been caused by this inadvertent breach of her confidentiality and for not getting her permission to communicate by text message.

Ideally, the complaint should resolved verbally within 24 hours, so a formal written complaints response is not required (NHS and Social Care Complaint Procedures, 2009).

You may also decide to hold a significant event meeting to discuss this incident further and adopt an ‘opt in' approach to your text messaging service, rather than relying on patient's implied consent.

Dr Emma Cuzner is a medico-legal adviser at the Medical Defence Union

Dr Emma Cuzner MDU